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Will Tennessee Health Insurance Rate Hikes Be Blocked?
State regulators are getting money to fight unreasonable Tennessee health insurance premium hikes
. The U.S. Department of Health and Human Services (HHS) announced an Affordable Care Act grant in the amount of $3,979,002 to help the state in this battle. HHS Secretary Kathleen Sebelius released a report called Rate Review Works to show how previous grants have already mitigated health insurance premium hikes. When rate hikes are publicizing, the bad publicity has had an effect.While Sebelius says, "States continue to have the primary responsibility for reviewing insurance rates and these grants give them more resources to hold insurance companies accountable, the grants are just the most recent federal action to increase access to health insurance for Tennessee. Almost $250 million in grant money have been distributed to different states to facilitate health insurance rate reviews.
Tennessee Health Insurance Changes Follow Health Care Reform
As of September 1, 2011, health care reform requires Tennessee health insurance companies that plan to increase individual and small group health insurance premiums by more that 10 percent to submit a request. If the rate increase is deemed to be unreasonable, the insurance company will need to publicly justify it. Federal authorities hope that this will improve health insurance accountability and lead to significantly lower costs for individuals, families and small business owners who buy coverage through the individual marketplace.
This May, Governor Haslam signed a bill into a law that expands the TN Department of Insurance's scope of review and gave the Department an approval authority regarding proposed rate increases on individual and small group policies. Currently, the department is working on regulations regarding its new approval authority.
As of July 1, 2011, all individual and small group Tennessee health insurance rates needed to be filed in advance for this approval from the commissioner. The department is exploring how to incorporate the Tennessee's All Payer Claims Database in order to enhance the rate review process.
Tennessee Health Insurance Has Not Yet Met All Of The Affordable Care Act Provisions
The state is one of four granted a temporary one-year waiver to slowly transition from policies available prior to health care reform to those that meet new national standards for increased coverage. The waiver was deemed necessary to prevent some Tennesseans from losing their existing coverage, even if it was below national standards.
Certain fast food restaurant chains implied they would end insuring workers completely if required to offer more substantial health insurance for Tennessee. These companies, along with Tennessee health insurance companies, are still required to meet federal standards after the waivers expire.
While marginal health insurance coverage is better than none at all, some of the policies available in Tennessee have been criticized as leaving policyholders exposed to major medical costs that could ultimately force bankruptcy. One of the most critical elements of any health insurance policy is the maximum out-of-pocket annual limit. That's a fancy way of saying the total amount of medical costs that you could be responsible for paying in a single year.
Since policies contain co-payments, co-insurance and sometimes multiply deductibles, confirm what you'd end up spending in a worst-case scenario. Why don't Tennessee health insurance companies just say what they will pay and what you'll have to pay? Perhaps someday the pressure to increase transparency will make that possible. For now, there are online resources that can help you decipher what insurance terms mean in terms of how much you'll actually be paying for health care with a particular policy.
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