Published October 2nd, 2014 at 1:58 PM
A Missouri consumers group has sued the Department of Health and Human Services over its alleged failure to disclose health insurance rates filed with the state.
The lawsuit, filed Tuesday in federal court in St. Louis by the Consumers Council of Missouri, comes just six weeks before the enrollment period for coverage under the Affordable Care Act begins on Nov. 15.
An HHS regulation requires the Centers for Medicare & Medicaid Services, an arm of HHS, to set up a procedure to enable the public to comment on proposed health insurance rates.
The lawsuit, however, alleges that HHS ignored a request for the rates sent by the council as well as dozens of other state consumer organizations and eight consumer representatives of the National Association of Insurance Commissioners.
Missouri is one of the few states whose insurance departments have no authority to review health insurance rates for the individual market. Some states require health plans to justify rate increases; others require rate filings but may or may not exercise their authority to push rates down.
In Kansas, rate filings are required but the state so far has not been willing to identify the insurers for 2015 or their rates. KCUR filed a request for the information in June but was told by the insurance department that a request had been made that they be kept confidential.
The Affordable Care Act, also known as Obamacare, authorizes HHS to review proposed rate increases of 10 percent or more if HHS decides that a state does not have an effective rate review process. As of April, it was responsible for rate reviews in the individual markets of Missouri, Alabama, Oklahoma, Texas and Wyoming.
The idea behind the authorization is to allow the public to submit comments on proposed rate increases. The council’s lawsuit, however, says that HHS declined its requests under the Freedom of Information Act for the rate filing information.
“One of the purposes of the Affordable Care Act is to ensure that all rates are reviewed and all rate filings – that is, the justification for rates that insurers submit to the insurance department or to HHS if the state insurance department isn’t regulating rates – that those justifications be public,” Jay Angoff, a former Missouri insurance commissioner and the attorney representing the Consumers Council of Missouri, said in a conference call.
“And the reason it’s so important for those justifications to be public is that the ACA… and the (regulation) that HHS has put out contemplates the public will be able to comment on rate justifications and, if necessary, take issue with them.”
Asked if the department had a response to the lawsuit, Ben Wakana, an HHS spokesman, said in an email, “We are readying the rate change information. The department is committed to providing consumers accurate information so they can make informed decisions, and therefore, before the beginning of Open Enrollment, the agency will publish final insurance rates for all 50 states.”
Angoff said that because the Missouri insurance department has no power to approve or disapprove rates – insurers don’t even have to file rates with the department — the federal government under the ACA has the authority to disclose that information.
“HHS has not made any of this public,” he said. “It hasn’t made the justifications for the rates public, it hasn’t made the rates themselves public and it hasn’t even made the identities of the carriers who are going to be selling in 2015 public. And that violates the Affordable Care Act, the statute itself.”
Joan Bray, the executive director of Consumers Council of Missouri, said that HHS had not been cooperative “in helping Missourians get the information that we believe we need before open enrollment comes on Nov. 15.”
“It goes against all our sensibilities that other citizens of the United States, other residents who qualify for health care can know this in other states, but Missourians can’t,” she said in the conference call. “So it’s really important that we become full citizens under the health care law and get the same information.”
Dan Margolies is health editor of Heartland Health Monitor, a reporting collaboration among KCUR Public Radio, KCPT Public Television, KHI News Service and Kansas Public Radio. He is based at KCUR.