Bill provides for Missouri agency review of ACA rate hikes

ST. LOUIS -- Health insurance companies would no longer be able to raise rates for Affordable Care Act consumers in Missouri without review by a state agency under a measure awaiting the governor's signature.

Advocates say the change is long overdue. Missouri is the only state that does not receive or review health-insurance rates, said Yaryna Klimchak, spokeswoman for the state Department of Insurance, Financial Institutions and Professional Registration. Only the federal government reviews rate changes before they are implemented in Missouri.

State lawmakers this month approved Senate Bill 865, which includes a provision giving the state agency authority to review any proposed rate increase before it affects consumers who get individual health insurance through the ACA. The notification also would give consumers a chance to comment on the rate hike proposals.

The measure must still be signed into law by Democratic Gov. Jay Nixon.

The "Missouri Health Insurance Rate Transparency Act" would allow the state agency to determine if the rate increase is reasonable, and request a change if it is deemed unreasonable. The state agency wouldn't have the authority to reject the rate hike, but could make it public.

The bill's sponsor, Republican Sen. David Sater, said consumers will benefit by learning about proposed rate hikes before they occur. About 350,000 Missourians each year are eligible to obtain an individual health plan through the Affordable Care Act.

"Transparency is always good," Sater said.

Charles Gaba, founder of ACASignups.net, who has tracked Affordable Care Act enrollments since the exchanges launched in October 2013, said some states have laws giving them approval power over rate increases. While the Missouri measure stops short of that, "this is a lot better than nothing," Gaba said. "I think it's long overdue."

State-based ACA exchanges provide coverage to more than 12 million people nationwide, but several health insurers are considering significantly scaling back next year. Their bottom lines have been affected because of sicker-than-expected customers and the inability to attract enough younger, healthy people to the exchanges.

UnitedHealth Group Inc., the nation's biggest insurer, said last month it was cutting its participation in the exchanges down to only a handful of states in 2017. Missouri is among those being cut. Humana this month served notice it might leave some exchanges.

"Each year that has passed since the Affordable Care Act began we have lost plan offerings," said Rep. Justin Hill, a Republican from Lake St. Louis.

Many industry observers say they expect insurers to seek significant premium hikes in several markets. Final rates will come out later this year, and enrollment for 2017 coverage will begin Nov. 1.