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Health Law and Policy

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Selected Works

2016

Affordable Care Act

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Full-Text Articles in Law

Health Insurance Rate Review, John Aloysius Cogan Jr. Dec 2015

Health Insurance Rate Review, John Aloysius Cogan Jr.

John Aloysius Cogan Jr.

The Affordable Care Act’s health insurance rate review process has been touted by government officials and consumer advocates as an effective tool to control rising health insurance premiums. This Article argues that the current rate review process is limited in its ability to lower health insurance costs as it does not address the primary driver of rising premiums — the excessive prices paid by health insurers to healthcare providers. The efficacy of the Act’s rate review process is further diminished by two additional factors: (1) a retrospective medical loss ratio requirement that pressures insurers to lower administrative costs prior to …