[Congressional Record Volume 159, Number 32 (Wednesday, March 6, 2013)]
[Senate]
[Pages S1234-S1235]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. FEINSTEIN (for herself, Mrs. Boxer, Mr. Lautenberg, Mr. 
        Sanders, and Mr. Tester):
  S. 482. A bill to amend the Public Health Service Act to provide 
protections for consumers against excessive, unjustified, or unfairly 
discriminatory increases in premium rates; to the Committee on Health, 
Education, Labor, and Pensions.
  Mrs. FEINSTEIN. Mr. President, we have made great strides in 
improving the accountability of health insurance companies and 
protecting consumers from egregious practices. However, despite the 
progress we have made, many States still lack the ability to regulate 
excessive health insurance rate increases.
  Health insurance premiums in the individual and small group market 
continue to grow beyond the rate of medical inflation. The Affordable 
Care Act has brought greater scrutiny to the market and we've seen some 
great progress. In fact, the number of requested increases in health 
insurance premiums beyond 10 percent comprised 75 percent of rate 
filings in 2010, and that has declined to 34 percent in 2012. This is a 
large step forward but without closing the remaining loophole not all 
consumers will be able to benefit from protection from unreasonable 
rate increases. Health insurance companies will continue to do what 
they have done for far too long: put their profits ahead of people. 
Rapidly escalating insurance costs strain businesses, families, and 
individuals.
  Currently, 15 States still have little or no authority to block or 
modify unreasonable rate increases in the individual and small group 
markets. This means that even when the state's insurance regulators 
find a rate increase to be excessive, they do not have the ability to 
block or modify the increase. The Health Insurance Rate Review Act 
creates a Federal fallback for States currently lacking this authority. 
This will create parity across the country and give greater consistency 
of review and accountability for insurance companies seeking to raise 
rates beyond what is reasonable.
  This legislation is a simple, commonsense solution: for States where 
the insurance commissioner does not have or use authority to block 
unreasonable rate increases, the Secretary of Health and Human Services 
can do so.
  Affordability is vital to insuring access to quality health care. A 
2010 survey by the Commonwealth Fund found

[[Page S1235]]

that 70 percent of people with a health problem found it difficult or 
impossible to find affordable coverage on the individual market. This 
problem goes beyond the increased cost of overall medical care. From 
the year 2000 to 2010, average premiums for family coverage increased 
by 117 percent, compared to medical inflation which rose close to 49 
percent.
  Insurance premiums make up a higher percentage of household income 
than ever before, increasing around three times faster than wages are. 
This means that more and more families have to choose between health 
care and daily living expenses, saving for retirement, and education. 
This is unacceptable, and more must be done to protect consumers.
  The Affordable Care Act made important steps forward in defining the 
rate review process and making rate increases and reviews public 
information. This has improved transparency but falls short of creating 
a strong rate review system in all States, and relies too heavily on 
the notion that public disclosure of rates will cause insurance 
companies to change their behavior every time they should.
  I believe there needs to be a Federal fallback in states that lack 
the legal authority, capacity, or resources to conduct strong rate 
review.
  In some States, like California, companies are not required to go 
through prior approval before rate increases go into effect. This means 
that when the California Insurance Commissioner finds rate increases to 
be unreasonable and excessive, he has no authority to actually stop or 
modify the increases to consumers. California is facing double digit 
rate hikes again this year and this legislation would help prevent such 
excessive increases.
  Earlier this year the California Insurance Commissioner found a rate 
increase by Anthem Blue Cross to be unreasonable and the company 
decided to proceed anyway. This affected around 250,000 small business 
policy holders who saw an increase of around 10.6 percent, and when 
combined with previous increases the average rate hike over two years 
reaches 19.5 percent.
  In 2012, proposed rate increases across nine States by the John Alden 
Life Insurance Company and Time Insurance Company were found to be 
unreasonable but went forward anyway. These increases varied from a 12 
percent increase in Louisiana to a 24 percent increase in Wisconsin. 
These increases in the individual and small group market also affected 
Arizona, Idaho, Missouri, Montana, Nebraska, Virginia, and Wyoming.
  In some States, insurance commissioners already have this authority 
and are using it to protect consumers. This bill doesn't touch what 
they are doing.
  In New York, because state regulators have the authority to modify 
rates, the average individual market increase for 2013 is four and a 
half percent instead of the initial request of a nine and a half 
percent increase.
  In 2011, the Connecticut Insurance Department found an increase of 
nearly 13 percent by Anthem Blue Cross and Blue Shield to be excessive, 
and approved a four percent increase instead.
  Also in 2011, some North Dakota consumers on the individual health 
insurance market were facing a nearly 30 percent increase before state 
regulators stepped in and decreased the proposed hikes by almost half.
  I strongly believe that we need to take action to strengthen the law 
so all consumers get the protection of effective health insurance rate 
review. I appreciate working with Representative Schakowsky, who is 
sponsoring the House companion bill.
  I urge my colleagues to join me in supporting the Health Insurance 
Rate Review Act to stand up for American families struggling to pay for 
health coverage. I look forward to working with my colleagues on this 
important issue.
                                 ______