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Rate Review: Holding Health Plans Accountable for Your Premium Dollars

By Cheryl Fish-Parcham,


When health insurance companies want to raise premiums, states use a process called “rate review” to decide whether proposed increases are justified. Many states have limited authority to prevent unreasonable premium increases, leaving consumers unprotected from unfair prices. Health reform will strengthen rate review and protect consumers.

Explore these key lessons from state rate review procedures:

  • States need the authority to approve rate hikes before they go into effect.
  • States need clear standards for determining whether rates are reasonable.
  • The public needs to know how insurance companies come up with new rates.
  • The public needs a strong voice in rate review.
  • States need resources to carry out meaningful rate review.