Editorials

Missouri is ‘unique’ in failing to protect consumers from health insurance rate hikes

Missouri’s hands-off stance on health insurance costs consumers.
Missouri’s hands-off stance on health insurance costs consumers. The Fresno Bee

Officials in most states are busy protecting consumers by reviewing and, if necessary, resisting 2016 rate increases requested by health insurance companies.

But not Missouri.

It’s one of five states whose insurance departments have no authority to review the cost of policies in their markets. Missouri is the only state where insurers don’t even have to disclose rates to regulators.

“Missouri is unique,” said Jay Angoff, a lawyer for the Consumers Council of Missouri and a former state insurance director. “Insurers don’t have to file their rates, and there is no law prohibiting excessive rates.”

Ironically, given the Missouri General Assembly’s hostility toward Washington, the state has yielded its watchdog role to the federal government.

Thanks to pressure from the Consumers Council and other groups, the U.S. Department of Health and Human Services has agreed to review the rates that Missouri insurers plan to charge next year in the federal HealthCare.gov marketplace. If reviewers find proposed increases unreasonable, both HHS and the insurers will post that information on their websites.

That arrangement will aid the cause of transparency, but it falls far short of adequate protection.

Some other states give insurance officials authority to reject burdensome increases. Others, including Kansas, empower regulators to negotiate with companies.

Proposals for rate review in recent years have gone nowhere in Missouri’s GOP-controlled General Assembly. The explanation is predictable: The insurance lobby is powerful, and the ethically challenged legislature will always cave to a powerful interest group.

Despite healthy earnings, many insurers are planning substantial rate increases in 2016, contending that newly insured customers are costing more than expected. Coventry Health Care, a unit of Aetna, is planning increases averaging 19 percent in Missouri, according to the Consumers Council.

It’s not surprising that people who postponed medical care for lack of a way to pay for it would rack up expenses once insured. But there are indications costs for insurers may drop next year.

State insurance officials are in the best position to evaluate the reasonableness of rate requests. The Missouri legislature’s refusal to allow them to do their jobs shows a deplorable lack of concern for consumers and a stable insurance market.

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