State Insurance Reforms Tackle Price Transparency, Rising Costs, and the Uninsured

September was a busy time for state insurance regulators as they worked to finalize rate filings and prepare for the upcoming health insurance open enrollment season. While initial filings indicate nominal increases to individual market premiums for the 2020 plan year, insurance costs are escalating for individuals and families who receive coverage through their employers.  

Beyond monitoring rates, state regulators continue to take action to ensure that all consumers across their markets have access to affordable, high-value coverage. Below are a few notable updates from states:

California enacts bills to address cost transparency. During the last month of its legislative session, California enacted two new laws that require insurers to provide enhanced reporting on health costs and quality.

  • AB 731 (Health Care Coverage: Rate Review) requires insurers, including large group health plans, to submit data to the state on medical use trends by geographic region and enhances requirements for plans to report data on spending compared to Medicare rates. The law will go into effect by July of 2021.
  • AB 929 (California Health Benefit Exchange: Data Collection) mandates that insurers provide data to the health insurance marketplace so that it can evaluate progress toward lowering costs, improving quality, and reducing disparities in the state. The law also requires that the marketplace make data on costs, quality, and health disparities public.

Connecticut seeks to “redefine the health care dynamic” through state employee plans. The state comptroller recently issued a request for proposals for insurers to administer state health benefits. The request for proposal carves out a role for the state to act as an active participant in negotiations between insurers and providers on reimbursement rates, including access to full details about negotiated payments. 

Nevada releases detailed report on its uninsured. Reports estimate that nearly 400,000 Nevadans are currently uninsured. Among the uninsured, nearly 22 percent are young adults, 60 percent are Latino, and 63 percent are employed. Nevada’s recently implemented state-based marketplace will use this detailed data to target outreach efforts for the upcoming open enrollment period. 

The National Academy for State Health Policy will continue to track and report on these and other insurance initiatives as they unfold in the coming months.