Consumers Council Sues to Make Public Health Insurance Rate Information

St. Louis Post-Dispatch, October 2, 2014

A Missouri consumer advocacy group is suing the federal government in an attempt to force the public disclosure of health insurance rate information ahead of the upcoming enrollment period.

The Consumers Council of Missouri said it filed the lawsuit late Tuesday in U.S. District Court in St. Louis after its Freedom of Information Act request for the rate filings was denied by the U.S. Department of Health and Human Services. The council said it is looking for information about pricing and insurers’ reasons for raising or lowering rates.

“It seems to be the only way we are going to have a chance to get this information,” said Joan Bray, the council’s executive director and a former Democratic Missouri state senator.

The consumer group says the Affordable Care Act requires federal officials to make rate information public so consumers have the chance to challenge the price of health insurance before online shopping begins on Nov. 15.

For many states, that role can be performed by state insurance regulators who have the ability to review an insurer’s proposed prices for health plans.

But Missouri’s insurance department has no such authority, leaving the federal government as the only entity — other than the insurers themselves — with access to rate information before the plans are sold.

The Centers for Medicare and Medicaid Services, the division of the Health and Human Services Department (HHS) that runs the online marketplace, has yet to release any information about proposed rates or the identity of the insurers who have applied to sell on the Missouri marketplace.

A spokesman, asked about the Missouri lawsuit, told the Post-Dispatch that it plans to release the information but did not say how soon.

“We are readying the rate change information. The department is committed to providing consumers accurate information so they can make informed decisions, and therefore, before the beginning of open enrollment, the agency will publish final insurance rates for all 50 states,” HHS spokesman Ben Wakana said in a statement late Wednesday.

Jay Angoff, the attorney filing the lawsuit on behalf of the consumer group and a former Missouri insurance commissioner, said it could be some time before a judge considers the case. With open enrollment starting in about six weeks, there may not be enough time for a court ruling before people begin signing up for plans, he acknowledged.

But Angoff said he hoped the lawsuit would send a message that federal officials should be more transparent about rate information.

Tim McBride, a health policy professor at Washington University, said he thinks it would be better to have more rate information available but that insurance shoppers will have enough time to carefully consider their options during the four-month enrollment period.

“People need to know a lot of information to make decisions as to why rates are going up or down and the rationale behind it,” he said.

McBride added that federal officials and insurers could be keeping pricing information quiet for competitive reasons.

The lawsuit underscores the increasing importance of rate review as more and more Americans sign up for health insurance coverage using HealthCare.gov, the online marketplace.

Because Missouri is one of the few states that doesn’t review health insurance rates, many customers will learn about pricing and benefit options on Nov. 15 when the next enrollment begins.

Many won’t know which companies will be offering plans in their areas.

The two insurers who sold plans last year — Anthem Blue Cross Blue Shield of Missouri and Coventry Healthcare — are expected to continue offering coverage, and two additional companies have publicly announced they plan to join the fold this year.

But there is no way to tell if other companies are preparing to offer plans or if an insurer will be offering coverage in all parts of the state.

Bray said the lack of information puts Missourians at a disadvantage compared to residents of other states where insurance information is available before the start of enrollment.

“I don’t believe Missourians should be second-class citizens under the Affordable Care Act,” she said.

Andrea Routh, the executive director of the Missouri Health Advocacy Alliance, called the lawsuit good news for Missouri consumers.

“Part of the premise around the Affordable Care Act is we are going to empower consumers to make good purchasing decisions,” she said. “To do that they have got to be able to see the rate and have somebody asking questions about them.”