A report from the Robert Wood Johnson Foundation, compiled as part of its Affordable Care Act (ACA) Implementation—Monitoring and Tracking Series, examines the status of rate review in 10 featured states. Implemented in August 2010, rate review is intended to constrain unjustified premium increases through a comprehensive review process that helps ensure that insurers’ insurance rates are based on accurate, verifiable data and realistic projections. The report finds that although there was significant variation, all 10 states have taken action to improve their rate review process and ensure that insurers’ proposed rates are justified.

Prepared by researchers at Georgetown University Health Policy Institute’s Center on Health Insurance Reforms, the report summarizes how the 10 states have enhanced their rate review authority and processes, increased transparency, and expanded consumer outreach in response to the ACA. The report finds that six states have an effective rate review process for all markets, while three had a partially effective rate review process. Regardless of their authority to review rates, all 10 states applied for and received rate review grants and reported improvements to the quality of the rate review process as a result. The authors conclude that the majority of states appear to review the ACA’s rate review provisions as a welcome opportunity to hold insurers more accountable for rates, educate the public about the factors underlying rate increases, and make the rate review process more transparent and inclusive for consumers.

This report is one of a series papers focusing on ACA implementation issues uncovered in Alabama, Colorado, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island and Virginia.