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CA Insurance Commissioner Heightens Scrutiny of Rate Hikes

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California's new Insurance Commissioner Dave Jones (D) is preparing to combat major rate hikes that have characterized the state's individual health insurance marketplace in recent years, the Wall Street Journal reports. Jones already has started putting pressure on several health insurance companies that recently announced rate increases for individual policies.

Recent Rate Hikes

On Jan. 6, Jones asked Blue Shield of California to delay a planned series of rate hikes that could total as high as 59% for individual policyholders. This week, the commissioner asked Aetna, Anthem Blue Cross and PacifiCare to postpone their planned rate increases so he could review the filings.

Jones said, "We have a long history in California of 10%, 20%, 30%, 40% rate hikes. This is just business as usual."

Major Issue in California

Rate increases in the individual health insurance market have been a major issue in California because the state has the largest number of individual policyholders. About two million Californians purchased individual health insurance policies in 2009, according to the Kaiser Family Foundation. Marian Mulkey -- director of health reform at the California HealthCare Foundation -- said premiums have been rising across California because the state's economic downturn has prompted many healthy residents to cancel their coverage, leaving insurers with a higher proportion of sick people in their coverage pools.

Authority Over Rate Hikes

California regulations require health plans to submit their rates to the insurance commissioner, who can review them to ensure they are in compliance with state law. The state does not allow the commissioner to reject premium increases. During his time in the state Assembly, Jones authored legislation that would have authorized the commissioner to reject rate hikes, but the measure failed to pass. Jones has said he intends to support similar legislation this year.

Meanwhile, the federal health reform law is expected to increase oversight of rate increases nationwide. Starting in July, the federal government will have the authority to review premium hikes exceeding 10% in states that do not have sufficient rate review procedures in place. Although federal officials will not be able to reject the premium increases, insurers will be required to justify their rates.

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