Moody's: Health Rate Reviews a Worry

January 06, 2011 at 07:00 PM
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The possibility that federal regulators could politicize reviews of health insurance rate increase notices could be a financial risk factor for insurers this year, according to analysts at Moody's Investors Service.

The analysts at Moody's, New York, say they will continue to have a negative outlook on the U.S. health insurance sector this year, even though results were better than expected in 2010.

The analysts are predicting that regulatory, political, and economic threats will to lead to lower earnings and low membership growth for health insurers.

Implementation of the Affordable Care Act, the federal health care package that includes the Patient Protection and Affordable Care Act (PPACA), may force health insurers to eliminate some products and leave some markets, and to find ways to generate revenue streams that will not be affected by act requirements, the analysts say.

Republicans in Congress are trying to block implementation of the act, but, if the act takes effect as the Obama administration expects, one provision will give the U.S. Department of Health and Human Services (HHS) responsibility for identifying health insurance rate increase requests that officials believe to be "unreasonable."

HHS officials say they may review any requests for individual or small group rate increases of 10% or higher for indications that the requests are unreasonable.

HHS Secretary Kathleen Sebelius says that HHS will keep track of insurers with a record of unreasonable rate increases, and that regulators may exclude those insurers from the health insurance exchange distribution system that is supposed to start up in 2014.

"Our concern is that the review and approval process for healthcare insurers may become more politically driven, resulting in an over burdensome process that could result in rates being delayed, denied, or approved at lower/ insufficient levels, thus hurting profitability," Moody analysts say.

- Ashley Scudder

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