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Consumer advocates call NYS Insurance rate review process strong

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The New York Department of Financial Services will post the new coverage rates proposed by insurance companies and allow for public review starting next month.

Last year, the state allowed insurers an average increase of 5-point-7 percent. They had requested rates higher than 12 percent above the previous year.

Matt Anderson, spokesperson for the state department of Financial Services, says several factors go into the final increased health insurance companies are allowed, including consumer comment. And he says the factor that weighs heaviest is the cost billed by providers.

"Even though we’ve cut down health care costs pretty significantly after the implementation of the Affordable Care Act, there is still a lot of work to do, particularly on the provider side since a lot of times the insurers are simply passing on the costs they are billed by providers."

Consumer advocates consider New York’s prior approval process more transparent than in states where insurers file without an open review.

"We have a pretty protective regime in place to protect consumers which is not something that’s in place for every state," says Anderson.

In New York, companies must include their reasoning for increasing consumer cost of coverage. Meanwhile, in some states companies claim their pricing processes are trade secrets.

By law, final approved insurance rates must be available by the end of October. Last year, New Yorkers’ rates were released in September.

Michelle Faust, MA, is a reporter/ producer whose work focuses strongly on issues related to health and health policy. She joined the WXXI newsroom in February 2014, and in short time became the lead producer on the Understanding the Affordable Care Act series. Michelle is a reporter with the health collaborative Side Effects and regularly contributes to The Innovation Trail. Working across media, she also produces packages for WXXI-TV’s weekly news magazine Need to Know.
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