Health Insurance Companies Try to Shape Rules

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http://www.nytimes.com/2010/05/16/health/policy/16health.html?hp

Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law.

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Lobbyists are focusing on two provisions whose stated purpose is to ensure that consumers “get value for their dollars.”

One provision bars insurers from carrying out an “unreasonable premium increase” unless they first submit justifications to federal and state officials. Congress did not say what is unreasonable, leaving that task to rule-writers.

Another provision, effective Jan. 1, requires that a minimum percentage of premium dollars be spent on true medical costs related to patient care — not retained by insurers as profits or used to cover administrative expenses. Insurers must refund money to consumers if they do not meet the standards, known as minimum loss ratios.

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