On 1 September things got a
lot tougher for US health insurers aiming to implement double-digit
increases in premiums charged to individuals and small

Under a new regulation
required by the Affordable Care Act, health insurers seeking to
increase their rates by 10% or more must now submit a request to
state or federal reviewers who will determine whether the request
is reasonable or not.

“For far too long, families
and small employers have been at the mercy of insurance rate
increases that often put coverage out of their reach,” said
Secretary of Health and Human Services Kathleen Sebelius. “Rate
review will shed a bright light on the industry’s behaviour and
drive market competition to lower costs. We are pleased to team
with states to bring this important new protection to consumers and

According to the Department
of Health and Human Services, which is a US federal agency, states
still have the primary responsibility for reviewing insurance
rates. The agency noted that because many states lack the resources
needed to perform strong rate reviews, the Affordable Care Act
provides for $250m in health insurance premium review grants to
states over five years. To date, rate review grants totalling $48m
have been paid.