The notion of a rate being reasonable or unreasonable strikes to the heart of a national debate about how health insurance should be priced. The same debate played out in Connecticut, pitting insurers against advocates who say the cost of health insurance is out of control.
Earlier this year, Connecticut Healthcare Advocate Kevin Lembo and Attorney General Richard Blumenthal introduced legislation, though it did not pass, that would have required health-insurance rate increases to be "reasonable" rather than "not excessive," as current statutes require.
Insurers and state Insurance Commissioner Thomas Sullivan, who approves rates for health plans, say that premiums reflect rising medical costs, such as doctor visits, hospital expenses, pharmaceuticals, medical machines and an overuse of medical services by patients or doctors or both.
So, how would the state go about studying rates? It would require access to proprietary information -- history of claims, actuarial assumptions -- that insurers give to the Connecticut Insurance Department.
It's too early to tell who would study the rate-review process, but the Obama administration has said it will have a say in the matter.