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As health care law rolls out, its effects will depend on your state

By By Noam N. Levey

Tribune Washington Bureau (MCT)

Published: Tuesday, Sept. 10 2013 12:12 p.m. MDT

“We’re just trying to do what’s best for our consumers,” said Praeger, a former head of the National Association of Insurance Commissioners. “If state regulators are not going to do anything, then consumers will be the ones who suffer.”

Consumers won’t get the extra help in Alabama, Oklahoma, Texas or Wyoming, where insurance commissioners will not review health plans being offered on the new marketplaces to ensure they provide consumers with the required benefits and protections.

“The federal government will decide which health insurance plans will be certified and offered in Alabama,” said Mark Fowler, a spokesman for that state’s insurance department. “Likewise, the federal government will address consumer complaints.”

In Missouri, state workers are explicitly forbidden from providing any assistance to the new health insurance marketplace under a 2012 initiative passed by voters.

And in Florida, the Legislature and governor stripped the insurance commissioner’s authority to block rate hikes for two years. Since the new health law does not give the federal government this power, that effectively allows insurance companies to raise some premiums as much as they choose in 2014 and 2015, the first two years that Obama’s health care law will be fully in effect.

State Sen. David Simmons, a Republican who championed the legislation, said state leaders felt they did not have the resources to review insurance premiums. “It seemed reasonable to defer to the federal government,” he said. “They are the ones who said they would be able to do it all.”

The health law made $250 million in federal grants available to states to help them bolster their ability to review proposed rate increases. Florida was one of three states that returned their grant money.

In contrast, several states backing the health law, including Colorado, Maryland, New Mexico and New York, have passed legislation in response to the federal law to give their regulators more authority to review health insurance.

Insurance regulators in states implementing the law have moved aggressively to scrutinize proposed premium increases by insurance carriers, leading in many cases to lower premiums.

Insurers selling plans next year in Portland, Ore., for example, were forced by state regulators to reduce their rates by nearly 10 percent on average. Three of the 12 insurance companies in that market had to lower their rates more than 20 percent compared with what they requested.

In addition to potentially paying more, consumers in states resisting the law will also get less help shopping for insurance.

Maryland, which is enthusiastically implementing the law, just opened a call center to help consumers with questions. It is also hiring more than 300 people to educate residents and help them enroll in health coverage.

California, which has received nearly $1 billion from the federal government to set up its insurance marketplace and hopes to enroll 5 million residents, is opening three customer service centers that will employ 1,200 people.

Even some small communities are taking steps to assist residents. In far northern Minnesota, another state that has moved aggressively to implement the law, largely rural St. Louis County has hired a dozen new workers to help an estimated 11,000 uninsured residents enroll.

Obama administration officials say new federal call centers will provide assistance to consumers in states that are not implementing the law. But they acknowledge the job will be difficult, especially in states with large numbers of uninsured residents, such as Texas, where more than 6 million people lack coverage.

In contrast to St. Louis County, Minn., the state of Texas cut employees who could have educated residents about the new law, according to the state Department of Insurance.

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©2013 Tribune Co.

Visit Tribune Co. at www.latimes.com

Distributed by MCT Information Services

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