article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Health Insurance Rate Review Act''. SEC. 2. PROTECTION OF CONSUMERS FROM EXCESSIVE, UNJUSTIFIED, OR UNFAIRLY DISCRIMINATORY RATES. (a) Protection From Excessive, Unjustified, or Unfairly Discriminatory Rates.--The first section 2794 of the Public Health Service Act (42 U.S.C. 300gg-94), as added by section 1003 of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by adding at the end the following new subsection: ``(e) Protection From Excessive, Unjustified, or Unfairly Discriminatory Rates.-- ``(1) Authority of states.--Nothing in this section shall be construed to prohibit a State from imposing requirements (including requirements relating to rate review standards and procedures and information reporting) on health insurance issuers with respect to rates that are in addition to the requirements of this section and are more protective of consumers than such requirements. ``(2) Consultation in rate review process.--In carrying out this section, the Secretary shall consult with the National Association of Insurance Commissioners and consumer groups. ``(3) Determination of who conducts reviews for each state.--The Secretary shall determine, after the date of enactment of this section and periodically thereafter, the following: ``(A) In which States the State insurance commissioner or relevant State regulator shall undertake the corrective actions under paragraph (4), as a condition of the State receiving the grant in subsection (c), based on the Secretary's determination that the State is adequately prepared to undertake and is adequately undertaking such actions. ``(B) In which States the Secretary shall undertake the corrective actions under paragraph (4), in cooperation with the relevant State insurance commissioner or State regulator, based on the Secretary's determination that the State is not adequately prepared to undertake or is not adequately undertaking such actions. ``(4) Corrective action for excessive, unjustified, or unfairly discriminatory rates.--In accordance with the process established under this section, the Secretary or the relevant State insurance commissioner or State regulator shall take corrective actions to ensure that any excessive, unjustified, or unfairly discriminatory rates are corrected prior to implementation, or as soon as possible thereafter, including through mechanisms such as-- ``(A) denying rates; ``(B) modifying rates; or ``(C) requiring rebates to consumers.''. (b) Clarification of Regulatory Authority.--Such section is further amended-- (1) in subsection (a)-- (A) in the heading, by striking ``Premium'' and inserting ``Rate''; (B) in paragraph (1), by striking ``unreasonable increases in premiums'' and inserting ``potentially excessive, unjustified, or unfairly discriminatory rates, including premiums,''; and (C) in paragraph (2)-- (i) by striking ``an unreasonable premium increase'' and inserting ``a potentially excessive, unjustified, or unfairly discriminatory rate''; (ii) by striking ``the increase'' and inserting ``the rate''; and (iii) by striking ``such increases'' and inserting ``such rates''; (2) in subsection (b)-- (A) by striking ``premium increases'' each place it appears and inserting ``rates''; and (B) in paragraph (2)(B), by striking ``premium'' and inserting ``rate''; and (3) in subsection (c)(1)-- (A) in the heading, by striking ``Premium'' and inserting ``Rate''; (B) by inserting ``that satisfy the condition under subsection (e)(3)(A)'' after ``award grants to States''; and (C) in subparagraph (A), by striking ``premium increases'' and inserting ``rates''. (c) Conforming Amendment.--Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended-- (1) in section 2723 (42 U.S.C. 300gg-22), as redesignated by the Patient Protection and Affordable Care Act-- (A) in subsection (a)-- (i) in paragraph (1), by inserting ``and section 2794'' after ``this part''; and (ii) in paragraph (2), by inserting ``or section 2794'' after ``this part''; and (B) in subsection (b)-- (i) in paragraph (1), by inserting ``and section 2794'' after ``this part''; and (ii) in paragraph (2)-- (I) in subparagraph (A), by inserting ``or section 2794 that is'' after ``this part''; and (II) in subparagraph (C)(ii), by inserting ``or section 2794'' after ``this part''; and (2) in section 2761 (42 U.S.C. 300gg-61)-- (A) in subsection (a)-- (i) in paragraph (1), by inserting ``and section 2794'' after ``this part''; and (ii) in paragraph (2)-- (I) by inserting ``or section 2794'' after ``set forth in this part''; and (II) by inserting ``and section 2794'' after ``the requirements of this part''; and (B) in subsection (b)-- (i) by inserting ``and section 2794'' after ``this part''; and (ii) by inserting ``and section 2794'' after ``part A''. (d) Applicability to Grandfathered Plans.--Section 1251(a)(4)(A) of the Patient Protection and Affordable Care Act (Public Law 111-148), as added by section 2301 of the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), is amended by adding at the end the following: ``(v) Section 2794 (relating to reasonableness of rates with respect to health insurance coverage).''. (e) Effective Date.--The amendments made by this section shall take effect on the date of enactment of this Act.
summary: Health Insurance Rate Review Act - Amends the Public Health Service Act to declare that federal provisions requiring the Secretary of Health and Human Services (HHS) to review unreasonable premium increases in health care coverage shall not be construed to prohibit a state from imposing additional rate requirements on health insurance issuers that are more protective of consumers. Expands such review to include all rate increases, not only premium increases. Directs the Secretary or the relevant state insurance commissioner (or state regulator) to take corrective actions to ensure that any excessive, unjustified, or unfairly discriminatory rates are corrected prior to, or as soon as possible after, implementation, including through mechanisms such as denying rates, modifying rates, or requiring rebates to consumers. Requires the Secretary to determine whether the state insurance commissioner or regulator or the Secretary will undertake such corrective actions based on whether the state can adequately undertake such actions. Applies these provisions to grandfathered health plans under the Patient Protection and Affordable Care Act.