At a time when health-insurance premiums continue their steady rise, Pennsylvania legislators will likely pass twin bills in the Senate and House that will broaden the state Insurance Department's ability to review rate increases.
That sounds as if it should be good news to health advocates such as Antoinette Kraus and Sharon Ward, who have been tracking the legislation in Harrisburg. The bills are set to come to a vote Wednesday.
But it's not good news, Kraus and Ward say.
"If this law passes, fewer rate reviews will be scrutinized," said Ward, director of the Pennsylvania Budget and Policy Center in Harrisburg. "And, consumers, individuals, and small businesses will be likely to see higher rates because of it."
Meanwhile, state insurers back the bills.
"These bills create the 'effective rate-review process' in Pennsylvania that is envisioned by the federal reform law, and we support the legislation," said Elizabeth Williams, a spokeswoman for Independence Blue Cross, the area's largest health insurer.
The dispute is an outgrowth of the federal Affordable Care Act passed in 2010.
That law authorized the federal government to determine which states did not have "effective" review regulations.
Pennsylvania and six other states were found lacking. Pennsylvania's procedures were considered ineffective because they did not require for-profit insurers, such as Aetna Inc., to submit premium-increase requests for small groups to the Insurance Department for review.
Under current law, only nonprofit insurers, such as Independence Blue Cross, have to submit proposed increases to the state. Small groups cover two to 50 people.
Under the new law, all insurers will need to submit their small-group rate increases for review, but only proposed increases over 10 percent must be approved before they are enacted.
Also under the new law, increases of less than 10 percent can be reviewed but don't have to be.
Kraus, director of the Pennsylvania Health Access Network, finds the situation ironic.
Requiring more companies to submit their rate proposals had been a longtime goal for her group.
Now that goal is being met, but the 10 percent threshold poses a problem for Kraus and her allies. "It actually takes a step back and loosens regulations that are currently in place," she said.
Like Kraus, Samuel Marshall also finds the situation ironic. President of the Insurance Federation of Pennsylvania, a trade group, he represents big insurers like Aetna.
Pennsylvania, he said, is taking measures to comply with the federal law - a law that its governor, Tom Corbett, is on record opposing.
Yet, he said, health advocates like Kraus and Ward want even stronger measures than the federal law mandates. "I think they should take that fight to Washington, not Harrisburg."