Illinois Sen. Laura Fine just became my new favorite out-of-state legislator.


I'd never heard of Illinois state Senator Laura Fine before now. I know absolutely nothing else about her besides her being a Democrat who represents IL Senate District 9.

What I do know (thanks to a heads up from my friend & colleague Louise Norris) is that Sen. Fine recently introduced IL SB1912 into the legislative process:

  • Amends the Department of Insurance Law.
  • Provides that the Department of Insurance shall establish the Office of the Healthcare Advocate.
  • Provides that the Office shall be administered by the Chief Health Care Advocate, who shall report to the Director of Insurance.
  • Amends the Illinois Insurance Code and the Health Maintenance Organization Act.
  • Provides that all individual and small group accident and health policies written subject to certain federal standards must file rates with the Department for approval.
  • Provides that unreasonable rate increases or inadequate rates shall be modified or disapproved.
  • Provides that when an insurer files a schedule or table of premium rates for individual or small group health benefit plans, the insurer shall post notice of the premium rate filings and a filing summary in plain language on the insurer's website.
  • Provides that the Department shall post all insurers' rate filings and summaries on the Department's website.
  • Provides that the Department shall open a 30-day public comment period on the date that a rate filing is posted on the website.
  • Provides that the Department shall hold a public hearing during the 30-day comment period.
  • Provides that the Director shall adopt affordability standards that must be considered in any decision to approve, disapprove, or modify rate filings.
  • Provides that after the close of the public comment period, the Department shall issue a decision to approve, disapprove, or modify a rate filing, and post the decision on the Department's website.
  • Provides that the Department shall adopt rules implementing specified procedures.
  • Defines "inadequate rate", "plain language", and "unreasonable rate increase".

All of this is totally reasonable and should have been required years ago...but it's the bullets highlighted in yellow which put a bounce in my step personally.

As I noted in my most recent annual rate change post for Illinois (which, sadly, is mirrored in far too many other states as well):

Unfortuantely, Illinois is another state which doesn't make it easy to analyze annual health insurance premium rate filings.

There's no details on their insurance department website, their SERFF listings don't seem to include the actuarial memos or URRT forms, and even the federal Rate Review listings only include the average requested rate changes; the actuarial memos there are mostly heavily redacted.

Every summer/fall a big part of my job has been to analyze the rate filings for the individual and small group health insurance markets for all 50 states + DC. Every summer/fall this rate analysis project is made extremely difficult for states which redact, bury or otherwise make it extremely difficult if not impossible to view the actual rate filings and the associated actuarial data needed to calculate the average premium changes and reasoning behind it.

Some states are extremely up front & transparent about it...but others are pretty awful, and Illinois (which conventional wisdom would make you think would be progressive on this sort of thing) has always been one of the worse states on this front.

The main specific data I really need is pretty basic:

  • The average premium rate change for each carriers individual & small group markets
  • The number of effectuated enrollees in each carriers individual & small group markets
  • The reasons, broken out as specifically as possible, for those changes

...none of which you'd think would be too big of a deal to make public...and yet it's virtually impossible to get the second & third bullets in some states (in fact, some don't even break out the first bullet by carrier, instead only giving an overall marketwide average, which isn't terribly helpful without the enrollment data to go with it).

I don't know whether Sen. Fine's bill will ever get a hearing, much less pass and be signed into law, but she deserves a huge shout-out from everyone interested in good government and healthcare data analysis. I hope it passes and that other states follow suit.