Why is your health insurance so expensive?

In some cases, it's because your insurer was simply allowed to increase premiums unchecked.

But not anymore. Under health care reform's "rate review" provision, all proposed rate increases of 10 percent or more must be gone over by independent experts. If the planned price hikes don't stand up to scrutiny, states can negotiate them down or, where authorized, deny them outright. The law also makes it easy for you to track how your health insurer's rate proposals have stood up to the test.

Since the crackdown on rising premiums began last September, Connecticut reduced a proposed Anthem Blue Cross Blue Shield increase from 12.9 percent to 3.9 percent, New Mexico trimmed a Presbyterian Healthcare rate hike from 9.7 percent to 4.7 percent, and New York held three companies' average proposed increases of 12.7 percent to 8.2 percent.

Cutting down price hikes that are deemed unreasonable is just one facet of the federal rate review initiative. Under the Affordable Care Act, or ACA, health insurance companies in every state now must publicly justify any proposed rate increase at or above the 10 percent threshold, in postings on the federal Healthcare.gov rate review website. Think of it as a report card for your health insurance company.

You can log on to the site and search by state or health insurer to see if and why your premiums may be jumping at least 10 percent, and read the findings by state or federal examiners on whether a requested increase passed muster. To date, more than 185 rate increases affecting 1.3 million policyholders have been posted to the site.

Later this year, the "medical loss ratios" of health insurers also will be posted, giving you a closer look at whether your insurer is meeting the health care law's requirement that at least 80 percent of your premium be spent directly on medical care. If that's not the case, the insurance company will now owe you a rebate for the difference.

"The whole point of the Affordable Care Act is to create this very open, transparent marketplace so that consumer choice can guide toward better outcomes," says Brian Chiglinsky, spokesman for the federal Centers for Medicare & Medicaid Services. "We're trying to prompt consumers to say, 'Should I be buying this policy?'"

Kansas Insurance Commissioner Sandy Praeger, who chairs the Health Insurance and Managed Care Committee of the National Association of Insurance Commissioners, says health care reform's rate review program will help states stand up to insurance companies.

"Some states have had what's called 'prior approval authority' to review and modify health insurance rate increases for years, some have prior authority over the individual market but not the small group market, and some have no rate review at all," she says.

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No gouging! Reform curbs health care hikes