GAO Study on Waiver Applications

The GAO’s internal study found that applications with a projected premium increase of 10 percent or more tended to be approved while applications with a projected premium increase of 6 percent or less tended to be denied. Applications with a premium increase between 7 and 9 percent warranted additional staff reviews

Document Excerpt

¬†CCIIO granted waivers on the basis of an application’s projected significant increase in premiums or significant reduction in access to health care benefits. According to CCIIO officials, applications with a projected premium increase of 10 percent or more tended to be approved while applications with a projected premium increase of 6 percent or less tended to be denied. Applications with a premium increase between 7 and 9 percent warranted additional staff reviews to determine if the application met the agency’s criteria. In corroboration, among our 5 percent sample of approved applications, we found that CCIIO granted waivers mostly for applications that projected the annual limit restriction would result in a significant premium increase of more than 10 percent, in addition to a significant decrease in access to benefits. Conversely, most of the denied applications projected a premium increase of 6 percent or less. In reviewing a draft of this report, HHS provided technical comments, which we incorporated as appropriate.

Link http://www.gao.gov/products/GAO-11-725R

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