The ACA [new federal health law] does not alter states’ existing regulatory authority over health insurance rates. Such state authority varies dramatically, ranging from states with no authority at all to those that have robust authority to review and approve or disapprove rates before they are implemented. The authors of this issue brief conducted a survey of 50 state rate review statutes, and then did follow up interviews with insurance regulators in a subset of ten states to gain a deeper understanding of how rate regulation works in practice.