With the 2016 presidential election looming, federal regulators face a tricky political situation as they prepare to review four states’ exchange plan rate requests--some of which are steep.

As their rate review programs have been deemed "effective," state insurance commissioners review insurers’ rate requests for Affordable Care Act marketplace plans in 46 states, according to the New York Times. Insurers will notify consumers of rate increases in the weeks leading up to Election Day on Nov. 8 and the Obama administration is under added pressure to keep premium increases in check.

One of the states where federal regulators have jurisdiction is Texas, where Blue Cross and Blue Shield has requested a rate hike of nearly 60 percent to account for mounting losses in the individual market. In Missouri, Humana has filed for a 34 percent increase, and in Oklahoma, Blue Cross and Blue Shield has proposed increases that average 49 percent.

In the final state in which the federal government has rate review authority, Wyoming, the requested premium increases for marketplace plans are less than 10 percent. But the article notes that the state already has some of the highest rates in the country.

Federal health officials have pointed out that the rates requested by insurers are often not reflective of what consumers pay, as regulators negotiate them down and subsidies help many consumers pay their premiums. Yet not all consumers receive subsidies, and even for those who do, “the subsidy doesn’t change the actual cost,” Rep. Mike Kelly, (R-Pa.), tells the Times, pointing out that the taxpayer ends up picking up the tab.

- read the Times article