O TETO DE REAJUSTE DE 15,5% PARA PLANOS DE SAÚDE EM 2022: IMPLICAÇÕES LEGAIS E IMPACTOS SOCIAIS DA ATUAÇÃO DA ANS

Abstract

This article investigates the decision of the National Supplementary Health Agency (ANS) to limit increase in individual and family health plans to a ceiling of 15,5% for the year 2022, highlighting the complexities of regulation of the supplementary health sector in Brazil. The study focuses on the the need to balance the interests of the market and the fundamental rights
of consumers, especially in a period exarcebated by the Covid-19 pandemic. The study highlights the relevance of qualitative data control and the importance of addressing abusive practices and the challenges arising from the asymmetry of information between the parties involved in the healthcare market. Critical analyses are made regarding the insufficiency of
ANS's increase ceiling and its potential adverse effects on the market, as well as the importance of an adequate data treatment in the sector. Furthermore, the paper examines the relationship between the Judiciary and the ANS, suggesting that, despite the possibility of questioning ANS decisions, a balance between the agency´s technical capacity and judicial
oversight is vital for ensuring an equitable and responsible supplementary healthcare market. It is concluded that deference to ANS´s technical decisions of the ANS, combined with careful judicial control, is fundamental to maintaining the integrity of the sector and protecting consumer rights.