Most U.S. health insurers last year would have satisfied the much-disputed spending rules under President Barack Obama’s healthcare reform, according to a report by a congressional watchdog agency.
The rules require insurers such as Aetna and UnitedHealth to spend most of customers’ premium payments on medical care, not administrative costs or profit, or risk paying patients a rebate. The Patient Protection and Affordable Care Act (PPACA) established minimum “medical loss ratio” (MLR) standards for insurers. Beginning in 2011, PPACA required insurers to meet minimum standards of 85 percent in the large group market and 80 percent in the small group and individual markets or pay rebates to their enrollees.
A number of states have sought waivers to get leeway in how fast the rules go into effect. The rest of the insurance community continues to grumble about the rules, which they have said could force companies to desert some small-group and other niche markets.
Topics Carriers
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