Changes in Claims, Premiums, and Medical Loss Ratios Across and Within States' Individual Markets Between 2010 and 2014

This brief uses data submitted by insurers on medical loss ratios (MLRs) from 2010 to 2014 to assess how the Affordable Care Act’s (ACA’s) provisions impacted states’ individual health insurance markets. It compares average net MLRs by state and examines the distribution of net MLRs across insurers in each state. In the individual market, researchers found: average net MLRs rose because of rising net claims relative to net premiums, almost all states had average net MLRs higher than 80 percent by 2014, and average net MLRs varied from 83 percent at the 25th percentile to 99 percent at the 75th percentile.