Insurance Market Reform

Florida Request for an Adjustment of the Medical Loss Ratio Standard

In a letter to Maine’s Superintendent of Insurance, Mila Kofman, HHS outlined the terms of the MLR waiver and HHS’s reasons for approving the state’s request.

The ACA requires that carriers covering large employers spend at least 85 percent of premiums paid on claims or quality improvements, and carriers covering small group and individual insurers spend 80 percent, or refund the difference to policyholders, beginning in 2012.

On March 8, Maine became the first state to be granted a waiver from the medical loss ratio (MLR) requirement of the Affordable Care Act (ACA). 

Louisiana Insurance Commissioner Jim Donelon requested a two-year MLR waiver, dropping the spending requirements to 70 percent in 2011, 75 percent in 2012 and then hitting the federal 80 percent target in 2013.

Department of Health and Human Services (HHS) announced that it made new resources available to states, members of the media, consumer groups, providers, and others to increase awareness of the pre-existing condition insurance plans (PCIPs), the temporary high-risk pools implemented to provide comprehensive health coverage to people who have been unable to obtain coverage because of a pre-existing condition.

This issue brief examines how the essential benefits provision in the Affordable Care Act will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need.

A guide written by Consumers Union to answer key questions about insurance rate hikes.

This Health Affairs article lays out the issues changes in eligibility may have on individuals whose incomes flucuate throughout the year.

The report outlines both the potential benefits of BHP and possible pitfalls—it is a must-read for states considering a BHP.