Our Health Policy Matters

Obamacare may already be making private health insurers more efficient, according to a year-over-year comparison of data related to the biggest consumer protection in the law. Last year, insurers had to rebate $1.1 billion to consumers because they failed to meet the minimum payout percentage required by the law .  That was the first year the payout provision, or mandatory minimum loss ratio, was in effect. This year, the federal government has announced that the rebate will be just half that – slightly more than $504 million. And the number of consumers who receive a rebate will also be smaller.  Last year, 12.7 million customers received rebates.  This year, the number receiving rebates has dropped by one-third, to 8.5 million. Why are fewer and smaller rebates a good thing? According to the Department of Health and Human Services, this is evidence that insurers are “ spending more of their premium dollars directly toward patient care and qualit...

Obamacare may already be making private health insurers more efficient, according to a year-over-year comparison of data related to the biggest consumer protection in the law. Last year, insurers had to rebate $1.1 billion to consumers because they failed to meet the minimum payout percentage required by the law .  That was the first year the payout provision, or mandatory minimum loss ratio, was in effect. This year, the federal government has announced that the rebate will be just half that – slightly more than $504 million. And the number of consumers who receive a rebate will also be smaller.  Last year, 12.7 million customers received rebates.  This year, the number receiving rebates has dropped by one-third, to 8.5 million. Why are fewer and smaller rebates a good thing? According to the Department of Health and Human Services, this is evidence that insurers are “ spending more of their premium dollars directly toward patient care and qualit...

If you run a small business in Florida, are self-employed in Texas, or work for a large corporation in New Jersey ( see an update below ), then your state insurance regulators probably haven't been working for you. The news that 15.8 million people can expect $1.3 billion in rebates from insurers this year because of the Affordable Care Act (ACA) underscores how weak health insurance regulation has been in states across the country.  It may come as no surprise that Florida and Texas, two leaders in the fight against ACA, have been exposed as anti-consumer.  But they are not the only states with an anti-consumer bias. First, the good news: last week, the federal government announced that three-quarters of us will get letters beginning on July 1 telling us that our insurance plans paid out at least 80 to 85 cents in benefits for every premium dollar they collected. This means that under ACA they met the minimum standard for a reasonable benefit payout (which i...

If you run a small business in Florida, are self-employed in Texas, or work for a large corporation in New Jersey ( see an update below ), then your state insurance regulators probably haven't been working for you. The news that 15.8 million people can expect $1.3 billion in rebates from insurers this year because of the Affordable Care Act (ACA) underscores how weak health insurance regulation has been in states across the country.  It may come as no surprise that Florida and Texas, two leaders in the fight against ACA, have been exposed as anti-consumer.  But they are not the only states with an anti-consumer bias. First, the good news: last week, the federal government announced that three-quarters of us will get letters beginning on July 1 telling us that our insurance plans paid out at least 80 to 85 cents in benefits for every premium dollar they collected. This means that under ACA they met the minimum standard for a reasonable benefit payout (which i...

Opponents of the Affordable Care Act (ACA) are now looking to the Supreme Court to overturn the 2010 law before time runs out on them. After ACA became law eighteen months ago, they were optimistic that they could beat back several of its key provisions.   These included the minimum medical loss ratios, the expansion of Medicaid, the health insurance exchanges, and the individual mandate. A brief review of the current status of each shows why the individual mandate is the last one standing.   But as the arguments for and against it have crystallized in the Courts, they show how the Supreme Court could open a Pandora’s Box best left closed.   Minimum loss ratios ACA mandates that all private insurance plans will have to pay at least 80 to 85 cents in benefits for every premium dollar collected, or rebate the difference to policy holders beginning in 2012.   Opponents argued that many existing plans would be forced out of the market because of high ad...

Opponents of the Affordable Care Act (ACA) are now looking to the Supreme Court to overturn the 2010 law before time runs out on them. After ACA became law eighteen months ago, they were optimistic that they could beat back several of its key provisions.   These included the minimum medical loss ratios, the expansion of Medicaid, the health insurance exchanges, and the individual mandate. A brief review of the current status of each shows why the individual mandate is the last one standing.   But as the arguments for and against it have crystallized in the Courts, they show how the Supreme Court could open a Pandora’s Box best left closed.   Minimum loss ratios ACA mandates that all private insurance plans will have to pay at least 80 to 85 cents in benefits for every premium dollar collected, or rebate the difference to policy holders beginning in 2012.   Opponents argued that many existing plans would be forced out of the market because of high ad...

Babies crawl before they walk.  c. Microsoft Office Image The Affordable Care Act (ACA) marks its first birthday this week.   It may not be off to a running start, but it isn’t exactly sitting still either.   The most debated provisions, like the individual mandate and the Medicaid expansions, are still three years in the future. In the first year, ACA’s biggest developmental milestones have affected older Americans, people with mental and physical disabilities, and consumers in general.   Which of these populations is making the most progress? Medicare recipients and early retirees have taken the most steps forward .     As of January 1 st , all Medicare Part B recipients are entitled to a free annual physical, with free cancer, cardiovascular, and skeletal screenings, and free flu shots.   150,000 beneficiaries had taken advantage of this through February 23 rd .   This number will grow, to many millions before the end of the year. Also, over ...

Babies crawl before they walk.  c. Microsoft Office Image The Affordable Care Act (ACA) marks its first birthday this week.   It may not be off to a running start, but it isn’t exactly sitting still either.   The most debated provisions, like the individual mandate and the Medicaid expansions, are still three years in the future. In the first year, ACA’s biggest developmental milestones have affected older Americans, people with mental and physical disabilities, and consumers in general.   Which of these populations is making the most progress? Medicare recipients and early retirees have taken the most steps forward .     As of January 1 st , all Medicare Part B recipients are entitled to a free annual physical, with free cancer, cardiovascular, and skeletal screenings, and free flu shots.   150,000 beneficiaries had taken advantage of this through February 23 rd .   This number will grow, to many millions before the end of the year. Also, over ...

Health insurance reform is being implemented now, and it's no surprise that there’s a big battle going on pitting consumers against insurers.   The surprise is that the state regulators charged with protecting consumers are siding with insurers on some key issues. The Biggest Consumer Protection in Health Reform If you ask 100 people what the biggest consumer protection in the health reform law is, I would guess that fewer than 10 of them would tell you it’s the loss ratio mandate. The what, you say?    We know about lifetime caps and pre-existing conditions and minimum benefit packages.   Few of us know about “loss ratios.” As we’ll see, consumers have a lot at stake in the loss ratio battle, including – for some – hundreds of dollars of premium costs per month .   What’s a loss ratio? What’s a loss ratio, and why should you care?   Simply put, a loss ratio is the percentage of dollars taken in through premiums paid back out in benefits.   For ex...

Health insurance reform is being implemented now, and it's no surprise that there’s a big battle going on pitting consumers against insurers.   The surprise is that the state regulators charged with protecting consumers are siding with insurers on some key issues. The Biggest Consumer Protection in Health Reform If you ask 100 people what the biggest consumer protection in the health reform law is, I would guess that fewer than 10 of them would tell you it’s the loss ratio mandate. The what, you say?    We know about lifetime caps and pre-existing conditions and minimum benefit packages.   Few of us know about “loss ratios.” As we’ll see, consumers have a lot at stake in the loss ratio battle, including – for some – hundreds of dollars of premium costs per month .   What’s a loss ratio? What’s a loss ratio, and why should you care?   Simply put, a loss ratio is the percentage of dollars taken in through premiums paid back out in benefits.   For ex...