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Insurance companies have a very technical term for this proportion - "medical loss ratio" (MLR) - and critics say the terminology itself illustrates the callousness of the health insurance business. Companies that sell coverage consider revenues that go to pay for medical costs "losses,"; minimizing these losses by dropping sick customers and...
The original Senate bill called for lower thresholds - 75% and 80% respectively - while the House bill calls for an 85% limit across the board; crucially, both of those bills would have ended the requirement in 2013, the year much of health reform only begins to take effect, while Reid's...
Rockefeller had been pushing for a 90% threshold, but the Congressional Budget Office said such a requirement would severely limit companies' flexibility and "make such insurance an essentially governmental program." Many states currently have MLR requirements, but most are below the federal level that would be established under Democratic health...
Earlier this year Rockefeller - who is chairman of the Senate Commerce, Science and Transportation Committee - launched an investigation into MLRs. According to Rockefeller, in 2008, insurers in the individual market spent an average of 74% of premiums on health care, compared with 80% in the small group market and 84...
But setting a new national MLR floor is not the end of the equation. The CBO, in its report on the regulations, said insurers might react to new thresholds by "cutting back on efforts to restrain benefit costs through care management." Translation: Anything that doesn't count as "medical costs...