Last Thursday, Health Care for America Now, the national grassroots campaign founded with the help of USAction, released a report on how the health insurance industry is pressuring state insurance regulators to undermine some key provisions in the new health care law.  You heard right: health insurance companies are still trying to block key provisions that will help average Americans get quality, affordable health care. It sounds like business as usual, right? “The insurance companies and their army of lobbyists are doing everything they can to undercut this law,” said HCAN Executive Director Ethan Rome.

This is especially true in the provision about medical-loss ratios or MLRs.  What are Medical Loss Ratios, you ask? Simply put, MLRs lay out how much insurance companies spend on medical services versus their own expenses per customer.  The Affordable Care Act requires at least 80 percent of health premiums to be spent on medical services for individuals and small businesses (85 percent for large employers).  That is a big departure from previous practices.

According to the report, if the new law was in effect one year ago at the rates they are required to pay now, the six largest for-profit insurance companies would have been required to refund $1.9 billion for 2009 alone.  Think about that:  $1.9 billion that could have gone to paying for the care you pay for, but are instead going to administrative and advertisement costs. And the health insurance industry is still trying to get exemptions? The state of Maine has filed for an exemption to this provision of the new law.  In a letter to Secretary Kathleen Sebelius, the Superintendent of Insurance for Maine, said the following,

In its filings with the Securities and Exchanges Commission, one insurer has indicated its intent to pull out of individual health insurance markets, (and has explicitly named one state where that decision has already been made). Based on preliminary discussions I had with the insurer, the company could continue to operate successfully in the Maine market in compliance with our current MLR standard, but would probably need to withdraw from this market if the minimum loss ratio requirement were increased.

But the current MLR standard is allowing nearly $1.9 billion not to be spent on your health care. Enough already! It’s time that we tell the health insurance companies what we want.  We can’t let them play the system anymore. This is one of many battles still to come from this new health care law–let’s hope they don’t win this one!

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