A new provision of the Patient Protection and Affordable Care Act known as medical loss ratio (MLR) provides greater value for consumers by requiring insurance companies to not only disclose how they spend their individual policyholders’ premium dollars but also dedicate at least 80 percent of those paid premium dollars to direct medical care and quality improvement programs for their customers.
Last spring, Georgia’s insurance commissioner, however, requested leniency on behalf of Georgia’s insurance companies to phase in this provision over three years rather than implement it immediately. This request was a tremendous disservice to the Georgians currently insured through individual policies.
Georgia Watch, along with Georgians for a Healthy Future, asked the US Department of Health and Human Services to deny Georgia’s request. We issued public comments to HHS and we authored an issue brief made available to the public. Luckily, our voice was heard, and a middle ground was struck. The Insurance Commissioner’s Office can still phase in the MLR rules, but at a much faster rate, which is a benefit to all Georgia policyholders with individual insurance. Read more