Two House chair­men sup­port Mich.’s loss-ra­tio waiver re­quest

Modern Healthcare - - Late News -

The chair­men of two in­flu­en­tial House com­mit­tees sent a letter to HHS Sec­re­tary Kath­leen Se­be­lius sup­port­ing their home state of Michi­gan’s re­quest for a waiver from the med­i­cal-loss ra­tio pro­vi­sion for in­di­vid­ual health in­surance. Man­dated in last year’s Pa­tient Pro­tec­tion and Affordable Care Act, the med­i­cal-loss ra­tio pro­vi­sion re­quires that in­surance com­pa­nies in the in­di­vid­ual mar­ket spend at least 80% of pre­mium dol­lars on med­i­cal ser­vices. “In Michi­gan, seven health plans in­sure al­most 90% of con­sumers in the in­di­vid­ual in­surance mar­ket, to­tal­ing 305,003 peo­ple in 2010,” Reps. Dave Camp (R-Mich.), chair­man of the House Ways and Means Com­mit­tee, and Fred Up­ton (R-Mich.), chair­man of the lower cham­ber’s En­ergy and Com­merce Com­mit­tee,” wrote to Se­be­lius. “Based on 2010 data, only two of the seven health plans would be able to meet the 80% MLR thresh­old,” they wrote, adding that com­bined, the seven plans would have a net es­ti­mated loss of $30.9 mil­lion in 2010 if they were forced to com­ply with the re­quire­ments.

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