Private Insurers Expect to Pay $1.1 Billion in Rebates This Year for Setting Premiums Too High Relative to Medical Costs May 17, 2023 News Release Private insurance companies are expecting to pay out about $1.1 billion in rebates this fall under an Affordable Care Act (ACA) provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three…
Explaining Health Care Reform: Medical Loss Ratio (MLR) February 29, 2012 Fact Sheet This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.
Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision? June 6, 2013 Perspective The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.
Insurer Financial Performance in the Early Years of the Affordable Care Act April 21, 2017 Issue Brief This data note looks at trends in insurer financial performance in the individual market, as the Affordable Care Act (ACA) marketplaces were established, finding that the market showed signs of stabilizing in 2016.
Analysis: Insurer Financial Indicators Show Signs of Stabilizing After Transition to ACA Marketplaces April 21, 2017 News Release A new Kaiser Family Foundation analysis of key insurer financial indicators suggests that the individual insurance market showed signs of stabilizing in 2016, although profitability remained below the level of performance prior to the opening of the Affordable Care Act’s insurance marketplaces. The new analysis tracks insurer financial performance in…
The Economy and Medical Care November 15, 2011 Perspective Various market watchers have reported that the use of health care services has not been growing recently as it had in the past, resulting in lower than expected health care claims for people with private insurance and higher than expected earnings for insurers. A look at physician office visits by…
Kaiser Health Tracking Poll: August 2012 August 31, 2012 Poll Finding This poll, conducted as the GOP prepares for its national convention, finds that the Affordable Care Act is not the top health care priority among Republicans. While jobs are still the number one issue for Republicans, when asked about the health care issues that will impact their vote this fall,…
Kaiser Analysis: Estimated Health Insurance Rebates Under the Health Reform Law Total $1.3 Billion in 2012 April 1, 2012 News Release NEWS RELEASE April 26, 2012 Rebates Expected to Vary Significantly by State MENLO PARK, Calif. – Consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act…