June 2, 2022
Payers
  • A new Kaiser Family Foundation analysis found that private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under the Affordable Care Act (ACA) Medical Loss Ratio (MLR) provision. Individual market insurers are expected to pay out an estimated $603 million in rebates to more than 4 million people while small and large group insurers are expected to pay about $275 million and $168 million respectively to plans that cover about 4 million more people. This year’s total is roughly half the size of last year’s $2 billion, in part because 2021 was a less profitable year and because the three-year window no longer includes 2018, when individual market insurers overpriced their ACA marketplace plans due to uncertainty caused by the repeal-and-replace debate and other ACA policies. (Analysis here)