CMS Denies Florida's MLR Waiver Request

"Most insurers in the state have told us that they will be adapting their business models and pricing to the 80% MLR so consumers will receive a better value for their premium dollar," Larsen said.

The Florida waiver application drew early criticism for its lack of substance. Citi analyst Carl MacDonald said in a March report "in our view, Florida's minimum MLR waiver request is pretty weak, and we don't think it's likely that the waiver request will be granted, mainly because the state didn't present a real convincing argument that the individual market will be meaningfully disrupted."

Larsen made a point of mentioning the "unprecedented level of public comment that was uniformly in opposition to the adjustment."

State officials, who now have 10 days to appeal the CMS decision, declined to reveal if they will continue to pursue the waiver. "We are not going to make that decision until we have had time to review and evaluate the letter," Jack McDermott, spokesperson for the Florida Office of Insurance Regulation, told HealthLeaders Media in an e-mail exchange.

State politics may favor an appeal. Healthcare reform is unpopular in the state and Gov. Rick Scott has declined to implement provisions of the act.

Florida is one of 17 states have filed MLR waiver requests. CMS has granted waivers to Georgia, Iowa, Kentucky, Maine, New Hampshire and Nevada. It denied waivers for Delaware, Florida, Indiana, Louisiana and North Dakota. Waiver decisions for Kansas, Michigan, Oklahoma, and Texas are pending. North Carolina and Wisconsin are waiting to hear if their applications are complete so the review process can begin.

See also:
4 States Await Word on MLR Waiver Requests
Understanding MLR Waiver Requests