MLR Waiver Bill Would Shift Power to States
The waiver provision is discounted as a "totally political provision with no serious policy considerations behind it, " Ethan Rome, executive director of the advocacy group Health Care for America Now, told HealthLeaders Media. "This is not a case of state versus federal rights. Most state insurance offices don't have the capacity to do the necessary market analysis."
What seems to be lost amid a lot of political rhetoric is that health insurers have been taking the steps to adjust their company operations to reflect the new MLR reality. Still, there's no mistaking that they don't favor the MLR rule, which America's Health Insurance Plans says "completely ignores" the real driver of healthcare expenses—soaring medical costs.
The waiver provision hasn't received as much attention as the section of HR 1206 that would amend the PPACA MLR rule to exclude broker and agent fees and commissions from administrative expense calculations. That industry and political battle has been raging for more than a year.
Supporters of the exclusion, such as the National Association of Health Underwriters, say that agents and brokers face "a desperate economic situation" that can be attributed to job losses and lower incomes that it blames on MLR requirements. The group contends that because agents and brokers are mostly self-employed, their commissions shouldn't be considered administrative expenses.
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