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MLR Waiver Bill Would Shift Power to States



A key provision in a bill set to go before a House committee would give states the final say on medical loss ratio waiver requests. But one critic says, "Most state insurance offices don't have the capacity to do the necessary market analysis."



3 comments on "MLR Waiver Bill Would Shift Power to States"
E. Thomas (9/20/2012 at 11:53 AM)

Two points. First, if broker and agent fees and commissions are not included as administrative expenses (the 20% bucket), surely they cannot be considerd to be related to direct patient care and/or improving the quality of care (the 80% bucket). Second, if future legislation allows the sale of health insurance across state lines, then moving the MLR waiver decision to the state level could lead to insurers basing operations in MLR friendly states.
krockholt (9/20/2012 at 11:24 AM)

Makes a lot of sense to shift power back to the states, especially with such an unpopular act. I anticipate Romney winning the election and repealing anyway.
Donald R. First (9/20/2012 at 10:22 AM)

I haven't read the bill as it stands now, but I read an earlier version. Th e ability to give States the right to change the MLR is really silly and counter Productive. When did paying commissions to broker become a state Mandate. Take a dood solid look at the texas filing last year and you will see thay had no idea what plans were being marketed or what was realistic. The MLR calculation has plenty of fat. I would advise soe tweeks. I don't think groups of 250 or more should be limited by the MLR and I would excuse them, and I would use a lower MLR on HDHP plans.