Wide Variation in Medical Loss Ratios within States in 2010 Suggests the Affordable Care Act's Standards Could Lead to Higher Value Insurance Options

Clemans-Cope, Lisa; Blumberg, Linda; Zuckerman, Stephen; Roth, Jeremy
December 2013
Journal of Insurance Regulation;Winter2013, Vol. 32, p119
Academic Journal
Medical loss ratios in the individual health insurance market varied widely by state in 2010, but there was much less variation in small group markets. During 2010, prior to the enforcement of the ACA's new federal standards, insurers with low medical loss ratios dominated coverage in the individual market in more than one-third of states, and smaller insurers had lower medical loss ratios. States that regulated loss ratios and premiums in 2010 generally had higher average medical loss ratios in both individual and small group markets. While insurers' responses to the new federal standards are not yet known, the result may be higher value choices in many state markets.


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