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ACA’s 2015 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $469 million in premium refunds to 5.5 million Americans in 2014, its third year

The Affordable Care Act's medical loss ratio (MLR) returned $469 million to 5.5 million American consumers in its fourth year.

The Affordable Care Act’s requirement that health insurance companies spend 80 percent of your premium dollars on actual health care – rather than marketing, administrative and CEO salaries – returned $469 million to 5.5 million American consumers in its fourth year.

The medical loss ratio – also known as the 80/20 rule – means that insurers for the first time have to disclose where they’re spending plan holder premium dollars. If they spend less than 80 percent (less than 85 percent for large group plans) on providing medical care, they must rebate the excess dollars back to consumers each year.

The medical loss ratio has returned billions in health insurance premium rebates to consumers since 2012.

The average American household received $129 in the fourth year, with the highest rebates in Wyoming ($1,617), Hawaii ($1,597), Idaho ($846) and District of Columbia ($564). See the statistics for your state below.

ACA’s 2015 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $597,002 12,777 $59
Alabama $1,503,011 12,336 $177
Arkansas $13,860,180 80,460 $305
Arizona $10,360,072 259,855 $59
California $97,950,227 723,170 $158
Colorado $5,434,880 117,683 $84
Connecticut $1,834,954 22,166 $177
District of Columbia $14,557,940 41,620 $564
Delaware $2,072,207 14,399 $241
Florida $59,908,232 821,814 $114
Georgia $17,253,523 187,600 $124
Hawaii $1,419,597 1,723 $1,597
Iowa $663,723 8,671 $119
Idaho $738,522 1,461 $846
Illinois $3,574,850 48,949 $114
Indiana $11,850,559 261,183 $84
Kansas $2,469,180 21,369 $184
Kentucky $8,982,159 137,806 $89
Louisiana $1,978,637 57,469 $61
Massachusetts $12,617,420 98,790 $235
Maryland $23,054,136 164,535 $245
Maine $3,488,556 35,861 $105
Michigan $25,676,256 449,681 $120
Minnesota $0 0 $0
Missouri $13,587,035 225,482 $109
Mississippi $20,694,520 99,289 $284
Montana $612,253 10,240 $87
North Carolina $8,449,762 162,234 $81
North Dakota $53,680 193 $287
Nebraska $194,613 999 $262
New Hampshire $9,306,221 54,519 $197
New Jersey $3,091,497 89,403 $46
New Mexico $1,512,640 11,862 $240
Nevada $3,797,839 50,981 $116
New York $8,381,114 293,721 $55
Ohio $4,516,640 157,480 $36
Oklahoma $6,673,626 76,285 $153
Oregon $3,171,343 29,692 $152
Pennsylvania $6,367,923 40,544 $188
Rhode Island $0 0 $0
South Carolina $14,872,151 121,015 $142
South Dakota $0 0 $0
Tennessee $3,251,939 51,863 $105
Texas $14,119,897 96,024 $234
Utah $430,430 2,464 $325
Virginia $12,130,227 180,113 $119
Vermont $0 0 $0
Washington $11,024,698 190,474 $76
Wisconsin $566,915 4,963 $179
West Virginia $445,019 1,770 $329
Wyoming $266,734 484 $1,617
Guam $2,502,478 39,670 $107
Northern Mariana Islands $2113,595 1,796 $120
Puerto Rico $3,545,675 76,230 $99
Virgin Islands $0 0 $0

 

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