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BDNWith a significant federal health insurance regulation taking effect Saturday, the fate of Maine’s request for an exemption remains uncertain.
Although several others are expected to follow suit, Maine is the only state so far to have filed for an exemption to an Affordable Care Act regulation that requires health insurance companies to maintain a minimum “medical loss ratio” of 80 percent. That means the companies must spend an average of at least 80 cents of every premium dollar for health care services delivered to policyholders. The remaining 20 cents can be used for operational expenses such as administration and marketing as well as for boosting profits.
The current minimum medical loss ratio in Maine is 65 percent, and Maine Insurance Superintendent Mila Kofman, a strong supporter of national health care reform, would like to keep it that way for now.
In a July 1 letter to Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, Kofman expressed concern that implementing the 80 percent medical loss ratio here “would have a serious destabilizing effect in our individual
market.” With only two companies competing effectively for the Maine individual market, Kofman said in her letter, one had already indicated its intent to pull out of the state if the higher loss ratio were imposed.
Read more: http://new.bangordailynews.com/2011/01/01/health/only-maine-seeks-insurance-waiver/