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Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision?

The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.

Visualizing Health Policy: Premium Subsidy Scenarios Under Obamacare

This month’s Visualizing Health Policy infographic shows 3 scenarios that illustrate the cost of health insurance under the Affordable Care Act for families in different circumstances, both before and after premium subsidies (in the form of a tax credit).

Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

This report examines the premium stabilization programs under the Affordable Care Act (ACA). Risk Adjustment, Reinsurance, and Risk Corridors — also called the Three R’s — will work in the early years of health reform to stabilize premiums and promote insurer competition on the basis of quality and promote market stability.

Quantifying Tax Credits for People Now Buying Insurance on Their Own

This analysis estimates that Americans currently buying insurance on the individual market would receive $2700 in subsidies (as tax credits) in 2014 under Obamacare. Tax credits are available for qualifying people buying insurance through the new health care marketplaces, or exchanges.

An Early Look at Premiums and Insurer Participation in Health Insurance Marketplaces, 2014

The analysis compares the premiums in the largest cities in each of the 17 states plus DC for individuals and families in different circumstances to illustrate the insurance rates they might pay, with and without the tax credits created under the law to make coverage more affordable. The 17 states plus DC include eleven operating their own marketplaces (also called exchanges) and seven that have defaulted to the federal government.

State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act

Key provisions of the 2010 Affordable Care Act (ACA) create new Marketplaces for people who purchase insurance directly and provide new premium tax credits to help people with low or moderate incomes afford that coverage. This analysis estimates that about 17 million people who are now uninsured or who buy insurance on their own (“nongroup purchasers”) will be eligible for premium tax credits in 2014. This issue brief provides national and state estimates for tax credit eligibility for people in these groups.

Explaining Health Care Reform: Medical Loss Ratio (MLR)

This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.