Earlier today, the National Association of Insurance Commissioners voted to recommend a key package of consumer protections as part of the implementation of federal health reform–and to reject amendments by the insurance industry to significantly weaken these “medical loss ratio” regulations.
We are proud that Elizabeth Abbott, director of administrative advocacy for Health Access California, was one of the 28 designated consumer representatives at the NAIC who prevailed against the full-court press of literally hundreds of insurance company lobbyists who attended the meeting in Orlando, FL this week. Yes, the NAIC meeting this quarter, which travels around the country, was for this session just three miles from DisneyWorld.
Despite the clunky name, these “medical loss ratio” rules are crucial because they help ensure that our premium dollars are going to patient care, rather than to administration and profit. The requirement that at least 80% or 85% go to patient care then brings up questions about how to calculate the definitions and formulas, and that’s what this package is important.
Although we did not get everything we wanted, the NAIC consumer advocates think the medical loss ratio rule that the NAIC adopted is fair, workable, and faithful to the law. They spent months and literally hundreds of hours on conference calls and meetings negotiating a careful compromise, and then at the last moment the insurance industry pulls out all the stops to weaken these consumer protections. They sought a loopholes the size of the country–for example, they sought so-called “national aggregation” to have these regulations applied nationwide, rather than state-by-state.
We appreciate that the insurance commissioners from California and elsewhere rebuffed the industry’s attemps at undermining reform, and we hope they continue to put consumers front and center in the adoption of all the new consumer protections in the new federal health law.