The Healthcare Debate Continues
August 17, 2010
It would have been a mistake to think that the healthcare debate was over, at least for a little while. Evidently, debate rages on the meaning of some of the terms used… Stay tuned!
The healthcare reform law requires that, starting in 2011, insurance companies’ medical loss ratios — the ratio of an insurance company’s spending on healthcare for policyholders to its revenues — must be 85% or higher in large-group markets and 80% or higher in individual and small-group markets.The Department of Health and Human Services asked the NAIC to propose specifics for the medical loss ratio, and that definition was due by June 1. The NAIC missed that deadline and explained to HHS Secretary Kathleen Sebelius that it needed more time to figure out a formula that wouldn't harm the insurance market.Although the Patient Protection and Affordable Care Act PPACA stated that federal taxes would be excluded from the formula used to calculate the medical loss ratio, the NAIC, the insurance industry, members of Congress, and others, are locked in a debate about what, exactly, constitutes a “federal tax.”Ultimately, HHS will have the final say.