After spending tens of millions of dollars trying to kill the new health care reform law, the nation’s big health insurance companies now are "sparing no expense to weaken this new law and the protection it promises to America’s consumers," says Sen. Jay Rockefeller (D-W.Va.).
According to a new report by the coalition Health Care for America Now (HCAN), big insurers are trying to gut proposed new rules that require they spend a certain amount of premium dollars on actual medical care, not wasteful administration, marketing or executive pay and bonuses.
The medical care cost benchmark under the Affordable Health Care for America Act is known as the medical-loss ratio (MLR). It is set at a minimum of 80 percent of premiums for individual and small employer plans and 85 percent of premiums for large employer plans. Insurers that fail to meet those MLRs must rebate the difference to enrollees.
The new MLR rules are being established by the National Association of Insurance Commissioners (NAIC), which is made up of insurance regulators from the states. According to the HCAN report, the America’s Health Insurance Plans (AHIP) and the Blue Cross and Blue Shield Association and their member insurers:
want to redefine MLRs by pressuring the NAIC to give insurers vast discretion over what expenses they may classify as clinical and administrative costs. Already, Wellpoint Inc., the nation’s largest private health insurer by enrollment, has reclassified $500 million in administrative costs as medical expenses.
Rockefeller says the insurance industry is “furiously lobbying” the NAIC to write the new rules in a way that will:
allow them to do business as they did before the passage of health reform. The resources health insurance companies are throwing into the effort to weaken the medical loss ratio appear almost endless.