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It’s still all about affordable coverage.

ACA's provisions focused on expanding access through affordability. The law's medical loss ratio continues to improve health plans' value.

  • August 1, 2017

The impact of ACA’s Medical Loss Ratio at a glance – through the highest average rebates per family in 2016.

Since the very beginning of the debate about how to expand access to health coverage on the individual market, proponents of reform have focused on one important word: affordability.

And affordability was front and center in the provisions ultimately baked into the Affordable Care Act – from income-based subsidies that lowered premiums and out-of-pocket costs, to the expansion of Medicaid, to prohibitions on insurers’ ability to raise rates for those with pre-existing conditions.

Perhaps not as high profile in the debate has been the medical loss ratio – an ACA provision that forces health insurers to devote more of each premium dollar to actual care instead of marketing and administrative costs. But that provision has been effective, too, as evidenced by almost $3 billion in rebates to consumers for 2012, 2013, 2014, and 2015.

While it’s not clear whether the GOP will ultimately be successful in rolling back the “80/20 Rule,” it is clear that repealers would like to see it on the chopping block. For a look at the potential impacts of MLR repeal, check out Louise Norris’ latest post, Are health insurance premium rebates in danger?

Access to comprehensive health coverage has become a reality for millions of Americans. We’ll help you understand your options.

A majority of Americans get coverage for their medical care through group health insurance – and it’s popular coverage because it’s easy to enroll, and made more affordable by employer contributions and tax subsidies.

But millions more purchase health plans on the individual health insurance market – and navigating that market hasn’t historically been easy. For years, consumers seeking coverage for their families – including the self-employed – faced the intimidating challenge of wading through coverage options that featured a mind-boggling array of premiums, out-of-pocket costs and coverage limitations.

Far worse for buyers who desperately needed coverage was the very real likelihood that a pre-existing condition would make coverage ridiculously expensive – or not available at any price. In the past, many turned to high-risk insurance pools, though even those were considered a “last resort” for the uninsured.

Read Wendell Potter’s reflections on the ‘Good old days before Obamacare.’

Improved health coverage options

Fortunately, buying a quality, affordable health policy has gotten much easier in recent years, thanks in part to online comparison tools. (You can quickly compare plans through this site’s free health insurance quote tool.)

And thanks to the Affordable Care Act, millions of previously uninsured Americans gained access to more affordable plans – some through the law’s subsidies, others through the ACA’s Medicaid expansion. We’re not talking about the cheap health insurance known as junk plans, but plans strengthened by the law’s essential health benefits.

A guide to individual and family health insurance

As much as we love the Affordable Care Act, we know as well as anyone that the individual health insurance market continues to be a source of confusion for many, many consumers.

Since 1994, this web site has been a guide for consumers seeking straightforward explanations about the workings of individual health insurance – also known as medical insurance. Within this site, you’ll find hundreds of articles loaded with straightforward explanations about health insurance – and the health law – all written by a team of respected health insurance experts.

Our most popular resources include:

Helping you find a plan that fits your needs

At healthinsurance.org, we don’t sell insurance, but we do partner with qualified call centers staffed with agents who are both licensed in your state and exchange-certified. These partnerships also allow us to deliver health insurance quotes quickly and easily.

Don’t hesitate to let us know if you hit a snag in the process – or if you’re stumped by a question about health coverage. Of course, we’d also love to hear about your success in getting coverage and quality healthcare.

But today, with the complexities of premium subsidies, cost-sharing subsidies, penalties – and now qualifying events and special enrollment periods – it’s a smart move to talk to a professional who can help minimize your cost and maximize your benefits, and save you research time. Call 1-877-809-0501 to get free assistance.