The Affordable Care Act's requirement that health insurance companies spend 80 percent of your premium dollars on actual health care – rather than marketing, administrative and CEO salaries – returned $1,101,372,250 to 12.8 million American consumers in its first year.

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ACA’s 2012 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $1.1 billion in premium refunds to 12.8 million American consumers in its first year

  • September 30, 2012

The Affordable Care Act’s requirement that health insurance companies spend 80 percent of your premium dollars on actual health care – rather than marketing, administrative and CEO salaries – returned $1,101,372,250 to 12.8 million American consumers in its first year.

The medical loss ratio – also known as the 80/20 rule – means that insurers for the first time have to disclose where they’re spending plan holder premium dollars. If they spend less than 80 percent (less than 85 percent for large group plans) on providing medical care, they must rebate the excess dollars back to consumers each year.

The average American household received $151 in the first year, with the highest rebates in Vermont ($807), Mississippi ($651), Alaska ($622), Alabama ($518), Maine ($463), Illinois ($380, West Virginia ($374) and Wyoming ($350). See the statistics for your state below.

ACA’s 2012 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $1,280,908 2,712 $622
Alabama $4,220,331 13,556 $518
Arkansas $7,787,177 115,461 $114
Arizona $27,868,667 413,912 $118
California $73,905,280 1,877,186 $65
Colorado $27,452,769 208,197 $227
Connecticut $12,949,130 137,452 $168
District of Columbia $47,189,436 592,234 $157
Delaware $1,846,989 5,639 $351
Florida $123,624,635 1,251,397 $168
Georgia $19,764,771 243,813 $134
Hawaii $195,053 26,900 $15
Iowa $1,469,276 28,042 $100
Idaho $1,124,918 32,576 $70
Illinois $61,802,411 299,544 $380
Indiana $14,249,673 283,432 $99
Kansas $4,139,506 67,512 $91
Kentucky $15,326,103 249,275 $114
Louisiana $4,111,975 75,493 $94
Massachusetts $11,886,643 163,949 $140
Maryland $27,882,606 141,129 $340
Maine $2,579,922 10,589 $463
Michigan $13,908,262 113,995 $214
Minnesota $8,956,885 123,171 $160
Missouri $60,664,564 587,654 $173
Mississippi $10,122,532 51,744 $329
Montana $2,607,244 25,353 $194
North Carolina $18,678,898 216,649 $158
North Dakota $10,160 4,229 $5
Nebraska $4,832,049 46,444 $215
New Hampshire $77,507 16,023 $9
New Jersey $7,670,066 44,998 $300
New Mexico $0 0
Nevada $4,548,500 46,590 $180
New York $86,526,642 1,001,476 $138
Ohio $11,331,726 143,327 $139
Oklahoma $20,296,875 263,404 $126
Oregon $4,654,772 23,394 $368
Pennsylvania $51,588,303 575,551 $165
Rhode Island $0 0
South Carolina $19,630,152 251,632 $131
South Dakota $47,948 1,370 $68
Tennessee $28,810,557 240,298 $201
Texas $166,975,840 1,516,721 $187
Utah $3,696,778 109,893 $85
Virginia $43,127,639 686,738 $115
Vermont $2,346,018 4,636 $807
Washington $594,031 7,681 $185
Wisconsin $10,369,793 282,812 $76
West Virginia $2,703,790 16,434 $374
Wyoming $1,112,043 6,290 $350
Guam $15,394,953 46,390 $852
Northern Mariana Islands $291,586 1,022 $782
Puerto Rico $5,508,831 58,648 $225
Virgin Islands $1,629,124 5,698 $462

 

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