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 $519,313,127 to 8.9 million American consumers in its second year.

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ACA’s 2013 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $519 million in premium refunds to 8.9 million American consumers in its second year

  • September 30, 2013

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 $519,313,127 to 8.9 million American consumers in its second 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 $98 in the second year, with the highest rebates in Delaware ($495), Washington ($457), and Massachusetts ($390). See the statistics for your state below.

ACA’s 2013 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $1,645,701 12,344 $190
Alabama $314,374 1,487 $248
Arkansas $4,171,735 121,224 $58
Arizona $18,711,068 423,981 $71
California $65,513,584 1,440,544 $74
Colorado $11,486,675 151,236 $136
Connecticut $5,530,448 49,534 $145
District of Columbia $5,149,792 210,233 $53
Delaware $1,361,054 4,096 $495
Florida $54,560,916 624,163 $131
Georgia $17,817,736 250,293 $125
Hawaii $1,551,371 39,589 $59
Iowa $264,438 56,900 $5
Idaho $2,300,265 28,163 $152
Illinois $6,240,594 184,832 $53
Indiana $22,656,341 274,396 $157
Kansas $4,043,320 83,742 $71
Kentucky $14,405,533 206,771 $100
Louisiana $2,377,674 80,994 $50
Massachusetts $40,126,759 201,890 $390
Maryland $13,065,596 151,412 $142
Maine $501,240 8796 $106
Michigan $18,810,417 231,117 $133
Minnesota $1,435,260 9,161 $254
Missouri $19,186,416 457,019 $72
Mississippi $5,851,557 59,995 $140
Montana $1,537,571 13,274 $173
North Carolina $10,478,768 213,253 $85
North Dakota $19,792 572 $64
Nebraska $2,000,151 42,036 $82
New Hampshire $1,171,335 15,407 $147
New Jersey $10,768,382 220,010 $104
New Mexico $239,568 17,536  $24
Nevada $4,139,073 88,491 $76
New York $35,290,183 818,375 $82
Ohio $486,681 6,333 $142
Oklahoma $16,014,998 273,694 $92
Oregon $2,928,540 22,346 $206
Pennsylvania $6,877,988 126,357 $76
Rhode Island $18,053 1,265  $43
South Carolina $6,169,507 119,448 $74
South Dakota $41,240 784 $70
Tennessee $5,676,202 132,529 $70
Texas $46,695,311 730,496 $96
Utah $4,582,857 139,655 $85
Virginia $11,874,030 237,350 $89
Vermont $126,810 5,248 $58
Washington $806,497 3,007 $457
Wisconsin $3,567,932 147,144 $46
West Virginia $2,703,790 16,434 $374
Wyoming $1,477,087 8,427 $284
Guam $2,042,664 49,160 $83
Northern Mariana Islands $90,099 1,766 $113
Puerto Rico $3,955,123 41,541 $198
Virgin Islands $36,068 4,181 $15

 

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