A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
Call our agency partners 866-553-3223
Call our agency partners 866-553-3223
Medicare & Medicaid Medicare & Medicaid
Featured Featured
ACA open enrollment: what’s new for 2025
Open enrollment for 2025 ACA (Affordable Care Act)-compliant health insurance is just around the corner. Let’s take a look at the various changes that consumers should be aware of this fall.
Featured Featured
Fact check: Is the $6,400 subsidy real?
Ads on social media – promising a $6,400 subsidy – have been flagged as misleading. Here's what you need to know about the $6,400 subsidy scam.

ACA’s 2017 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $447 million in premium refunds to 3.95 million Americans in 2016, its sixth year

The Affordable Care Act's medical loss ratio (MRL) returned $447 million to 3.95 million American consumers in its sixth year.

The Affordable Care Act’s requirement that health insurance companies spend 80 percent of your health insurance premium dollars on actual health care – rather than marketing, administrative and CEO salaries – returned $447 million to 3.95 million American consumers in its sixth year.

The medical loss ratio – also known as the 80/20 rule – means that insurers 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 medical loss ratio has returned billions in health insurance premium rebates to consumers since 2012.

The average American household received $113 in the sixth year, with the highest average rebates in California ($559), Arizona ($268) and North Dakota ($264). See the statistics for your state below.

ACA’s 2017 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $0 0 $0
Alabama $1,082,961 5,792 $187
Arkansas $3,405,615 68,758 $48
Arizona $7,614,255 28,931 $268
California $17,296,405 30,945 $559
Colorado $3,490,011 84,019 $42
Connecticut $0 0 $0
District of Columbia $17,283,050 96,771 $179
Delaware $38,315 6,908 $6
Florida $70,055,092 673,907 $104
Georgia $20,138,857 361,248 $56
Hawaii $0 0 $0
Iowa $762,520 3,608 $211
Idaho $145,995 1,396 $105
Illinois $6,168,260 54,915 $112
Indiana $6,728,777 35,727 $188
Kansas $5,469,822 23,567 $232
Kentucky $142,896 861 $166
Louisiana $156,362 1,753 $89
Massachusetts $40,563,956 162,848 $249
Maryland $60,530,581 316,952 $191
Maine $0 0 $0
Michigan $47,254,187 363,756 $130
Minnesota $0 0 $0
Missouri $13,767,411 242,809 $57
Mississippi $8,038,596 75,847 $106
Montana $0 0 $0
North Carolina $7,121,178 71,244 $100
North Dakota $282,828 1,070 $264
Nebraska $118,097 992 $119
New Hampshire $11,207,622 63,460 $177 $
New Jersey $11,331,648 137,202 $83
New Mexico $0 0 $0
Nevada $4,689,070 38,480 $122
New York $31,637,681 459,305 $69
Ohio $7,806,432 110,196 $71
Oklahoma $531,403 5,230 $102
Oregon $0 0 $0
Pennsylvania $1,861,095 67,011 $28
Rhode Island $2,735,599 16,696 $164
South Carolina $25,234 783 $32
South Dakota $0 0 $0
Tennessee $1,524,373 21,833 $70
Texas $8,019,143 67,857 $118
Utah $133,015 3,189 $42
Virginia $26,394,905 185,431 $142
Vermont $0 0 $0
Washington $1,103,455 50,454 $22
Wisconsin $84,127 1,089 $77
West Virginia $142,748 7,936 $18
Wyoming $0 0 $0
American Samoa N/A N/A N/A
Guam N/A N/A N/A
Northern Mariana Islands N/A N/A N/A
Puerto Rico N/A N/A N/A
Virgin Islands N/A N/A N/A
sticky-bottom-cta

Get your free quote now through licensed agency partners!