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 2018 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $707 million in premium refunds to 5.96 million Americans in 2017, its seventh year

The Affordable Care Act's medical loss ratio (MLR) returned $707 million to 5.96 million American consumers in its seventh year.

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 $707 million to 5.96 million American consumers in its seventh 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 $119 in the seventh year, with the highest average rebates in Minnesota ($479), Connecticut ($423) and Hawaii ($384). 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 $206,196 5,061 $41
Arkansas $1,944,299 12,870 $151
Arizona $27,576,292 157,020 $176
California $97,386,263 919,608 $106
Colorado $7,475,523 70,758 $106
Connecticut $48,929 1,154 $423
District of Columbia $26,601,653 93,420 $285
Delaware $6,551,746 37,324 $176
Florida $86,231,898 679,522 $127
Georgia $29,380,080 403,707 $73
Hawaii $314,241 818 $384
Iowa $2,468,147 17,473 $141
Idaho $64,430 2,021 $32
Illinois $14,554,527 118,385 $123
Indiana $1,499,908 74,991 $20
Kansas $3,695,019 23,526 $157
Kentucky $26,253 923 $28
Louisiana $314,880 61,158 $5
Massachusetts $31,895,756 208,749 $153
Maryland $75,754,059 552,175 $137
Maine $0 0 $0
Michigan $55,651,722 392,288 $142
Minnesota $19,659,847 41,034 $479
Missouri $45,538,433 298,071 $153
Mississippi $10,466,683 91,084 $115
Montana $116,211 1,102 $105
North Carolina $4,355,031 112,738 $39
North Dakota $64,550 794 $81
Nebraska $69,737 1,665 $42
New Hampshire $8,064,209 34,995 $230
New Jersey $14,368,862 94,341 $152
New Mexico $4,513,998 32,498 $139
Nevada $6,451,083 43,778 $147
New York $25,961,536 445,849 $58
Ohio $4,706,404 26,186 $180
Oklahoma $2,434,273 33,380 $73
Oregon $96,757 636 $152
Pennsylvania $30,734,528 416,910 $74
Rhode Island $0 0 $0
South Carolina $453,504 41,437 $11
South Dakota $0 0 $0
Tennessee $10,634,459 100,638 $106
Texas $7,813,406 54,851 $142
Utah $3,722,184 27,957 $133
Virginia $35,342,998 210,094 $168
Vermont $0 0 $0
Washington $0 0 $0
Wisconsin $317,325 10,671 $30
West Virginia $1,207,286 6,840 $177
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!