ACA’s 2019 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $1.37 billion in premium refunds to 8.9 million Americans in 2019, its eighth 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 $1.37 billion to 8.9 million American consumers in its eighth 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 $154 in the eighth year, with the highest average rebates in Kansas ($1,081), Arizona ($716) and Minnesota ($552). See the statistics for your state below.

ACA’s 2018 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $5,885,625 19,019 $309
Alabama $26,348 490 $54
Arkansas $16,226,275 147,415 $110
Arizona $99,535,043 139,065 $716
California $89,538,302 1,007,064 $89
Colorado $19,425,443 153,791 $126
Connecticut $20,891 1,062 $20
District of Columbia $31,804,452 107,939 $295
Delaware $8,261,424 38,251 $216
Florida $107,406,822 1,102,427 $97
Georgia $65,648,241 209,802 $313
Hawaii $277,110 701 $395
Iowa $2,402,990 51,116 $47
Idaho $140,221 1,181 $119
Illinois $19,560,851 145,881 $134
Indiana $5,392,696 89,544 $60
Kansas $27,210,671 25,175 $1,081
Kentucky $44,505 363 $123
Louisiana $10,105,345 74,315 $136
Massachusetts $48,775,291 263,727 $185
Maryland $59,369,470 522,126 $114
Maine $0 0 $0
Michigan $19,993,937 191,621 $104
Minnesota $50,249,199 91,064 $552
Missouri $52,067,788 226,223 $230
Mississippi $35,078,651 95,552 $367
Montana $528,294 2,960 $178
North Carolina $9,874,567 537,983 $18
North Dakota $0 0 $0
Nebraska $827,045 45,641 $18
New Hampshire $27,088,031 127,617 $212
New Jersey $15,568,469 97,780 $159
New Mexico $14,180,935 34,468 $411
Nevada $8,680,429 65,980 $132
New York $24,041,704 449,222 $54
Ohio $4,656,274 25,442 $183
Oklahoma $16,000,483 291,073 $55
Oregon $0 0 $0
Pennsylvania $129,984,697 487,734 $267
Rhode Island $0 0 $0
South Carolina $6,701,642 98,565 $68
South Dakota $0 0 $0
Tennessee $61,406,473 334,273 $184
Texas $91,875,636 680,961 $135
Utah $8,778,764 49,316 $178
Virginia $149,564,650 515,567 $290
Vermont $0 0 $0
Washington $3,696,911 220,975 $17
Wisconsin $20,988,802 150,396 $140
West Virginia $1,373,859 3,777 $364
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

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