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ACA’s 2020 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $2.46 billion in premium refunds to 11.2 million Americans in 2020, its ninth year

The Affordable Care Act's medical loss ratio returned $2.46 billion to 11.2 million American consumers in its ninth 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 $2.46 billion to 11.2 million American consumers in its ninth 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 $219 in the ninth year, with the highest average rebates in Kansas ($611), Missouri ($558), and Montana ($521). See the statistics for your state below.

ACA’s 2019 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $14,608,271 31,471 $464
Alabama $53,454 782 $68
Arkansas $14,568,401 188,689 $77
Arizona $89,335,042 250,992 $356
California $111,290,349 1,266,485 $88
Colorado $19,295,497 161,248 $120
Connecticut $51,497 981 $53
District of Columbia $31,821,569 105,283 $302
Delaware $21,584,336 53,350 $405
Florida $246,252,312 1,094,565 $225
Georgia $86,737,877 289,774 $299
Hawaii $2,919,947 21,090 $138
Iowa $25,335,314 92,036 $275
Idaho $279,235 9,561 $29
Illinois $132,427,486 437,631 $303
Indiana $2,088,034 83,852 $25
Kansas $24,618,299 40,260 $611
Kentucky $407,121 3,479 $117
Louisiana $14,347,143 110,431 $130
Massachusetts $51,643,293 475,787 $109
Maryland $76,119,651 497,714 $153
Maine $19,933,657 70,993 $281
Michigan $59,743,985 326,779 $183
Minnesota $42,167,584 95,837 $440
Missouri $192,765,761 345,312 $558
Mississippi $37,388,648 108,885 $343
Montana $15,169,863 29,135 $521
North Carolina $4,844,756 510,985 $9
North Dakota $0 0 $0
Nebraska $1,999,458 33,321 $60
New Hampshire $23,046,305 88,610 $260
New Jersey $24,931,324 385,376 $65
New Mexico $15,201,557 32,436 $469
Nevada $14,383,246 124,203 $116
New York $29,510,228 433,758 $68
Ohio $7,376,503 58,574 $126
Oklahoma $88,920,276 305,740 $291
Oregon $276,976 3,192 $87
Pennsylvania $166,262,469 438,532 $379
Rhode Island $0 0 $0
South Carolina $37,744,075 307,670 $123
South Dakota $814,462 3,029 $269
Tennessee $129,303,855 386,910 $334
Texas $278,969,190 776,058 $359
Utah $7,901,895 58,160 $136
Virginia $162,676,818 671,655 $263
Vermont $54,756 1,831 $30
Washington $45,520,424 292,175 $156
Wisconsin $86,071,972 175,062 $492
West Virginia $0 0 $0
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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