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ACA’s 2021 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $2.01 billion in premium refunds to 9.8 million Americans in 2020, its tenth year

The Affordable Care Act's medical loss ratio returned $2.01 billion to 9.8 million American consumers in its tenth 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 $2.01 billion to 9.8 million American consumers in its tenth 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 $205 in the tenth year, with the highest average rebates in Oregon ($647), South Dakota ($508), and Montana ($501). See the statistics for your state below.

ACA’s 2020 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $4,213,601 29,444 $143
Alabama $43,807 670 $65
Arkansas $11,399,411 149,021 $76
Arizona $65,641,048 269,463 $244
California $95,372,541 815,593 $117
Colorado $21,554,795 206,020 $105
Connecticut $806,397 6,309 $128
District of Columbia $33,971,471 240,209 $141
Delaware $12,952,195 53,431 $242
Florida $220,518,186 1,049,726 $210
Georgia $39,185,472 406,642 $96
Hawaii $3,641,401 33,542 $109
Iowa $28,264,892 138,496 $204
Idaho $2,477,493 14,569 $170
Illinois $62,741,140 390,267 $161
Indiana $1,971,249 76,129 $26
Kansas $14,023,024 29,721 $472
Kentucky $5,386,145 45,728 $118
Louisiana $9,076,650 77,539 $117
Massachusetts $57,986,650 497,201 $117
Maryland $105,861,131 454,183 $233
Maine $46,666,706 83,127 $561
Michigan $63,517,018 279,163 $228
Minnesota $33,839,312 118,709 $285
Missouri $49,284,308 269,783 $183
Mississippi $17,317,834 89,813 $193
Montana $9,833,331 19,645 $501
North Carolina $1,299,712 28,317 $46
North Dakota $0 0 $0
Nebraska $2,771,512 27,466 $101
New Hampshire $35,953,238 84,407 $426
New Jersey $34,919,073 354,343 $99
New Mexico $15,387,778 30,995 $496
Nevada $10,443,945 80,946 $129
New York $32,589,088 438,583 $74
Ohio $16,182,787 207,359 $78
Oklahoma $11,836,898 156,328 $76
Oregon $200,811 311 $647
Pennsylvania $172,178,420 500,691 $344
Rhode Island $0 0 $0
South Carolina $30,387,759 304,009 $100
South Dakota $953,698 1,876 $508
Tennessee $67,509,740 357,638 $189
Texas $212,577,902 537,232 $396
Utah $6,728,863 25,311 $266
Virginia $234,575,147 538,380 $436
Vermont $0 0 $0
Washington $48,849,645 113,497 $430
Wisconsin $50,020,790 121,272 $412
West Virginia $0 0 $0
Wyoming $3,809,511 26,837 $142
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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