Every year that the Affordable Care Act is law of the land, health care consumers get to see the benefits. One of those benefits is the result of the 80-20 rule, which says that insurers can’t just hike up your premiums to pad their own profits.
Instead, they have to spend at least 80% of your premium dollars on actual health care. If they spend less than 80% of what you pay for health care (and instead try to apply it to CEO compensation or marketing or the like), they have to refund the difference to you, the consumer.
This year, 726,000 Texas consumers will receive over $46 million in money back from their insurers because of this Affordable Care Act rule. The average for a Texas family receiving a rebate this year is about $95.
While that’s less than it was last year, that in itself may be a good sign. Insurers don’t want to pay the rebates, so more are obeying the rule and keeping to that baseline. If hiking up profits for profit’s sake isn’t profitable … well, why do it?
Check out our video from last year, as our former community educator Cheasty Anderson explains this and other insurance industry regulations brought to you by the Affordable Care Act.
Written by: Christine Sinatra, Texans Care for ChildrenPosted in News|Tagged 80-20 rule, affordable care act, medical loss ratio, Obamacare|