New Study Shows Medicare for All Would Save US $5.1 Trillion Over Ten Years

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122. You have it reversed. If they don't spend the 80% then they have to rebate the difference

Over $ 3 billion dollars has been rebated since ACA started.

I got a $ 200 credit this month.

If you are an individual you get the money. If your company pays for your insurance they get the money.

It was a brilliant provision added by Senator Al Franken

https://www.healthinsurance.org/obamacare/billions-in-aca-rebates-show-80-20-rules-impact/


Medical loss ratio forced carriers to devote more premium dollars to care. The proof of its impact? $3.24 billion refunded to consumers over the last six years.

Ever since 2012, millions of Americans have received rebates from their health insurers each fall, refunding portions of prior-year premiums that were essentially too high.

It’s all thanks to the Affordable Care Act’s medical loss ratio (MLR) a provision – sponsored by Minnesota’s former Senator, Al Franken – that forces health insurance companies to use your premium dollars to provide actual health care and quality improvements for plan participants, or return that money to you. In 2017, insurers were required to pay nearly $447 million in rebates to about 3.95 million people, bringing the total over six years of the program to about $3.24 billion.

In 2017, the highest average rebates were in California, where nearly 31,000 consumers got rebates that averaged $559. Arizona residents who received rebates averaged $268, followed closely by North Dakotans, who received an average of $264.

To clarify, the goal is to have insurers spending the majority of your premium dollars on medical claims so that rebates aren’t necessary. But given that insurers set premiums a year in advance, it’s not always possible to accurately project membership (and thus revenue) and claims costs. So the rebates serve as a backstop, ensuring that even if premiums are ultimately set too high in a given year, the MLR rules still apply.

So if the claims only come to 79% then the insurers must return the 1% back to the clients.

The suggestion that is often made that health insurance companies can make more profits by denying claims is simply no longer true.

That's because we elected Senator Al Franken and President Obama and a whole bunch of others.

It is astonishing that so many people don't understand how great the ACA turned out to be.

In January I will be paying $ 5 for my ACA insurance plan. In April when I go on to Medicare my part B will cost me $ 135 per month.

In my opinion the ACA is way out performing its promises even as the Republicans try to sabotage it. In my district when Martha McSally lied about the benefits of the ACA hundreds of her constituents gathered at her town halls, mostly middle aged professional women. She couldn't announce her town halls more than a few hours in advance because they were literally stormed and she tried to get just her followers.

She announced a town hall two hours before it happened and it was an hour out of town. Three hundred protesters showed up and she cancelled, didn't try to run in this district and lost in her Senate race because she could only get questions about the ACA and nothing about the caravan.

Again, if the health insurance company denies claims and the Medical Loss Ratio is below 80% (or 85% for groups) then the company has to rebate the money back to the clients, they don't get more money.

Hope this helps