Insurers Tell Congress: Beware Rate Shock If Obamacare Enrollment Extended

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14. the MLR is important here

Insurance companies have been returning premiums if they don't spend 80-85% on medical costs. Now, they are likely to have lots of people who need care for 4 months and relatively few people who don't need care. That means very high medical costs. They will turn the MLR around and say they need premiums 20-25% above the costs they've had for these plans.

Regulators will come back and say "but you'll have lots more healthy people next year so calculate it that way." They'll respond that they were told they'd have "lots of healthy people in 2014" and didn't get that so they won't count on it again. Healthy people very well may decide they don't want insurance in the numbers the government says. Insurers will go with the hard numbers they gather instead of some assumptions from the government. And they will claim they worked with the MLR in good faith in previous years and returned premiums so that med costs were 80% of the premium so now the regulators need to work in good faith and allow premiums 20+% over medical costs.