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Advocates and insurers clash over bill to raise insurers' medical-loss ratio to 90%
Summary
House Bill 2283 would raise the medical-loss ratio to 90% for fully insured plans starting in 2027; patient groups and small-business advocates backed the change as a way to lower premiums, while major carriers warned it could destabilize markets and reduce consumer-facing services.
Representative Alicia Ruhl, prime sponsor of House Bill 2283, described the Patient Premium Value Act as a measure to ensure a greater share of premium dollars go to direct patient care rather than administration or profit, arguing tighter medical-loss ratios will improve affordability and reduce out-of-pocket costs.
Kim Weidner, committee staff, summarized the bill and the current federal MLR framework under the Affordable Care Act: federal rules set MLR minimums at 80% for individual/small group plans and 85% for large-group plans. HB 2283 would establish a 90% floor for fully insured individual, small-group and large-group…
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