House Panel To Consider Health Law Change That Would Help Brokers


Topics: Health Costs, Insurance, Marketplace, Politics, Health Reform

Sep 19, 2012

A House committee is preparing a bill that would change the health law’s medical loss ratio provision to exclude brokers’ fees from counting as administrative costs.

The Hill: House Panel Readies Bill To Alter Health Law’s Medical Loss Ratio
A feature of President Obama’s healthcare law often touted by Democrats would change under a House bill now ready for mark-up. The measure (H.R. 1206) from Rep. Mike Rogers (R-Mich.) would alter the law’s medical loss ratio (MLR) by excluding insurance brokers’ fees from counting as administrative costs under the requirement. The medical loss ratio mandates that insurers spend no less than about 80 percent of their premiums on medical care rather than administrative costs or profit, or rebate the difference to policyholders. Democrats and the Obama administration have praised the policy for producing more than $1 billion in consumer rebates this year (Viebeck, 9/18).

Meanwhile, a Senate subcommittee releases a report questioning the oversight of disability benefits –

The Hill: Report: Disability Benefits Wrongly Awarded
Lax oversight is leading the government to approve disability benefits for people who can’t prove that they’re disabled, according to a report released Tuesday by a Senate subcommittee. The report, spearheaded by Sen. Tom Coburn (R-Okla.), says more than a quarter of disability claims are approved despite inadequate or conflicting information. That doesn’t necessarily mean all of those claims should have been rejected, Coburn said at a hearing Tuesday — but some unfounded approvals are surely slipping through the cracks of an inadequate review process. The report does not address people who might have been wrongly denied disability benefits (Baker, 9/18).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

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