2010 Insurance Rebates Would Have Hit $2 Billion, Study Says - 麻豆女优 Health News /news/2010-insurance-rebates-would-have-hit-2-billion-study-says/ 麻豆女优 Health News produces in-depth journalism on health issues and is a core operating program of 麻豆女优. Thu, 16 Apr 2026 05:30:28 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.5 /wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=32 2010 Insurance Rebates Would Have Hit $2 Billion, Study Says - 麻豆女优 Health News /news/2010-insurance-rebates-would-have-hit-2-billion-study-says/ 32 32 161476233 2010 Insurance Rebates Would Have Hit $2 Billion, Study Says /news/2010-insurance-rebates-would-have-hit-2-billion-study-says/ /news/2010-insurance-rebates-would-have-hit-2-billion-study-says/#respond Thu, 05 Apr 2012 10:12:42 +0000 http://khn.wp.alley.ws/news/2010-insurance-rebates-would-have-hit-2-billion-study-says/ Consumers would have received rebates of聽nearly $2 billion — in some cases as much as聽$300 a聽member —聽if the health-law cap on insurance profits and overhead had been in place in 2010,聽.

The whole point of the nation’s conversation about health reform has been to find ways to spend differently so that the result is a higher quality, more humane health care system.

The paper,聽published Thursday by the Commonwealth Fund, makes no predictions about the rebates聽that insurers will be required to pay this year for the first time. But the study shows聽that insurers have been spending聽more on administrative costs than what the聽health law聽will allow,聽said Sara Collins, a Commonwealth Fund economist.

“The United States has聽insurer administrative聽costs that exceed those of private insurance companies in other industrialized countries,” she said.聽 “It’s an indication that there is waste in the system that can be reduced.”

The 2010 Affordable Care Act allows聽insurers to devote聽no more than 15 to 20 percent of their revenue,聽in most cases, to聽overhead, profits, executive pay and the like. (This is the mirror聽of the requirement that they spend at least 80 to 85 percent聽of their revenue on medical care and quality improvements.)

Anything over the cap must be returned to the plan members and employers聽who pay聽the premiums. The rules for what’s known as the medical loss ratio took聽effect for 2011, with rebate checks of an undetermined amount scheduled to be sent out in August.

If the cap had been in place for 2010, nearly聽a fourth of privately insured consumers would have received rebates, the study said. More than half of those with individual coverage would have pocketed refunds. Rebates would聽typically have been聽$100 to $300 per member, the study said.

Texas insurance customers collectively would have received the most in rebates — $255 million — followed by those in Florida, who would have gotten聽$202 million. One fifth of nonprofit insurers would have owed rebates. Among聽for-profit plans, 70 percent聽would have been required to send rebate checks,聽said the study, which was conducted by Mark Hall of Wake Forest University and Michael McCue of Virginia Commonwealth University.

While 2011 insurer profits were substantial, some have suggested that moves by the industry聽to lower premiums last year will reduce rebates owed this year.

“Given the unpredictable nature of health care costs, it’s not surprising that some health care plans expect to pay rebates to consumers in some markets,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, an industry lobby. “But the amount — and to whom and in what markets — we’ll find out when they’re filed in June.”

Even though the study doesn’t predict how much in rebates will聽be paid, it gives an idea of the administrative dollars聽that would henceforth聽be devoted to reduced premiums, rebates or medical spending in order for聽the industry to comply with the law, Collins said.

“What you would hope to see over time is a reduction in the premium dollar that goes to profits聽and administrative costs and more of that premium dollar going to medical care,” she said.

AHIP’s Zirkelbach, on the other hand, said administrative spending ratios have declined. And he portrayed profits and administrative costs as minor factors in the big picture of health expense.

“This arbitrary cap on health care administrative costs does nothing to affect the real drivers of premium increases,” he said. “It doesn’t get at the underlying medical costs that are contributing to those increases.”

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