Image: VeracityStew.com / Obama: Flickr/DonkeyHotey
The Affordable Care Act (known to all as “ObamaCare”) contains an 80/20 rule. Your HMO must spend at least 80% of your premium on health care and health-related services, or they must refund the difference to you. Through something known as the Medical Loss Ratio, the average amount your health care provider spent on patient care is calculated for each state. If the average amount your HMO spent falls X% below the 80% target, then each policy covered by that HMO within your state will be reimbursed X% of their respective premiums.
According to the Kaiser Family Foundation:
Image: VeracityStew.com
[C]onsumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the ACA. The rebates include $541 million in the large employer market, $377 million in the small business market, and $426 million for those buying insurance on their own. Rebates in the group market will generally be provided to employers, and in some cases be passed on to employees as well. The size of the checks will vary, but for many working Americans, they are likely to be the most tangible, and welcome, sign of the law’s benefits.
The size of the checks will vary, but for many working Americans, they are likely to be the most tangible, and welcome, sign of the law’s benefits. TIME provides a partial breakdown of disbursements by state:
| STATE | NUMBER OF RECIPIENTS | TOTAL DISBURSEMENT |
| Colorado | 511.684 | $25,725,984 |
| Florida | 1,753,065 | $148,589,661 |
| Iowa | 66,040 | $1,239,379 |
| Michigan | 144,542 | $18,995,911 |
| Nevada | 75,633 | $8,771,820 |
| New Hampshire | 3,884 | $244,132 |
| Ohio | 211,930 | $10,727,574 |
| Pennsylvania | 1,064,019 | $104,533,779 |
| Virginia | 642,886 | $40,896,992 |
Kathleen Sebelius says it well in her blog post:
When we pay for health insurance, we want to know that most of what we are paying for is for health care, not advertising, executive bonuses or overhead. It’s pretty simple: we want to get a good value for our premium dollars.
We concur Madame Secretary; and those Republicans who want to repeal ObamaCare can keep their Mitts off our money!
Thank you, Mr. President!
It’s sad that the GOP want to repeal what Mittens had already placed in Massachusetts as the model for Obamacare.
Does the Supreme Court even know this? I’ll bet they do.
Schuyler, it’s all hypocrisy. This law makes it hard for insurers to raise your premiums. If they fall below 80%, they’d have an even bigger check to pay out.
The states got cash back, Medicare looses $500 million, providers loose 30% of their cash, they leave the plan, the insurers drop advantage plan members and leave seniors on under the funded medicare, no original advantage plans survive, THAT IS THE OBJECTIVE. GET ANYONE ON A GOOD PLAN WITH GOOD CARE IN THE GROWING POOL OF THOSE IN JUNK PLANS. (ObamaCare)
The worst is that we fall for it, because of simple minded stories like this.
Mr Ellridge, since your feeble mind cannot grasp the significance of HEALTH CARE REGULATION and it’s beneficial effects there are to ordinary people that DO NOT HAVE SUCH MENTAL PROBLEMS, amazes me. The Affordable Care Act was developed WITHIN THE HOUSE AND SENATE CONFEREES, President Obama had VERY LITTLE to do with any of it’s befits, ALL OF THIS WAS DONE BY CONGRESS. The ONLY reason it is called Obamacare is the desire of sick teapublicraps to equate this lifesaving health care reform TO A BLACK MAN,……….Your racist bigotry is visible for all to see while you wrap yourself in a religious piousness that frankly exposes your stupidity. You may have the ability to post a comment, but some understand the underling reasoning, YOU WILL NEVER PERMIT FREEDOM FOR ANYONE ELSE, YOUR BUBBLE WILL BURST SOON AND YOU HAVE NO ONE ELSE TO BLAME, Your ignorance is profound!
seriously?!?! he didn’t even mention race. he barely mentioned the president. not even in pronoun form.
well played race card though. completely distracted from the fact the medicare is going to go bankrupt under ACA.
Mike – Well played Fox News education card by repeating canned talking points not based on reality — especially in light of SCOTUS ruling this morning… “bankrupt.” — Debate is welcome, your Fox News education is not.
Will not go bankrupt – they need to raise deduction from 1.45% – small amt will do it – plus they are changing the health care system from a sickness system to a wellness system – over the course of two decades the cost curve will go down.
Medicare Advantage was never meant to be advantageous for the doctors but for the patients – eliminating the overpayment to doctors on that system will probably mean it will go away and everyone will be on regular medicare as it should be. Anyone who is unable to handle the 20% and can’t afford supplements there are programs to take care of that
Well said, Ray Foret. They scout around on Drudge to get the talking points that they cut and paste on every site without giving a thought to what they are saying. Without even a clue about how the government works.
Ray, Karen, Stew and Schulyer……..THANK all of you for demonstrating how logic, common sense & math works. I’ve never seen so many ignorant tea baggery comments and hyperbole ever since the Supreme Court’s decision.!
I’m sure this is what it sounded like when SS was implemented as well! OMG, Medicare is “loosing” (it’s losing, you uneducated losers) XXXXXX dollars!!!!
If you repeated their vacuous thoughts back to them, they would just nod cuz they don’t even hear themselves speak. Try it sometime.! I like to insult them to their faces and they just smile and think you are complimenting them.
Thanks, Ray Foret, from someone who is age 51, on SSDI and Medicare, for something she was born with, which tried to kill her in her mid 30s and did kill her grandfather at 39…I just want to be able to live long enough to bury my elderly parents, after they’ve had the chance to see a great grandchild from both granddaughters…I have learned that I cannot take it for granted that that will ever happened, thanks to the so-called, self-styled “good people” out there…