Health insurers in Indiana and Louisiana won't get a temporary reprieve from complying with the medical-loss ratio (MLR) requirements after the Department of Health & Human Services (HHS) denied the states' waiver requests.
In Indiana, WellPoint would have benefited most from a waiver because it represents more than 60 percent of the individual market, while in Louisiana, Humana stood to gain the most from an MLR waiver, Bloomberg reports.
Indiana requested several adjustments, including a longer phase-in period, reaching 80 percent by 2015, beyond the MLR regulation. In its denial letter, HHS said only one insurer in Indiana's individual market would no longer be profitable after granting a MLR rebate if the standard were in effect today. However, that insurer has begun adapting its business practices to conform to the MLR requirements, according to Politico.
Louisiana, meanwhile, asked for an adjustment that would have lowered the MLR threshold to 70 percent in 2011 and 75 percent in 2012. But HHS disagreed with the state's claim that health reform already was forcing insurers out of the individual market, saying the two insurers that withdrew weren't active in the individual market and another insurer that left the state had only 12 people covered in the individual market.
In denying Indiana's and Louisiana's requests, HHS now has outright refused to grant four MLR waivers after it blocked requests from Delaware and North Dakota. The decision might reignite disputes over the waiver process since both Indiana and Louisiana have Republican governors, many of whom have been extremely critical of health reform's requirements for states, reports The Hill's Healthwatch.
HHS has granted waivers to Maine, New Hampshire, Kentucky, Nevada, Iowa, Georgia, and Wisconsin.
To learn more:
- read the Politico article
- see the Bloomberg article
- check out the Healthwatch article
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