Maine is the first U.S. state granted a three-year waiver against the Obama Administration's healthcare reform regulations that require health insurers to spend at least 80 percent of premium dollars on patient care, the Associated Press reports.
After concluding that the new federal spending requirement could destabilize Maine's individual health insurance market, the U.S. Department of Health and Human Services said March 8 that Maine's insurers may maintain their current ratio of 65 percent.
Strongly factoring into the decision is that the state has an unstable individual market serviced by just three major health insurers -- Anthem Blue Cross Blue Shield of Maine, MEGA Life & Health Insurance Company and HPHC Insurance Company. Maine's Insurance Superintendent had argued that the federal requirement would have caused at least one of the insurers to pull out of the state.
The decision makes Maine the first state to receive a waiver from the medical-loss ratio rule. Although the exemption will last through 2013, the agency plans to review the status of the individual market after two years, notes the AP.
The federal government is currently reviewing similar MLR waiver requests from Kentucky, Nevada and New Hampshire.