Maine's MLR exemption leads to bill for individual waivers

After Maine received the first waiver exempting its health insurers from the medical-loss ratio requirement and the Obama administration announced it has granted more than 1,000 waivers to mini-med health plans, one House Republican wants individuals to be eligible for similar exemptions under the healthcare reform law.

Rep. Mike Rogers (R-Mich.) says his proposed legislation would give consumers an opportunity similar to that already enjoyed by employers and unions to win exemptions if the new law significantly increases their premiums or decreases their access to insurance coverage, according to the Wall Street Journal.

"It's a matter of fairness. Every American and employer deserves the opportunity to receive a waiver from the new healthcare law if it's driving up costs and limiting services, not just the politically connected," Rogers said, reports The Hill’s Healthwatch.

The interest in waivers from the health reform law has piqued since HHS issued one to Maine, which requested the exemption because one of its three major insurers offering individual plans would withdraw from the market altogether if the federal requirement remained in place. The insurer, MEGA Life and Health Insurance Co., has 37 percent of the state's individual market, but HHS still concluded its departure would likely destabilize the individual market, according to the Associated Press.

Additionally, HHS has approved 94 percent of waiver requests for mini-med plans it received, totaling 1,040 waivers. The waiver affecting the largest group of enrollees was granted in September to the United Federation of Teachers Welfare Fund in New York, whose mini-med plan has 351,000 enrollees, Business Insurance reports.

To learn more:
- read The Hill’s Healthwatch story
- see the Wall Street Journal article
- check out the Associated Press piece
- read the Business Insurance article

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