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MLR ratio wrangling heats up as Dems try to resurrect public insurance

Officials with the National Association of Insurance Commissioners (NAIC) have told CQ HealthBeat that the U.S. Department of Health and Human Services likely will see by mid-August the NAIC's final recommendations for what services should count toward health insurers' medical costs under the health reform-mandated medical-loss ratios, reports California Healthline. The news comes amid a swirl of activity.

First, the trade association America's Health Insurance Plans (AHIP), as well as individual health insurers, are chiming in with last-minute ratio suggestions to limit market disruptions even as two U.S. senators and a consumer group call for tight definitions to reduce the possibility than insurers can abuse the system. Senator John Rockefeller (D-W. Va.) sent a letter to the NAIC because he was worried that insurers will have too strong an influence on the NAIC's decision, reports the New York Times. Similarly, Sen. Al Franken (D-Minn.) joined with the group Health Care for America Now to call for strict definitions, reports The Hill.

Second, Rep. Pete Stark (D-Calif.), chairman of the House Ways and Means health subcommittee, joined 128 Democrat co-sponsors to introduce legislation to create a public health insurance option in the health insurance exchanges, reports USA Today. A public health plan could reduce the federal deficit by $53 billion by 2019, estimates the Congressional Budget Office (CBO).

To learn more:
- read this California Healthline article
- read this New York Times article
- read this article at The Hill
- read the AHIP medical-loss ratio report
- read Sen. Rockefeller's letter
- read this Washington Post article
-read this USA Today article
- read the CBO analysis
- read Congressman Stark's press release

Related Articles:
Maine seeks waiver from medical-loss ratio requirements
Medical-loss ratios: Rockefeller jumps into fray; insurers could abandon markets

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