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Consumers Reap $3 Billion in Benefits from Affordable Care Act Provision

The Affordable Care Act's medical loss ratio provision has benefited consumers to the tune of more than $3 billion in 2011 and 2012, either through the rebates that insurance companies have paid to them or through reduced health plan spending on overhead, according to a Commonwealth Fund report. Under the rule, insurers are required to spend 80 percent (for small-group and individual plans) or 85 percent (for large-group plans) of premiums on actual medical care and quality improvement activities.

According to researchers Michael McCue of Virginia Commonwealth University and Mark Hall of Wake Forest School of Law, insurers in 2012 paid out $513 million in consumer rebates, down nearly a half from the $1 billion paid to consumers in 2011—an indication, they say, that insurers were in greater compliance with the requirements.

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