“Republicans and a Democrat on a House Small Business subcommittee Dec. 15 expressed concerns that a key insurance requirement of the health care reform law will reduce competition and harm health insurance brokers… The Patient Protection and Affordable Care Act‘s medical loss ratio (MLR) provision, which requires insurers to spend at least 80 percent of premiums on medical claims or quality improvements in the individual and small group markets and at least 85 percent in the large group market, is likely to deter small insurers from entering the market and lead to established insurers leaving the market, Coffman said.”