[T]he MLR caps will also limit innovation. Right now, expenses that are on a pre-approved, government list of “activities that improve health care quality” are not included in the cost of administration and so don’t count against the 20 percent cap on what plans get to spend on overhead. If a health plan comes up with a new business approach that it believes improves quality and outcomes, it will be forced to count the costs against its allowable profits. It can’t incorporate the cost into the total money it spends on healthcare if the new scheme isn’t on the government list.”