Regulating the Medical Loss Ratio: Implications for the Individual Market

“In 2009, using a PPACA-adjusted MLR
definition, we estimated that 29% of insurer-state
observations in the individual market would have
MLRs below the 80% minimum, corresponding to
32% of total enrollment. Nine states would have
at least one-half of their health insurers below the
threshold. If insurers below the MLR threshold
exit the market, major coverage disruption could
occur for those in poor health; we estimated
the range to be between 104,624 and 158,736
member-years.”