"In less than three months time [MLR requirements] have had a devastating financial impact on the collective membership of our associations, our members' employees, and on the millions of employer and individual clients of our members," reads a letter from The Agent/Broker Alliance, which represents more than 500,000 state-licensed producers, to Florida Insurance Commissioner Kevin McCarty, chair of the Professional Health Insurance Advisors Task Force at the National Association of Insurance Commissioners. The task force will convene on March 27 in Austin to discuss the impact of medical loss ratio requirements on health insurance brokers/agents.

"In every state, as a direct result of the new law's MLR provisions, agency owners are reporting that they are reducing services to their clients, cutting benefits and eliminating jobs just to stay in business. At the same time, health insurance purchasers have more need for help than ever due to market and compliance changes related to PPACA," the letter continues.

"Since the interim final rule on MLR was issued by the Department of Health and Human Services (HHS) on December 1, 2010, health insurance carriers across the country have had to reduce the amount of commissions they imbed in health insurance premiums. Our members report that most health insurance carriers changed commission rates as of January 1, 2011, the date the MLR rule became effective.

"The majority of carriers have imposed the commission reductions on newly placed business, but a number of carriers across the country have also modified commissions for existing health insurance contracts. Those health insurance carriers that did not make commission changes for 2011 almost universally report to our membership that, unless a change is made in the MLR rules this year, they will be forced to reduce the amount of producer commissions from 2012 and beyond."

Democratic Sen. Al Franken of Minnesota expressed his concern that the House bill would undermine the medical loss ratio provision he championed last year. The senator fought for reformed MLR regulation because of its potential to bring down health costs and expand coverage for consumers.

In a letter to the leadership of two key committees that wrote the health care law in 2010, Sen. Franken urged them to protect the medical loss ratio requirement: "I'm gravely concerned that a bill recently introduced in the House of Representatives would undermine the integrity of the MLR provision by allowing money that should be spent on health care costs to be spent on commissions for insurance agents and brokers.

"American families should not have to shoulder those fees through further increases to their health insurance premiums. I hope you will join me in protecting American families from unsustainable increases in their health insurance premiums by opposing any similar legislation coming before your committees."

The letter was sent to HELP Chairman Tom Harkin, D-Iowa, HELP Ranking Member Mike Enzi, R-Wyo., Finance Chairman Max Baucus, D-Mont., and Finance Ranking Member Orrin Hatch, R-Utah.