Health insurers are having a banner year, driven by delayed or canceled medical procedures amid the pandemic. And it turns out, that's good news for consumers, who will once again see record-setting rebates as a result of the Medical Loss Ratio provision put into place under the Affordable Care Act. The regulation requires 80% to 85% of premium revenues to go to consumers' medical costs. MLR rebates have been increasing in the last several years amid uncertainty in the health care market. In 2019, insurers increased rates in anticipation of increased costs due to the lost risk-corridor subsidies and repeal of the individual mandate--but that didn't happen. Related: MLR vs market share, part 1: The argument Now, insurers will pay out more than $2.5 billion to some 11.2 million qualifying individuals, according to the most recent CMS data. That comes out to an average of $219 per person--though those who shopped the ACA markets can expect to see more ($322 per person) and those in small-group plans will see less ($124 per person). Note that those are rebates for premiums paid in 2019--before the pandemic began and health care utilization plummeted. "The MLR rebates next year are likely to make the MLR rebates paid out this year look small in comparison … even if utilization returns to baseline or above baseline in the latter half of 2020, as some insurers have indicated," Daniel McDermott, a research associate at the Kaiser Family Foundation, told Modern Healthcare. How much of the MLR rebate pot will your state get? Check out the slideshow above to see which states top the list, or check out CMS's database. Read more: |

• MLR has saved consumers $5 billion
• Low 2016 individual health margins trimmed insurers' rebate bills
• 7 ways brokers can be excluded from MLR