The most important question of the bill when it comes out of conference:

grantcart

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Thu Dec-17-09 10:55 PM
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The most important question of the bill when it comes out of conference:

In exchange for dropping the Public Option and Medicare Buy In, Senator Rockfeller was all smiles saying that he got an ammendment that would establish a Medical Loss Ratio at 85 or 90%. This would mean that it would be only 7% off of Medicare's 97%.

So far so good.

But no one is talking about the Medical Loss Ratio anymore. Why not? So I started digging around.

Frankly if it has a high Medical Loss Ratio (that was honestly applied) then it could be even better than a weak Public Option.

In fact the CBO says that it would be a de facto nationalization of health care:

http://wonkroom.thinkprogress.org/2009/12/14/cbo-90-mlr/

A proposal to require health insurers to provide rebates to their enrollees to the extent that their medical loss ratios are less than 90 percent would effectively force insurers to achieve a high medical loss ratio. Combining this requirement with the other provisions of the PPACA would greatly restrict flexibility related to the sale and purchase of health insurance. In CBO’s view, this further expansion of the federal government’s role in the health insurance market would make such insurance an essentially governmental program, so that all payments related to health insurance policies should be recorded as cash flows in the federal budget.

So why aren't all the Senators crowing about this??

http://wonkroom.thinkprogress.org/2009/11/16/medical-loss/

Once the bill is enacted, all health insurance plans would be required to spend at least 85 cents of every dollar paid in premiums each year to providing actual health care. If, in a given year, an insurer doesn’t spend that amount on health care, they would have to give their extra profit back to their customers in the form of rebates. <...>

But there’s a twist to all of this. The version of the bill that was passed by the House last weekend includes the provision, but also includes some curious, new “sunset” language. The sunset language states that the new minimum medical loss ratio requirements “shall not apply to health insurance coverage on and after the first date that health insurance coverage is offered through the Health Insurance Exchange.” In other words, in 2013, when most of the bill takes effect, the medical loss ratio language would be null and void. There would be no more profit control, just the market competition that is provided by whatever form of the public option is included in the bill.

The key and most important benefit of the bill, a tough medical loss ratio, expires at the time the bill takes effect.

So in the final bill - does it have a medical loss ratio? does it have a sunset year?

If you pass a bill with 90% medical loss ratio and no sunset then it would actually be a better bill than the House Bill.

The chance of that getting 60 votes in the Senate?