Wednesday, November 20, 2019

Why MLR is such a joke

It's been a while since we last visited MLR (Medical Loss Ratio):

"In case you didn't know, the ACA requires carriers to pay out (at least) 80% of premiums collected in claims. For large groups, that requirement is 85%. Anything less and they have to send the difference to their insureds."

The idea was to encourage (require) carriers to be more carful stewards of the premiums they receive and their obligation to pay out as much of those in claims as possible.

Anyone else see the glaring logical fallacy here?

Well, FoIB Ed Swan sure did:

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