HHS Denies Texas’ Request For MLR Waiver

On Friday, the Department of Health and Human Services rejected Texas' request to delay implementation of the health law's medical-loss ratio requirement.

The Dallas Morning News: Feds Reject Texas' Pleas To Slash Health Insurance Rebates 
The federal government on Friday refused to let Texas ease a requirement that health insurers devote at least 80 percent of premium revenue to medical care. The new federal rule, which makes insurers falling short of the mark pay back the difference to consumers, will bring rebate checks on last year's premiums to hundreds of thousands of Texans by August. Officials of the U.S. Department of Health and Human Services said Texas insurance regulators did not convincingly back up their claim that immediate enforcement of the medical-spending minimums would disrupt the state's "individual market" (Garrett, 1/27).

Texas Tribune: Feds Reject Texas' Request To Delay Insurance Reform
The U.S. Department of Health and Human Services has rejected the Texas Department of Insurance's proposal to delay implementation of a federal health care reform provision aimed at curbing rising premiums. Under the federal Affordable Care Act, starting in 2012, insurance companies are required to maintain a "medical loss ratio," or MLR, of 80/20 for individual insurance plans and 85/15 for the employer-provided insurance market starting. Put simply, that means insurance companies must devote 80 or 85 percent of premium dollars directly to health care services, and refund policyholders at the end of the year for spending on overhead costs above 20 or 15 percent. The intention of the provision is to pressure insurance providers to cut down on administrative, marketing and other non-health related operating costs in order to curb rising premiums (Aaronson, 1/27).

The Hill: Texas Will Not Receive A Health Care Waiver
The Health and Human Services Department on Friday denied Texas's request for an adjustment to new rules under the healthcare reform law that govern insurers' spending. The law says policies sold to individuals must spend 80 percent of their premiums on medical costs, leaving the other 20 percent for administrative costs and profit. HHS denied Texas's request to phase in that standard over three years (Baker, 1/27).

CQ HealthBeat: HHS Gives Texas MLR Request A Thumbs Down; Wisconsin And North Carolina Up Next
Department of Health and Human Services officials announced Friday that they’ve turned down a closely watched request by Texas officials to delay implementation of medical payout standards required under the health care law. Gary Cohen, acting director of oversight for the Center for Consumer Information and Insurance Oversight, told reporters in a conference call that federal officials found there is a "very robust and competitive" individual insurance market in Texas so there was no need to give the state’s insurance industry more time to comply (Norman, 1/27).

Modern Healthcare: Feds Reject Texas Request For MLR Waiver
Texas became the ninth state for which the Obama administration rejected a temporary waiver of the insurance market requirements in the 2010 federal healthcare overhaul. The state had sought a temporary adjustment of the Patient Protection and Affordable Care Act's medical-loss ratio requirement that insurance plans devote a minimum percentage of their budgets to pay for the care of enrollees... Texas requested an adjustment of the standard to 71% last year, 74% in 2012 and 77% in 2013 (Daly, 1/27).