Obamacare Rebates Totaling $1 Billion Due by Sept. 30

According to the “medical loss ratio” provision of the Affordable Care Act (ACA, or Obamacare), insurers must rebate excess premiums by Sept. 30 each year. The estimated tab for this fall is approximately $1 billion, according to estimates, as refunds are due for 2016, 2017 and 2018.

obamacare-enrollment-endsThe rebates will average about $200 for an individual and $600 for a family of three, but instead of checks, consumers will receive vouchers for future premiums. Next year, on the eve of the 2020 election, consumers could receive vouchers worth almost $5 billion, according to a report by Bloomberg Law.

Under the ACA’s medical loss ratio requirement, insurers must spend at least 80 percent of premiums in the individual and small group markets on medical claims or quality improvements. If they spend less than that, they must refund the difference to consumers.

In 2017, insurers doled out $706 million. The upcoming refunds reflect huge premium increases that insurers instituted when the Trump administration ended cost-sharing reduction (CSR)  payments and also zeroed out the individual mandate penalty.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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