Did You Get Your ObamaCare Letter Yet?

Cindy Simpson
I got my ObamaCare letter yesterday.  Lately I've been so caught up in the other troubling aspects of the AFA -- like the contraceptive mandate and the Supreme Court ruling on the penalty/tax -- that the "Medical Loss Ratio" rule had fallen off my radar screen.

But health insurers certainly haven't been able to forget about it.  Here's an excerpt of the letter I received from my insurer, which was described in the header as "informational only per government requirements":

The Affordable Care Act requires health insurers in the individual and small group markets to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality...If a health insurer does not spend at least 80 percent...[it] must rebate the difference.

The 2011 ratios were required to be calculated and rebates issued no later than August 1, 2012.

I wasn't surprised to not receive a rebate, but was floored to think of the implications of that letter:  Our government has actually granted itself the power to define via thousands of pages of new regulations ("and they're not even done yet"), specific practices, procedures, and limitations on the profits of a private industry.

Numerous factors that affect profits are out of the insurer's direct control, and nebulous terms like "services," "activities," and "quality" open the door for some creative accounting. And it's reasonable to question whether profit limitations truly benefit the insured if such limits also diminish the insurer's ability and incentive to improve the quality of its operations.  At the very least such rules give unelected HHS officials the power to exert lots of discretion, as it has already proven with the grant of numerous waivers and the contraception mandate.

Attorney Van Irion of the Liberty Legal Foundation, upon receiving his letter, published an article asserting that the precedent of the ObamaCare rebate "ends capitalism" and is indicative of the government's desire to destroy the market so it can take it over.

That day of destruction, intended or not, may come sooner than we realize.  Thousands of businesses are poised to drop their employee health insurance programs, finding it more cost-effective to pay the penalty. Thousands of individuals will do the same and only get insurance when they need it (since there are no more pre-existing condition exclusions).  Private insurers, like doctors, will probably exit the market in droves.

If government can pick winners then pull the strings in auto manufacturing, energy, banking and now the health insurance and health care industries, we can't help but wonder, like Irion, what's next.  Might the government require us to eat that broccoli after all? Such a slippery slope may logically lead not only to broccoli mandates, but also to requirements that grocers give away the veggies for free and have their profits limited under food distribution service and quality quotas.

Where does it end?  ObamaCare is an unhealthy recipe for disaster, with government intruding in the privacy of our doctor's offices, killing jobs in the private sector, and creating yet more government jobs to enforce the madness.  Hopefully we can put a stop to the nonsense before it's too late.


I got my ObamaCare letter yesterday.  Lately I've been so caught up in the other troubling aspects of the AFA -- like the contraceptive mandate and the Supreme Court ruling on the penalty/tax -- that the "Medical Loss Ratio" rule had fallen off my radar screen.

But health insurers certainly haven't been able to forget about it.  Here's an excerpt of the letter I received from my insurer, which was described in the header as "informational only per government requirements":

The Affordable Care Act requires health insurers in the individual and small group markets to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality...If a health insurer does not spend at least 80 percent...[it] must rebate the difference.

The 2011 ratios were required to be calculated and rebates issued no later than August 1, 2012.

I wasn't surprised to not receive a rebate, but was floored to think of the implications of that letter:  Our government has actually granted itself the power to define via thousands of pages of new regulations ("and they're not even done yet"), specific practices, procedures, and limitations on the profits of a private industry.

Numerous factors that affect profits are out of the insurer's direct control, and nebulous terms like "services," "activities," and "quality" open the door for some creative accounting. And it's reasonable to question whether profit limitations truly benefit the insured if such limits also diminish the insurer's ability and incentive to improve the quality of its operations.  At the very least such rules give unelected HHS officials the power to exert lots of discretion, as it has already proven with the grant of numerous waivers and the contraception mandate.

Attorney Van Irion of the Liberty Legal Foundation, upon receiving his letter, published an article asserting that the precedent of the ObamaCare rebate "ends capitalism" and is indicative of the government's desire to destroy the market so it can take it over.

That day of destruction, intended or not, may come sooner than we realize.  Thousands of businesses are poised to drop their employee health insurance programs, finding it more cost-effective to pay the penalty. Thousands of individuals will do the same and only get insurance when they need it (since there are no more pre-existing condition exclusions).  Private insurers, like doctors, will probably exit the market in droves.

If government can pick winners then pull the strings in auto manufacturing, energy, banking and now the health insurance and health care industries, we can't help but wonder, like Irion, what's next.  Might the government require us to eat that broccoli after all? Such a slippery slope may logically lead not only to broccoli mandates, but also to requirements that grocers give away the veggies for free and have their profits limited under food distribution service and quality quotas.

Where does it end?  ObamaCare is an unhealthy recipe for disaster, with government intruding in the privacy of our doctor's offices, killing jobs in the private sector, and creating yet more government jobs to enforce the madness.  Hopefully we can put a stop to the nonsense before it's too late.