Florida to seek waiver from health reform's medical loss ratio requirement

Florida's 14-member insurance advisory board has unanimously passed a resolution to seek a waiver from the health reform law's medical loss ratio.

An official with the Florida Office of Insurance Regulation tells The Hill that the board's vote means it's a "done deal" that the state will formally seek some kind of waiver but the board is gathering public input through Oct. 8. The resolution was adopted Friday during a hearing on the medical loss ratio, requested by Insurance Commissioner - and board chairman - Kevin McCarty.

Florida would become the third state to request a waiver, following Maine and Iowa. The health reform law requires health plans to spend at least 80 percent of premiums (85 percent in the large-group market) on care or give consumers rebates starting in 2012.

McCarty called the evidentiary hearing with the stated purpose of gathering ammunition for a formal waiver request. He said federal regulators demanded detailed testimony if they're going to entertain granting a waiver or phase-in.

"I am concerned that the Medical Loss Ratio requirements included in the Affordable Care Act could cause disruptions in the Florida health insurance marketplace," McCarty (R) said in a statement. "I am especially concerned about how the MLR requirements will affect the role of health care agents who are critically necessary to help consumers in this increasingly complicated health care landscape."

Representatives from Aetna, AvMed Health Plans, Golden Rule (a subsidiary of United Healthcare) and U.S. Health Plans testified, as did the agent trade group National Association of Insurance and Financial Advisors. The Florida Alliance for Retired Americans offered a lone voice of support for the medical loss ratio, defending it as an important tool to help control healthcare costs.

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