Another state wants healthcare reform waiver

North Dakota has joined a handful of states in asking the Obama administration for relief from a provision of the landmark healthcare law enacted almost a year ago.

The state’s insurance commissioner late Friday filed for a temporary waiver from a new healthcare reform regulation that limits the amount insurers can spend on overhead.

The so-called “medical loss ratio” rule requires insurers to spend at least 80 percent (85 percent in the large group market) of premium dollars on care or provide a rebate to customers for the difference.

North Dakota’s insurance market would be “destabilized” if insurers didn’t have time to adjust to the new regulation, state insurance commissioner Adam Hamm wrote to Health and Human Services Secretary Kathleen Sebelius. Hamm advocates for a gradual phase-in of the new insurance regulation, according to the waiver request obtained by The Hill. 

“Given that several of the companies selling individual policies in the state are relatively small and new to our market, the need for sufficient adjustment time is even more critical,” Hamm wrote. 

North Dakota currently applies a 55 percent medical loss ratio standard. Hamm wants to the state to gradually meet the federal target, with 65 percent in 2011, 70 percent in 2012, 75 percent in 2013 and 80 percent in 2014.

The request comes almost two week after HHS granted Maine insurers the first waiver for the requirement. Georgia, Florida, Kentucky, Nevada and New Hampshire are also seeking such waivers.

Waivers have become a hot-button issue for the administration almost a year into the law’s implementation. HHS has granted temporary waivers to more than a 1,000 companies for a provision that gradually eliminates annual benefits caps. And the administration is backing legislation that would allow states to opt out of the federal reform earlier if they can develop alternatives that meet the law’s access, affordability and coverage goals.