Feds Gives Maine A Break From Insurance Premium Rules

Maine was granted leeway — the first such waiver given by the federal government — with the health law provision known as the medical-loss ratio because of concerns it would destabilize the state's insurance market.

The Associated Press: Maine Gets Break In Federal Health Care Overhaul
The federal government Tuesday granted Maine a waiver of a key provision in President Barack Obama's health care overhaul, citing the likelihood that enforcement could destabilize the state's market for individual health insurance (Sharp, 3/8).

Bloomberg: Maine Wins First Waiver To Health Insurance Premium Rules
The state of Maine received a three-year waiver to federal rules in the 2010 health law that require health insurers to spend at least 80 percent of premiums on patient care, the U.S. government said today. Maine's waiver is the first the government has granted on the premium expenditure rules. Insurers in the state selling policies to individuals will have to spend only 65 percent of premiums on patients, with the rest going toward profits and administrative costs. The exemption will last through 2013, U.S. regulators said today in a letter to the state. The spending requirement "has a reasonable likelihood of destabilizing the Maine individual health insurance market," wrote Steve Larsen, deputy administrator of the Center for Consumer Information and Insurance Oversight. The office is part of the Department of Health and Human Services, which is implementing the law signed by President Barack Obama in March 2010 (Armstrong, 3/8).

Modern Healthcare: Maine Insurers Get Medical-Loss Leeway
Maine has been granted a three-year reprieve on a federal requirement that 80 percent of individual policyholders' premium dollars be spent on direct medical costs. Maine is the first state to receive HHS permission to forgo this rule. Insurers in the state must instead meet a lower threshold of spending at least 65 percent of member premiums on direct medical costs. The adjustment applies to the individual insurance market only, representing nearly 37,000 Maine residents (Vesely, 3/8).

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