Rick Scott Trying To Protect Insurers From Paying Rebates To 340,000 Florida Policy Holders

Gov. Rick Scott’s (R-FL) dogged insistence on rejecting federal funds associated with the Affordable Care Act may cause some 340,000 Floridians to “miss out on an estimated $60 million in health-insurance rebates next year,” Carol Gentry of Health News Florida reports. The money is part of the law’s medical loss ratio (MLR) provisions, which aim at tamping down industry profits by requiring insurers that don’t spend 80 to 85 percent of premium dollars on health care to reimburse policy holders. Florida’s insurance department (OIR) initially requested “a waiver of the rebates for companies operating in this state,” but is now calling for a phase in of the rule:

Consumer groups are angry, accusing OIR of protecting insurers at the expense of the public. In a May 25 letter to the Department of Health and Human Services, five of them asked for a public hearing . […]

If the waiver is granted, limits on MLR in Florida’s individual market would be 68 percent for this year, 72 percent next year and 76 percent in 2013. Not until 2014 would companies have to comply with the provisions of the 80-percent spending rule in the act. […]

Customers who have the most riding on the HHS decision are the 118,000 individual policyholders of Golden Rule Insurance Co., a subsidiary of the giant United Health Group. Estimates based on data from 2009 and 2010 indicate that if the Obama administration doesn’t grant a waiver, Golden Rule would owe Floridians $32.8 million next year.


Scott has turned down millions of health care funds, arguing that Florida would not accept federal grants from a law that he sees as unconstitutional. But this time, “the money doesn’t come from taxpayers, but from insurers. Those who would receive the money are self-employed workers and others who don’t have access to a group plan.”