Analyzing the impact of the medical loss ratio under health reform on the individual market for coverage in each state

The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.The purpose of this project is to estimate the potential impact of the minimum 80 percent medical loss ratio (MLR) threshold mandated by PPACA for insurers in the individual market in each state Using data from the NAIC, the researchers will: (1) estimate the number of market insurers in each state that, based on current business operations, would not meet the minimum 80 percent MLR; (2) estimate the corresponding enrollment of these insurers; (3) analyze volatility in member months, premiums per member per month (PMPM), claims PMPM, and MLRs within states for 2001-2009 in order to establish a baseline for individual market functioning prior to MLR implementation; and (4) document the strengths and weaknesses of the NAIC data as a tool for predicting the impact of the minimum MLR requirement in each state on market stability. Deliverables will include a project work plan, a final narrative and financial report, and a final policy summary. The grantee will also produce paper(s) and a technical appendix suitable for publication as deliverables of this project.

Grant Details

Amount Awarded $46,873.00

Awarded on: 8/26/2010

Time frame: 9/15/2010 - 8/31/2011

Grant Number: 68185


University of Minnesota

University of Minnesota
100 Church Street, S.E., Morrill Hall
Minneapolis, 55455-0110


Jean Marie Abraham
Project Director