Curtis Bowman

What the Affordable Care Act Has Done for Me - #7

Today, much to my surprise, I received another in a series of rebates of my monthly health care premiums. The Affordable Care Act governs what is known as the Medical Loss Ratio, which I discussed in some of those earlier posts. The MLR is the source of my rebates.

Anyway, I was surprised by my latest check because I had already gotten a check earlier this year. I wasn't expecting a second one.

Unfortunately, the amount was basically trivial, only $7.60, but money is money, so I'm glad to get it.

Over the years my rebates have amounted to $2362.28. That's not much, given the magnitude of my total payments, but it's been welcome nonetheless.

Thanks again, Obama!

What the Affordable Care Act Has Done for Me - #6

This post is the sixth in a series in which I record how I have benefitted from the Affordable Care Act. These posts tell the story of how the Medical Loss Ratio in the ACA has given me a bit of a rebate from time to time.

The good news in 2022 is that I have once again received a rebate. This time I got a check for $175.93, raising the sum total of my rebates to $2354.68.

Unfortunately, I'm currently paying $893 a month for my individual policy from Blue Cross Blue Shield of Texas, and that amount will jump to $981 a month in 2023. Consequently, my latest rebate doesn't do me much good, but, as the old saying goes, it's better than a kick in the teeth, especially since I don't have any dental benefits.

Thanks again, Obama!

What the Affordable Care Act Has Done for Me - #5

In four previous posts I recorded how I had benefitted from the Medical Loss Ratio rule in the Affordable Care Act. Through 2020 I had received checks for a total of $1343.01.

In 2021 I received two more checks from Blue Cross Blue Shield of Texas. The first was a rebate of $141.25 on my premium payments in 2018. The second was a rebate of $694.49 on my premium payments in 2020. The checks arrived in May and August, respectively, but I've been slow to blog about them. I apologize for the delay.

I still pay a ridiculous amount of money for my individual policy. In 2021 my monthly premium was $805, and it's scheduled to go up to $893 in 2022, which means that I'll break the $10,000 threshold next year.

Consequently, I appreciate the rebates. They aren't huge sums of money, but every little bit helps. I've received a grand total of $2178.75 since the Affordable Care Act was enacted in 2010.

Thanks again, Obama! 

What the Affordable Care Act Has Done for Me - #4

In three previous posts I recorded how I had benefitted from the Medical Loss Ratio rule in the Affordable Care Act. Through 2019 I had received checks for a total of $629.77.

Well, dear readers, the good news keeps coming!

Today I opened a letter from Blue Cross Blue Shield of Texas to discover a check for $713.24. That's more than my three previous checks combined! My four checks make for a grand total of $1343.01.

Given that my current monthly premium is $766, this year's rebate doesn't really amount to all that much, but it's welcome nonetheless.

Thanks again, Obama!

What the Affordable Care Act Has Done for Me - #3

In two previous posts I mentioned how I had benefitted from the Medical Loss Ratio rule in the Affordable Care Act. In 2012 and 2013, respectively, I received checks for $357.56 and $75.95.

Blue Cross Blue Shield of Texas did not give me another rebate until this year, when I received a check for $196.76. That means that so far I've received a total of $629.77.

Thanks, Obama!

What the Affordable Care Act Has Done for Me - #2

In a post from just over a year ago I discussed how I had benefitted from the Affordable Care Act. The AFA contains a Medical Loss Ratio rule that stipulates that a health insurance company may spend no more than 20% of premiums on administrative costs. Any excess must be returned to customers in the form of rebates. Last year I received a 7% rebate of my 2011 premiums, for a total of $357.56.

I didn't mention that my premium was reduced at the end of 2011 from $323 a month to $318 a month, and then again in early 2012 to $312 a month. I can only assume that this happened in anticipation of complying with the Medical Loss Ratio rule, although I don't know that for sure. But it makes sense, doesn't it? After all, how often do health insurance companies spontaneously lower their premiums?

Anyway, I recently received another rebate from Blue Cross and Blue Shield of Texas. The rebate for my 2012 premiums was 2.3%, for a total of $75.95. Not much, of course, but better than nothing.

I should mention, though, that my monthly premium for 2013 increased to $345, which means that I'll pay $4140 for my health insurance this year. That is almost three times what I was paying when I started my BCBS policy in the fall of 2003.

What the Affordable Care Act Has Done for Me - #1

When I moved back to Texas in 2003, I had to find new health insurance. It seemed that the company I had been using in Philadelphia didn't underwrite insurance in Texas. I contacted an agent, and he steered me towards Blue Cross Blue Shield of Texas. I applied and was accepted.

Because I'm a self-employed scholar, I wasn't eligible for a group plan. So I had to go with an individual plan with a deductible of $2500. Over the years the cost of this not-very-good policy has risen by roughly 150%. At my current premium of $312 a month, I'm now paying $3744 a year for my coverage.

Because I had health insurance, however mediocre, I never figured that the Affordable Care Act would make much of a difference to me. Turns out that I was wrong about that.

A few days ago I got a surprising letter from BCBSTX. Here are the important excerpts:

The Affordable Care Act requires Blue Cross and Blue Shield of Texas (BCBSTX) to issue a rebate to you if BCBSTX does not spend at least 80 percent of the premiums it receives on health care services, such as doctors and hospital bills, and activities to improve health care quality, such as efforts to improve patient safety. No more than 20 percent of premiums may be spent on administrative costs such as salaries, sales, and advertising. This requirement is referred to as the "Medical Loss Ratio" standard or the "80/20 rule". The 80/20 rule in the Affordable Care Act is intended to ensure that consumers get value for their health care dollars.

[. . .]

The Medical Loss Ratio rule is calculated on a State by State basis. In Texas, BCBSTX did not meet the Medical Loss Ratio standard. In 2011, BCBSTX spent only 71.0% of a total of $1,054,029,473 in premium dollars on health care and activities to improve health care quality. Since it missed the 80 percent target by 9.0% of premiums it received, BCBSTX must rebate 9.0% of your health insurance premiums.

[. . .]

We are issuing a credit to the bank account you used to pay your premium. Your credit is $357.56.

Color me surprised. I guess that some BCBSTX executive gets one less expensive dinner in a fancy Dallas restaurant.

I must have heard about this aspect of the Affordable Care Act at some point, but I can't remember anything about it. Since this would have been a major selling point for people like me who already had health insurance, I have to wonder how hard it was pressed when the bill was winding through Congress.

Did the Obama administration simply not talk this up very much? I really can't remember. But if you can, please let me know. Go to my "about me" page to get my email address.

And if you google "medical loss ratio" for yourself, you'll get lots of hits.