Jones Proposes Plan To Enforce Medical-Loss Ratio Regulations
In his first official action after being sworn in on Monday, Insurance Commissioner Dave Jones (D) proposed emergency regulations that would require California health insurers in the individual insurance market to spend at least 80% of their revenue on policyholders' medical claims, the Los Angeles Times reports (Helfand, Los Angeles Times, 1/4).
Existing California law requires insurers to spend at least 70% of premiums from the individual market on medical care.
Jones' proposal would align state regulations with national medical-loss ratio rules established under the federal health reform law. The federal medical-loss ratio regulations took effect this year.
Jones said his proposed regulations would allow him to enforce the new federal requirements at a time when Congressional Republicans are working to dismantle the reform law (Mohajer, AP/San Jose Mercury News, 1/3).
If California's Office of Administrative Law approves Jones' proposal, the regulations would take effect this month and remain in place for six months while the state Insurance Department develops permanent rules.
After being sworn in, Jones announced additional plans for his term, such as:
- Creating a new position in the Insurance Department to oversee health policy;
- Collaborating with the Legislature to give the insurance commissioner greater direct authority to oversee health insurance rates (Los Angeles Times, 1/4);
- Protecting consumers, especially seniors, from health insurance fraud;
- Quickly implementing new federal laws related to health insurance; and
- Reinstating a branch of the Insurance Department devoted to consumer education (Ortiz, Sacramento Bee, 1/4).