The rules that consumers should benefit expand significantly federal authority to use bonuses to head collected from companies such as UnitedHealth, Etna, Humana and Wellpoint. While some States have had such requirements,'s Monday announcement is the first such mandate by the Federal Government and grows out of the new national health care law.
"Millions of Americans better value will receive for your health insurance premium dollars," said Kathleen Sebelius, the Secretary of health and human services, when drawing up the rules.
Mrs Sebelius said the rules would protect nearly 75 million people: large employers 10.6 million with policies, 24.2 million with small group coverage and 40 million covered by.
From next year, she insurers in the market said individual and small groups have to spend at least 80 percent of their premium revenue to healthcare and activities to improve the quality of care.Insurer on the market of large group must spend at least 85 percent of premium dollars for these purposes.
Insurers who meet the standards not next year, discounts to consumers, starting in 2012 to zahlen.Frau Sebelius estimated that up to nine million people could receive discounts worth up to $ 1.4 billion.Are about 45 percent of people with individually acquired insurance in health plans that meet the new standards known as medical claims, federal officials said.
At a press conference on Monday attacks administration officials repeatedly rejected on Republican law to respond to public health.Still would discuss Republican calls for the abolition of the law, a centerpiece of President Obama's domestic agenda.
"We just try to implement this regulation", said Jay Angoff Director is the chief Autor.Er rules of Department of health and human services' consumer information and insurance oversight.
He said that most insurers should be able to meet the standards because "your profitability and reserves at an all-time high."
However, said State officials could destabilize the standard insurance markets in some countries.Specifically, you said you were afraid that some airlines withdraw from the market in some countries, would result in less individual choice and less competition.
According to the rules, federal officials can reduce sleeps up to three years in States, where "it's a fair chance that destabilization, market and thus harm to the consumer."
Mr Angoff said that Georgia, Iowa, Maine, South Carolina had asked for such adjustments.
Joshua R. Raskin, senior analyst at Barclays Capital, an investment bank, said: "With these rules, the Federal Government for the first time, health insurance companies for the placing on the market a minimum amount of premiums in the direction of medical expenses is accountable."
The rules allow special handling for health plans that provide limited benefits at an affordable price.At least 1.4 million people are in such 'Mini-med' plans, the cover for one or more services at $5,000 or $10,000 a year Cap $25,000 enrolled - or maybe.
Employer provides those cover had said it could at the end, because you could meet not the 80 percent standard next year.
Premiums are generally lower for mini-med plans as for regular insurance and administrative costs can be high because these plans often abdecken.Infolgedessen accounts for employees with high turnover rates administrative costs a higher share of premiums.
In addition, some consumer groups of mini-med plans said had higher profit margins than traditional insurance.
"Managing a smart accommodation made, which will temporarily save this covering industry is very important for many employees in the retail and restaurant" said E. Neil Trautwein, a Vice President of National Retail Federation.
"Is the dispensation for mini-med plans for a Jahr.Die Government will collect data on these plans next year and decide how you continued in 2012 and 2013.""In the year 2014, we expect these mini-med policies will disappear and be replaced by more comprehensive health plans", said Steven B. Larsen, a federal insurance regulator.
In general recommendations of the National Association of Insurance Commissioners, representing government regulators follow the rules.
However, "We have a disagreement on a point," Jane said L. Cline, Insurance Commissioner of West Virginia and President of the Association.
State officials Mr Obama said on States that allow requests over several years to avoid disruption of the individual or small group insurance market phase soll.Das White House, said "The law enables the adjustments of the medical loss ratio for the single market in a State and does not apply to small groups market."
Consumers Union, the American Heart Association and democratic members of Congress praised the rules.
Representative George Miller, Democrat of California, said the folly of efforts for the abolition of the health care showed the rules Act.
"If", Republican, Mr. Miller said, "take money directly from the pockets of millions of average Americans."
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