Today, thanks to the Affordable Care Act, as of today, big insurance companies will be refunding individuals and businesses in New York State $86.5 million. The ACA includes a provision that requires insurers to spend 85% of large-group premiums and 80% of small-group and individual premiums on clinical services and quality improvement. If they don’t spend enough on care, the insurer must refund the difference.
That $86.5 million will be divided up like this:
- $76.8 million to large-group markets
- $3.7 million to small-group markets
- $6 million or more to individuals who buy their own insurance
Douglas Lasdon – founder of the Urban Justice Center and someone who has personally benefited from these returns – was pleased to receive a check from United’s Oxford Unit for his Manhattan non-profit for $17,000.
In this case, the Oxford Unit had collected $2.1 billion in premiums from New York State. They spent 83% of that on healthcare and activities to improve healthcare. Their refunded 2% will total about $50 million for the state which is the highest total in New York’s large-group market according to HHS.
This large sum of money would have stayed in the hands of big health insurance companies if it weren’t for the Affordable Care Act. Due to our tireless hours of knocking on doors, phone calls, lobby visits, and days of action, we are finally seeing millions of hardworking people get the care they need and deserve.