Certainly, there are many issues that the United States government will have to grapple with regarding health care reform. One of these reforms that is already posing an issue is the 80-85% threshold, also known as the “medical loss ratio.” At the moment, the health care law requires all plans to meet the 80-85% threshold, meaning that insurers need to spend 80-85% of their premium revenue on medical costs.For a company like McDonald’s, for instance, this is a major stumbling block. McDonald’s current offers restaurant workers low-cost insurance plans that are designed to cover modest claims, but not major illnesses. With so many employees, and constant turn-over, this type of insurance plan works for their business model. With high administrative costs, as a result of high employee turnover, the threshold will simply drown McDonald’s.McDonald’s will, undoubtedly, find a way out of their predicament, receiving a waiver from the federal government to continue with their current insurance plan – at least for now. However, the larger question is whether this threshold is a good idea at all, and why the feds felt the need to set minimum medical loss ratios to begin with.
Janice Marks – A retired nurse and home health care professional, Janice has written prolifically about the American health care system. As a writer for Left Justified focused on the current changes in the health care community, she weaves her professional background and expertise into her evaluation of the current health care issues facing the American government and people. Contact Janice at janicemarks(at)leftjustified.com.View all posts by Janice Marks →