https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Medical-Loss-Ratio.html https://www.cms.gov/CCIIO/Programs-and-Initiatives/He

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Medical-Loss-Ratio.html https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-In... The ACA requires insurance companies to spend 80% of premiums on medical care. (Sometimes higher and state law can affect this too). This means that letting prices drift upwards is one of the only ways an insurance company can improve profits, so at least they’re taking a percentage of a bigger pie. They could also go the other direction and focus on reducing costs and going for more market share. But this is very difficult in practice, consolidation in the hospital industry has given many hospitals immense leverage. You can also save by identifying and rejecting unneeded care-but this is extraordinarily difficult to do and makes the customer extremely unhappy even when you’re correct (more like dead or bankrupt if you’re incorrect) as the doctor is telling them otherwise.