Medical Loss Ratio (MLR)

Expand access to affordable health coverage, protect consumers, and reduce the growth of health care costs — The Affordable Care Act was enacted to expand access to affordable health insurance — through guaranteed issue, the health insurance exchanges, premium tax credits, and Medicaid expansion — while protecting consumers through rules such as essential health benefits, metal tiers, and medical loss ratio requirements, and restraining the growth of health care costs. It did not replace Medicare or abolish state regulation; instead it layered federal market reforms onto the state-regulated insurance system while states continued to operate their own exchanges.

National insurance concept

Expanding access to health coverage and reducing the number of uninsured — The ACA was enacted to expand access to affordable health coverage and reduce the number of uninsured Americans. It does this through health insurance exchanges, premium tax credits and cost-sharing reductions, the individual and employer mandates, guaranteed issue, and the prohibition of pre-existing condition exclusions, along with Medicaid expansion. It also introduces market reforms such as minimum essential coverage requirements and medical loss ratio rules, all designed to broaden coverage rather than abolish private insurance.

National insurance concept