North Dakota became the first state to be denied a medical loss ratio waiver request under the PPACA.
NORTH DAKOTA became the first state to be denied a medical loss ratio (MLR) waiver request under the Patient Protection and Affordable Care Act. The state wanted an exemption from the requirement that health plans in the individual and small-group markets spend at least 80% of premiums on healthcare or give customers rebates.
The law allows states to get a waiver if the MLR requirement would disrupt their insurance market. KENTUCKY and IOWA were given more time to meet the requirement.
Eighty percent of MISSOURI has been designated a Health Provider Shortage Area by the U.S. Department of Health and Human Services. That means one in five Missourians is without access to primary healthcare. The problem is worse in rural areas.