The section of the Affordable Health care Law "that should have a long lasting and powerful impact on the future of health care in our country [is] the provision ... called the medical loss ratio, that requires health insurance companies to spend 80 percent of the consumers’ premium dollars they collect—85 percent for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.
"This is the true ‘bomb’ contained in [the law] and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time. It is this aspect of the law that represents the true ‘death panel’ found in [the law]—but not one that is going to lead to the death of American consumers. Rather, the medical loss ration will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry."