Prior to the ACA, many health insurance carriers spent a substantial portion of consumers’ premium dollars on administrative costs and profits, including executive salaries, overhead and marketing. States had the power to regulate this equation, but they didn’t. The ACA established the medical loss ratio (MLR) in an effort to require insurers to prioritize consumers’ healthcare above profits and salaries.

The Better Care Reconciliation Act (BCRA) would roll back an important consumer protection, bringing into question whether medical care will continue to be prioritized over profit and administrative expenses when it comes to spending premium dollars.