"It makes no sense to exclude broker and agent fees from the MLR. The entire idea of MLR regulation is to ensure that insurers are focusing their efforts on protecting us from risk, and not engaging in other activities around marketing and profit-taking."
Gruber suggested a more transparent approach: "Brokers should be priced separately when we purchase insurance, just as tax advisors are when we fill out our taxes. Then individuals who value those services can take advantage of the brokers, while those who do not will pass on their services."
HR 1206 would also require CMS to defer to state insurance commissioners regarding requests for MLR waivers. In his comments in support of the bill, Rep. Fred Upton (R-MI), who chairs the committee, noted that Michigan's request for a waiver was denied, despite the contention by state officials the MLR could destabilize the state's individual health insurance market.