companies are in control of their own businesses.
If they raised premiums in order to cover costs with the ACA prescribed Medical Loss Ratio, 85% on care : 15% for overhead, whose fault is it that they were apparently already in need of more than that 15% before the ACA MLR mandate? Whose fault is it that they were apparently already operating at less than 85% spent on health care services, before the ACA MLR raised that to 85%? So that, now that they have to live with that 15% limit on their costs per dollar of premium and they can't spend less than 85% on health care services, they have to raise premiums to cover their pre-existing greater than 15% overhead costs.
Some insurance company's premium dollars were running as high as 30-35% overhead before the ACA, do Ben and she, think that is a good deal for their money? Compare that 30-35% to Medicare overhead at 4-5% and you have some idea of how bad business practices must be in the company that Ben and she are buying their insurance from and other such companies who have top-heavy organizations and in-efficient business processes supported by our premium dollars, that is, supported and subtracted from the services that we pay our premium dollars for.
When the ACA insurance exchange is constructed in her state, she can compare health care services covered relative to premiums charged by other companies and surmise how well other companies are run and thus they are able to provide more service per dollar than the company she is dealing with which apparently needs more of her premium dollar to pay fat salaries and expense accounts in their overhead, instead of covering services for the insureds. When Ben and she see the difference between who they are dealing with and what's out there in the "free market", they can tell their employer that the insurance s/he is offering will not do. The employer can go get a better deal (from a company in which overhead is not so high), or they can stay with the expensive company they've been dealing with and Ben and she can take their premium dollars into the ACA mandated insurance exchange and find a better deal at a better fit with their health care needs.
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