States ranked by total MLR rebates in 2024

Alabama insurers issued the highest amount of medical loss ratio rebates to consumers in 2024, according to KFF.

Under the ACA, if an insurer in the individual market spends less than 80% of premium revenues on clinical services and quality improvement, it is required to provide a rebate to customers, based on a 3-year average. The ranking data was obtained from CMS.

States ranked by total MLR rebates in 2024:

1. Alabama: $181,950,179
2. Missouri: $156,356,470
3. South Carolina: $138,197,855
4. Louisiana: $130,147,819
5. Texas: $126,713,875
6. North Carolina: $99,695,252
7. Florida: $91,197,982
8. Oklahoma: $88,703,731
9. Ohio: $78,900,931
10. Massachusetts: $75,616,534
11. Indiana: $66,147,241
12. Pennsylvania: $55,729,203
13. Virginia: $43,219,764
14. Arkansas: $33,352,224
15. Maryland: $33,125,162
16. Nevada: $32,620,323
17. California: $31,167,747
18. Georgia: $24,173,251
19. New Jersey: $22,827,461
20. Wisconsin: $17,672,651
21. Tennessee: $16,054,530
22. Michigan: $11,718,564
23. Colorado: $11,596,239
24. Arizona: $10,172,912
25. New York: $8,964,289
26. New Hampshire: $8,706,576
27. Iowa: $7,255,919
28. Kansas: $6,224,665
29. Nebraska: $5,344,361
30. New Mexico: $5,285,688
31. Illinois: $4,761,075
32. Hawaii: $3,738,901
33. Mississippi: $3,711,031
34. Wyoming: $1,955,005
35. Kentucky: $1,684,980
36. Idaho: $1,625,416
37. Connecticut: $1,583,672
38. Utah: $950,864
39. Washington: $926,512
40. Maine: $174,838
41. Delaware: $74,534
42. District of Columbia: $65,628
43. Alaska: $0
44. Minnesota: $0
45. Montana: $0
46. North Dakota: $0
47. Oregon: $0
48. Rhode Island: $0
49. South Dakota: $0
50. Vermont: $0
51. West Virginia: $0