States ranked by total MLR rebates in 2024

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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

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