2026 Medical Loss Ratio Rebates Authors: Matt McGough, Jared Ortaliza, and Cynthia Cox Published: Jul 13, 2026

https://www.kff.org/private-insurance/medical-loss-ratio-rebates/ The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) limits the share of premium income that insurers can keep for administration, marketing, and profits. Insurers that fail to meet the applicable MLR threshold are required to pay back excess profits or margins in the form of rebates to individuals and employers that purchased coverage.