Medical loss ratio and rate review requirements are not a defense to further insurer consolidations

AHA comment letter to Commissioners Nickel and Wade raising concerns about whether provisions in the Affordable Care Act (ACA) that set minimum medical loss ratios (MLRs) and provide rate review standards might temper the anticompetitive effects that will follow in the wake of the pending mergers of Anthem with Cigna and Aetna with Humana.