Rick Ungar, for Forbes:

[The medical loss ratio, a provision of Obama's Affordable Care Act,] requires health insurance companies to spend 80% of the consumers’ premium dollars they collect on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time.

Today, that bomb goes off. Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement. As it turns out, HHS isn’t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.

Ungar goes on to predict two things: that this is the beginning of the end for the current crop of private insurance companies, who simply aren't set up to survive on just 20% of their current revenues, and—consequently—that this is the first small step toward a single-payer health care system in the United States.

Either thing would be change I can believe in. But this sounds too good to be true—there must be a loophole.