Health insurance companies are finally going to have to provide health insurance coverage rather than spend all their money on things, like huge executive salaries, parties, planes, and other miscellaneous "overhead expenses". Yes, today "we are now on an inescapable path to a single-payer system for most Americans".
The Affordable Care Act (ACA or Obamacare, take your pick), requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. That's ACTUAL MEDICAL CARE!
Failure on the part of insurers to meet this requirement results in the insurers having to send their customers a rebate check representing the amount in which they under spend on actual medical care. So, they either pay for it, or send money back to all their customers.
The key, of course, is what qualifies as a LEGITIMATE medical care cost. The Department of Health & Human Services is tasked with defining what insurers' expenses will quality.
Today is important because 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.
It appears that HHS is taking their task seriously. Insurance companies have been lobbying for months to be able to consider commissions paid for selling insurance as medical expenses. HHS, today, said NO! Paying someone to sell insurance is not an actual medical expense. DUH!
So the question is can insurance companies survive on having to pay out 80% - 85% of their premiums for medical care? Most are nowhere close to that now.
Medicare does, and a universal health care plan like Medicare For All will.
Extra Bonus: Some more ACA good news.