The PPACA's rate review and MLR provisions represent costly, bureaucratic interference with insurers' legitimate business decisions and state regulatory prerogatives. This will do little to enhance competition in health insurance markets and the availability and affordability of health insurance.

As part of the American Enterprise Institute project, Beyond "Repeal and Replace," insurance expert Scott E. Harrington argues that this new regulatory regime misdiagnoses the causes of health insurance problems and will worsen them.

This article provides an overview of the U.S. health care reform debate and legislation, with a focus on health insurance.