"MLRs in the individual market have risen dramatically since the adoption of the ACA, with insurers spending an average of 92 percent of individual health plan premiums on patient care or quality improvement in 2014, leaving 8 percent for administrative costs and profits.... In 10 states and the District of Columbia last year, the average MLR was more than 100 percent -- meaning that insurers spent more on medical care, on average, than they brought in from premiums."