To require a minimum loss ratio for 90 percent for health insurance coverage offered through an insurance exchange.

Prohibits any health insurance coverage from being offered through a health insurance exchange unless the coverage is demonstrated to have a medical loss ratio (a ratio of medical expenses paid to premiums received) of at least 90%. Defines "health insurance exchange" to mean a mechanism established or recognized under federal law that provides a coordinated, centralized mechanism for offering for purchase to individuals health insurance coverage from more than one health insurance issuer.