Academy Activities

The Medicare Board of Trustees issued its annual report on the financial status of Medicare programs on July 28. With the release of the trustees’ report, the Academy’s Medicare Steering Committee updated and published its annual issue brief, Beyond Actuarial Balance—Medicare’s Financial Condition. The brief offers policymakers an overview of Medicare’s financial condition and highlights the need to address the program’s long-term financial challenges.

The Medicaid Work Group sent a letter to the Centers for Medicare & Medicaid Services (CMS) requesting specific guidance on the Affordable Care Act’s (ACA) Health Insurance Providers (HIP) fee and how it affects the Medicaid program.

The Health Practice International Task Force published an issue brief, Curbing the High Cost of Diabetes. The brief examines initiatives within the U.S. and six other industrialized countries to reduce the costs of diabetes, including enhanced education to promote prevention, improvements in data collection, and greater deployment of information technology. It highlights how actuaries can offer their professional skills to assist “organizations ranging from insurance companies to public and government entities” in their efforts to reduce the economic and social burden of the disease.

Legislative/Regulatory Updates

On Aug. 1, CMS published a new document with frequently asked questions related to Medicare and the ACA’s qualified health plans (QHP) and exchanges. Topics include whether individuals with Medicare can enroll in coverage offered through exchanges, whether prescription drug coverage in an exchange plan qualify as creditable coverage under Medicare Part D, and whether coordination of benefits will apply if an individual is enrolled in Medicare and an exchange QHP.

On July 28, the Department of the Treasury published a final rule that also includes temporary regulations addressing the health insurance premium tax credit available under the ACA. The rule specifically addresses health insurance premium tax credits for self-employed individuals who have health insurance through a health insurance exchange. The rule clarifies existing provisions regarding when a married taxpayer is allowed to claim a credit on a separate return, indexing calculations, allocations for reconciliation of advance credit payments and the premium tax credit, reconciliation for divorced and separated taxpayers, reconciliation for married taxpayers who file separately, and the deduction for health insurance costs of self-employed individuals. The final rule and temporary regulations are effective as of July 28; comments on the temporary regulations are due by Oct. 27.

The projected financial condition of Medicare, according to the trustees’ report, has improved since last year. The Medicare Hospital Insurance (HI) trust fund is now projected to be depleted in 2030, four years later than projected in the 2013 report. In 2030, tax revenues would cover 85 percent of program costs. Further, the projected HI deficit over the next 75 years is 0.87 percent of taxable payroll, which is down from 1.11 percent in 2013. Eliminating this deficit would require an immediate 30 percent increase in payroll taxes or an immediate 19 percent reduction in benefits—or some combination of the two. The Supplementary Medical Insurance (SMI) trust fund is expected to remain solvent, because its financing is reset each year to meet projected future costs. According to the trustees’ report, SMI spending is expected to grow from 1.9 percent of gross domestic product (GDP) in 2013 to 4.5 percent of GDP in 2088. Total Medicare expenditures also are projected to increase as a share of GDP. Under current-law projections, total Medicare spending as a share of GDP is expected to grow from 3.5 percent in 2013 to 6.9 percent in 2088.

In the News/Media Activities

The Medicaid Work Group’s July 7 letter requesting specific guidance on the ACA’s HIP fee, as an alternative to the current approach of informal state-by-state discussions or a proposal-submission process, was mentioned in a Central Penn Business Journal article and on the National Association of Medicaid Directors website.

LifeHealthPro reported on the Cancer Claims Cost Group’s work to update cancer claim tables.

Upcoming Events

The Affordable Care Act: How Applicable Large Employers Should Report Health Care Coverage under IRS Section 6056
Briefing: Aug. 14, 12:00 p.m. EDT (no fee charged)
Sponsor: Internal Revenue Service

The Future of Health Care In America—The ACA & Beyond
Hill Briefing: Sept. 3, 12:00 p.m.–2:30 p.m. EDT (no fee charged)
Sponsor: National Institute for Health Care Management (NIHCM) Foundation

Advancing the Use of Biomarkers and Pharmacogenomics in Drug Development
Briefing: Sept. 5, 9:00 a.m.–4:30 p.m. EDT
Sponsor: Brookings Institution (no fee charged)

2014 Life and Health Qualifications Seminar
When: Nov. 10–13, 2014
Where: Key Bridge Marriot, Arlington, Va.

For a complete listing of upcoming and recent health care reform events, click here.