Academy Activities

• On Nov. 24, the Academy’s Council on Professionalism hosted a webinar, The New ASOP 6: Does Your Actuarial Work Measure Up?, which included a discussion of new requirements for retiree group benefits programs in pooled health plans. In addition to an overview of the revised actuarial standard of practice (ASOP) No. 6 and a review of the U.S. Qualification Standards, speakers walked attendees through data relevant for developing age-specific costs that the California Public Employee Retirement System (CalPERS) has recently made available via its website.

• Academy volunteers provided several key reports and updates to the NAIC’s Health Actuarial Task Force at its fall meeting in Washington in November. The Individual Disability Tables Work Group made a presentation on the newly revised individual disability report and actuarial guideline, and the Medicare Supplement Work Group made a presentation and submitted a report with recommendations for potential modifications to the Medicare Supplement refund formula.

Legislative/Regulatory Updates

On Nov. 26, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the Notice of Benefit and Payment Parameters for 2016. The proposed rule addresses a number of Affordable Care Act (ACA) provisions, including:

• Risk adjustment, reinsurance, and risk corridors (i.e., the 3Rs)
• Cost-sharing parameters and reductions
• Annual open enrollment period
• Essential health benefits
• The Small Business Health Options Program
• Rate review requirements
• Medical loss ratio program

On Nov. 21, CMS released a draft of the 2016 Actuarial Value (AV) Calculator and Methodology. The draft AV calculator includes a number of updates, some of which were initially proposed for the 2015 calculator.

On Dec. 3, the Office of the Actuary at the CMS reported that national health spending increased by 3.6 percent in 2013, continuing a slow growth rate from previous years. The figures were published in the journal Health Affairs, and showed declining rates of growth in private health insurance, Medicare spending, out-of-pocket spending, hospital spending, and physician and clinical services. Growth rates increased in retail prescription drugs and Medicaid expenditures.

In the News/Media Activities

Politico’s coverage of the Academy’s 2014 Annual Meeting and Public Policy Forum’s opening keynote speech focused on former Health and Human Services Secretary Kathleen Sebelius’ remarks on the future of state Medicaid expansion. “There are a bunch of brand-new governors, and there are also people who I think wanted to get through their election cycle and now will take a new look at this,” Sebelius said. A subscriber-only article in Inside Health Policy scrutinized the role of the individual mandate in the ACA, and the consequences of repealing that mandate. Video of the secretary’s remarks is available on the Academy website.  Other media outlets reported on Sebelius’ speech as well.

Two media outlets have looked to the Academy for an actuarial perspective to help readers make sense of possible increases to their 2015 health insurance premiums.

• Modern Healthcare reached out to Audrey Halvorson, chairperson of the Rate Review Practice Note Work Group, for comment in a story exploring changes in 2015 premiums for plans offered in ACA exchanges. “There is still a lot of uncertainty of what the costs are going to be,” Halvorson said, noting insurers had little hard data on which to base their 2015 rates.
• A CBS News report presented analysis from the Academy issue brief, “Drivers of 2015 Health Insurance Premium Changes.” The story focused on three drivers of health care costs: new ACA risk pool composition changes, reinsurance fund reductions, and the rising cost of medical services due to inflation and an aging U.S. population.
• A Commonwealth Fund blog post providing an update on state policies on existing non-ACA-compliant health policies cites the Academy issue brief “Drivers of 2015 Health Insurance Premium Changes.” The brief identified the transitional policy allowing renewals of non-compliant policies as a factor in 2015 premium changes.

Several publications covered the Medicaid Work Group’s Nov. 11 comment letter on risk-mitigation strategies for Sovaldi and other Breakthrough Therapy Designation medications.

• Inside Health Policy covered the Food and Drug Administration efforts to establish a standardized, faster approval pathway for promising drugs. The subscriber-only story is available through the Friends of Cancer Research website.
• AHIP Coverage reported on the issue’s potential impact on Medicaid costs.

Upcoming Health Care Reform Events

Medicare and Medicaid: The Next 50 Years
Conference: Jan. 28-29, National Press Club, Washington (fee charged)
Sponsor: National Academy of Social Insurance

2015 Annual Medicare Congress
Conference: Feb. 3-5, New Orleans Marriott Downtown at the Convention Center (fee charged)
Sponsor: Medicare Congress

2015 Intercompany Long Term Care Insurance Conference
Conference: March 22-25, The Broadmoor Hotel, Colorado Springs, Colo. (fee charged)
Sponsor: ILTCI

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