Academy Activities

Cori Uccello, the Academy’s senior health fellow, submitted written testimony to the U.S. House Oversight and Government Reform Committee on Feb. 5 for its hearing on the Affordable Care Act’s (ACA) risk-corridor program.

On Jan. 30, the Academy’s Risk-Based Capital (RBC) work groups, including the Health RBC Work Group, sent a letter to the National Association of Insurance Commissioners’ Solvency Modernization Initiative RBC Subgroup outlining concerns with a December 2013 Capital Adequacy Task Force operational risk proposal.

The Rate Review Practice Note Work Group sent a letter to the Center for Consumer Information and Insurance Oversight (CCIIO) on Jan. 24 with comments on a second draft of revisions to the Unified Rate Review Template (URRT) and actuarial memorandum instructions.

Legislative and Regulatory Updates

On Feb. 11, the Internal Revenue Service (IRS) published a final rule that provides guidance to large employers on the shared responsibility provision of the ACA. The rule amends and finalizes earlier guidance on issues such as the definition of minimum value, minimum essential coverage, and applicable large-employer and affordability safe harbors. The rule also provides transition relief for employers with 50 to 99 full-time employees, who now will have until 2016 to provide employee health insurance or face a penalty. Employers with 100 or more full-time employees also have some transition relief for 2015. Instead of having to offer coverage to 95 percent of employees, they can offer coverage to only 70 percent and still avoid the penalty. The rule will be effective on Feb. 12, and will apply to periods after Dec. 31, 2014.

A bipartisan, bicameral proposal seeking to repeal the Medicare sustainable growth rate was introduced on Feb. 6. S. 2000, sponsored by Sen. Max Baucus (D-Mont.), would end the current formula used to determine physician reimbursement under the Medicare program. The bill would institute a five-year period of annual updates of 0.5 percent to transition to the new system. The bill also includes provisions to improve the existing fee-for-service system, encourage movement to alternative payment models, and expand the use of Medicare data for transparency and quality improvement. The bill has been referred to the Senate Finance Committee.

The U.S. Government Accountability Office released a report on Jan. 31 providing benchmark health insurance premium pricing information. Requested by Sen. Orrin Hatch (R-Utah), the report provides lawmakers with an analytical tool for studying the effects of the ACA on individual health insurance prices. The report uses data provided by CCIIO on premium prices for consumers aged 19 to 64 in each of the 50 states and the District of Columbia.

The IRS also published a final rule on Jan. 7 on the computation and application of the medical loss ratio (MLR). The final rule applies to Blue Cross and Blue Shield organizations as well as other qualifying health care organizations. The final rule specifies how to determine the MLR, classifies the elements used to compute it, and sets out provisions for insurers that have an insufficient MLR. The final rule also states the circumstances when a change under MLR Internal Revenue Code provisions will be treated as a material change in the operations of an organization and the method for accounting for unearned premiums. The final rule was effective Jan. 7, and will apply to tax years beginning after Dec. 31, 2013.

In the News

The Health Practice Council’s fact sheet examining the ACA’s three risk-sharing mechanisms was widely cited by the media, including a story in the Wall Street Journal, an article in Time magazine and an article in the Hartford Courant. The fact sheet was linked within Politico and Kaiser Health News stories about the debate over proposals to repeal the ACA’s risk corridor program and the Washington Post featured a graphic from the fact sheet.

Academy Senior Health Fellow Cori Uccello provided perspective on new ACA enrollment data for the Washington Post, The Hill, Kaiser Health News, and other outlets.

A Forbes column on proposed ACA amendments mentioned the Academy.

The Academy’s pre-State of the Union call for policymakers to address the financial security of federal programs like Medicare and Social Security was reported by numerous media outlets, including BenefitsPro, Senior Journal, and the Social Security Report.

Upcoming Events

National Health Policy Conference: ACA and the Year Ahead
Conference: March 5–6, Washington
Sponsor: America’s Health Insurance Plans (fee charged)

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