On February 9, the actuarial profession lost a respected member of its community—Michael Stephen Abroe. An Academy volunteer for more than 20 years, Abroe was the recipient of the Jarvis Farley Service award in 2011. He chaired the Health Practice Council and served on the Actuarial Standards Board, and doubtless touched the lives of many reading this. He will be dearly missed.

Legislative/Regulatory Updates

On Jan. 9, the U.S. House passed a bill to change the full-time employee definition under the Affordable Care Act (ACA). The Save American Workers Act of 2015 raises the threshold that defines full-time employment from 30 hours to 40 hours a week. The U.S. Senate is expected to take this up early in 2015 even though President Obama has issued a veto threat.

On Jan. 16, The Center for Consumer Information & Insurance Oversight within the Centers for Medicare & Medicaid Services published the final 2016 Actuarial Value (AV) Calculator and Methodology.

On Jan. 26, the Congressional Budget Office released a report, The Budget and Economic Outlook: 2015 to 2025, which estimates that the ACA will cost less than initially projected over the next decade, and that 12 million Americans are expected to have gained coverage by the end of 2016. The report also estimates that by 2025, some 31 million Americans will still not have health insurance.

On Feb. 2, the Obama administration released its Fiscal Year (FY) 2016 Budget, which includes Medicare provisions that are projected to result in net savings of $423 billion over 10 years and Medicaid provisions that are projected to result in an increase in spending of $4 billion. Also included are sections to repeal the sustainable growth rate, change Medicare’s premium and cost-sharing structure, and extend Children’s Health Insurance Program funding through 2019. Many other health-related provisions, such as those related to ACA implementation and Medicaid’s financial condition, can be found in a “Budget in Brief” paper by the Department of Health and Human Services.

On Feb. 3, the U.S. House passed a full repeal of the ACA with H.R. 596, the first ACA repeal legislation of the 114th Congress. It was announced prior to the vote that the chairs of the House Ways and Means, Energy and Commerce, and Education and Workforce committees will form a task force to craft an alternative to the ACA and will also develop plans in case the Supreme Court rules that premium subsidies are not available in the federally-facilitated exchanges.

On Feb. 5, a bicameral ACA replacement bill was unveiled by Rep. Fred Upton (R-Mich.), Sen. Orrin Hatch (R-Utah), and Sen. Richard Burr (R-N.C.). This legislation, the Patient Choice, Affordability, Responsibility and Empowerment (CARE) Act, provides a means-tested tax credit to purchase insurance. There would be no denials or higher premiums based on pre-existing conditions for those who have been continuously enrolled in coverage. Otherwise, underwriting would be allowed. Similar legislation was also offered last year but failed to advance to a vote.

Upcoming Health Care Reform Events

Meet the Experts: Keys to PCORI Funding Success
Webinar: Feb. 18, 3 p.m.-4:30 p.m. EST (fee charged)
Sponsor: Academy Health

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.