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Academy Activities
In early March, the Academy’s Individual and Small Group Market Task Force published a new issue brief examining how the rules applying to groups sized 51-100 will change with the Affordable Care Act’s (ACA) scheduled expansion of the definition of small employers to those with up to 100 employees, and what that will mean for insurance coverage in the small group market.
On Feb. 24, the Academy’s Health Practice Council sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell highlighting that if the Supreme Court decides in favor of the petitioners in King v. Burwell, and no action is taken to allow enrollees access to premium subsidies in states participating in the federally facilitated marketplace, a significant drop in health plan enrollment and an increase in the risk profile of remaining enrollees would drive up average health costs for health plans. The letter urges the secretary to consider allowing changes to premium rate filings if the ACA subsidies are eliminated. The letter received significant media coverage (see “In the News/Media Activities,” below). |
Legislative/Regulatory Updates
 On Feb. 27, The Centers for Medicare & Medicaid Services (CMS) issued the final rule for the HHS Notice of Benefit and Payment Parameters for 2016. CMS also released its final annual letter to issuers on Feb. 20, providing a detailed breakdown of the standards for plans participating in federally facilitated marketplaces, as well as timelines for submitting applications for approval to CMS, among other guidance.
On Feb. 26, the Internal Revenue Service issued both final and proposed rules for Health Insurance Provider Fees. The rules provide the definition of a covered entity for purposes of the fee imposed by section 9010 of the ACA. The temporary regulations are necessary to clarify certain terms and affect those engaged in providing health insurance for United States health risks.
The Medicare Payment Advisory Commission (MedPAC) will be releasing its report to Congress on Medicare payment policy on March 13. It will be available at www.medpac.gov. |
In the News/Media Activities
With the U.S. Supreme Court holding oral hearings on the King v. Burwell ACA case this month, the national news media has frequently cited the Health Practice Council’s Feb. 24 letter to HHS Secretary Sylvia Mathews Burwell to illustrate the potential ramifications the court’s decision may have on insurer solvency and the nation’s health care system as a whole.
The McClatchyDC story “Burwell: No backup plan for uninsured if health care tax credit case loses” quotes Senior Health Fellow Cori Uccello, who shed light on the importance of rate setting flexibility in the event that ACA premium subsidies are eliminated by the Supreme Court’s upcoming decision in King v. Burwell. “Insurers can’t just flick a switch to increase premiums to take into account lower enrollment and higher costs,” Uccello said. The story ran in the Chicago Tribune, Miami Herald, and over two dozen local newspapers across the country.
Click the links below to read more King v. Burwell stories that cite the Academy.
A Bloomberg BNA story, “Little-Noticed ACA Provision Could Impact Small Group Plans in 2016,” reports on the Academy’s issue brief released this month. The story presents key points from the issue brief noting that “companies in the 51-100 size group with younger, healthier employees are likely to face higher premiums, while companies in that size group with older, sicker employees will pay less.” Bloomberg BNA also published a subscriber-only version of the story “Actuaries Say ACA Small Group Change Could Affect 3 Million.” The issue brief was also cited in Life & Health Advisor, PoliticoPro, and in a California Broker magazine story that focuses on the potential impact that the ACA’s new small group definition will have on California’s insurance market.
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Upcoming Health Care Reform Events
2015 Intercompany Long-Term Care Insurance Conference
Conference: March 22-25, The Broadmoor Hotel, Colorado Springs, Colo. (fee charged)
Sponsor: ILTCI
Webinar: Exploring Global Health Care Cost Drivers: U.S. and South Africa (more details coming soon)
May 13
Sponsor: Academy Health Practice International Task Force and International Actuarial Association Health Section.
For a complete listing of upcoming and recent health care reform events, click here. |
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