The Medicaid Subcommittee sent comments on the May 15, 2019 CMCS Informational Bulletin (CIB) titled Medical Loss Ratio (MLR) Requirements Related to Third-Party Vendors seeking additional clarification.

The Individual and Small Group Markets Committee published an issue brief outlining the major drivers behind why 2020 premiums could differ from those in 2019. The brief focuses primarily on the individual market, yet many of the factors discussed are also relevant to the small group market. Read the news release.

The Individual and Small Groups Committee, the Medicaid Subcommittee, and the Medicare Subcommittee gave a joint presentation at the SOA Health Meeting that reviewed the proliferation of proposals to expand access to public health insurance plans, either to strengthen insurance markets under the Affordable Care Act (ACA), or to replace ACA marketplaces or other health insurance programs altogether. Panelists discussed general approaches for expanding access to public plans and their potential implications.

The Individual and Small Groups Market Committee gave a presentation at the SOA Health Meeting providing an overview of the challenges that the Affordable Care Act (ACA) has faced since its enactment in 2010, and looking forward to where it’s headed in the future. Panelists discussed current ACA legislative and regulatory activities, as well as ongoing ACA litigation.

The Academy published a new Essential Elements paper, High-Performance Networks: Optimizing Health Insurance Networks to Improve Care, highlighting the potential of high-performance networks between health insurers and providers to reduce costs for patients. Essential Elements is a series designed to make actuarial analyses of public policy issues clearer to general audiences.

The Health Practice Council submitted comments to the U.S. House Committee on Ways and Means regarding its June 12 hearing, "Pathways to Universal Health Coverage."

The Health Practice Council submitted a letter to the U.S. House Committee on the Budget regarding its May 22 hearing, "Key Design Components and Considerations for Establishing a Single-Payer Health Care System."

The Health Practice Council submitted a comment letter to the Actuarial Standards Board on the fourth exposure draft of a proposed new actuarial standard of practice for modeling.

The Academy updated its Essential Elements reports on Medicare’s Long-Term Sustainability Challenge and Securing Social Security with information from the newly released 2019 Medicare and Social Security trustees reports. The Essential Elements series is designed to make actuarial analyses of public policy issues clearer to general audiences.

The Individual and Small Group Markets Committee sent comments in response to the Department of Health and Human Services’ request for information on selling insurance across state lines through Health Care Choice Compacts.

The Medicare Subcommittee has released a new issue brief, Medicare’s Financial Condition: Beyond Actuarial Balance. The brief highlights the findings of the annual report to Congress by the Boards of Trustees of the Federal Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) trust funds on Medicare’s financial condition.

The Medicare Subcommittee sent a comment letter to the Department of Health and Human Services’ Office of the Inspector General on a proposed rule on safe harbor protection for rebates involving prescription pharmaceuticals and the creation of new safe harbor protections.

The Premium Review Work Group sent comments on the recently released final Unified Rate Review Template (URRT) and Instructions.

Proposals to expand access to public health insurance plans are being put forward as a way to supplement efforts to strengthen insurance markets under the Affordable Care Act (ACA) or to replace the ACA marketplaces and/or other health insurance programs altogether. Goals of these proposals vary and include increasing access to affordable coverage, exerting downward pressure on provider prices, increasing plan availability, and reducing the number of uninsured. This issue paper from the American Academy of Actuaries Health Practice Council briefly outlines four approaches aiming to achieve such goals and highlights the key design elements that would need to be specified for an approach to be fully evaluated and implemented. Read the news release.

The Medicaid and Long-Term Care Insurance Work Group published an issue brief exploring the potential for catastrophic long-term care costs as a major financial risk especially facing older Americans and to help clarify the options currently available for dealing with it.