Actuaries Plan Ahead to Health Reform Implementation

WASHINGTON -- March 24, 2010 -- With the enactment of health care reform legislation yesterday, the American Academy of Actuaries said the successful implementation of this and forthcoming reconciliation legislation will require coordinated efforts to ensure that the regulatory development process accomplishes the intended goals of reform. The actuaries plan to work with regulatory authorities as they begin implementing reform legislation to meet its goals of increasing the availability and affordability of coverage, enhancing the quality of care, and addressing health spending growth.

“Health care reform legislation has been passed, but many of the details regarding implementation need to be worked out at both the federal and state levels,” said Cori Uccello, the senior health fellow for the American Academy of Actuaries. “Actuarial expertise will be essential in the development of new regulations if the insurance market is to successfully implement health care reform.”

In the near term the actuaries will focus on the reform provisions that take effect most immediately, including the new medical loss ratio requirements that will apply to insurers in the individual and group markets. To calculate loss ratios, the value of benefits received by policyholders is divided by the premiums paid. But Uccello said that, “There are countless technical issues regarding how to define benefits and premiums that will need to be worked out.”

The actuaries will also focus on forthcoming regulations regarding market reforms that will become effective in 2014. Uccello said that actuaries will work with regulators to structure health insurance exchanges and implement the individual health insurance coverage mandate to successfully reduce adverse selection.

For more information or to schedule an interview with Cori Uccello, please contact Andrew Simonelli, assistant director of communications for the American Academy of Actuaries, at 202.785.7872. For more information on the American Academy of Actuaries, please visit: www.actuary.org.

The American Academy of Actuaries is a 17,000-member professional association whose mission is to serve the public on behalf of the U.S. actuarial profession. The Academy assists public policymakers on all levels by providing leadership, objective expertise, and actuarial advice on risk and financial security issues. The Academy also sets qualification, practice, and professionalism standards for actuaries in the United States.

SOURCE: American Academy of Actuaries

Media contact: Andrew Simonelli, assistant director of communications for the American Academy of Actuaries, 202-785-7872, simonelli@actuary.org