The Academy’s Risk Sharing Subcommittee submitted comments Dec. 20 to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule on benefit and payment parameters for 2017. The comments addressed risk adjustment, reinsurance, risk corridors, and a number of small group considerations.
The Premium Review Work Group finalized a practice note in December—Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act—that provides information on general rate filing requirements and considerations related to the unified rate review template and actuarial memorandum.
Legislative/Regulatory Updates
On Jan. 6, the House of Representatives, in a symbolic vote, passed a bill (H.R. 3762) to repeal the Affordable Care Act (ACA), sending a bill for repealing the law to President Obama for the first time. The president vetoed the measure two days later.
On Dec. 18, the House passed a $1.1 trillion spending bill (H.R. 2029) for fiscal year 2016 that included provisions delaying the ACA’s tax on high-cost employer sponsored plans (also known as the “Cadillac tax”) and suspending the annual tax on insurers.
In the News/Media Activities
FactCheck.org cited an Academy issue brief, Implications of Medicaid Expansion Decisions on Private Coverage, in a story about statements by Democratic presidential primary candidate Hillary Clinton regarding the relationship between state Medicaid expansions and private health insurance premium increases. The Tucson Sentinel also ran the story.
The Academy issue briefDrivers of 2016 Health Insurance Premium Changes continues to be relied upon by news organizations and analysis sites as covering the emerging story of 2016 health insurance premiums. PolitiFactcited the Academy’s analysis in a story that fact-checks statements by House Speaker Paul Ryan (R-Wis.) regarding expected 2016 rate increases in relation to the ACA. The Richmond Times-Dispatchcited the issue brief in a story that examines statements by Republican presidential primary candidate Donald Trump regarding expected 2016 rate increases. The issue brief was also cited in a story by Health Payer Intelligence that provided an in-depth analysis of the various factors influencing 2016 rates.
A graphic from the Health Practice Council’sfact sheet examining the ACA’s three risk-sharing mechanisms was reproduced in a Bangor Daily News (Maine) editorial warning readers of the potential systemic risks of congressional underfunding of the ACA risk corridor program. The editorial also ran in Insurance News Net.
A Health Practice Council letter to HHS Secretary Sylvia Mathews Burwell was cited on healthinsurance.org in a piece examining premium subsidies for participants in Kansas’ health insurance marketplace.
The Risk Sharing Subcommittee’s Dec. 20 letter to HHS regarding the proposed rule on benefit and payment parameters for 2017 was posted in Benefitslink.com.
Upcoming Academy Health Care Events
A Jan. 25 webinar, “ORSA: A Short Duration Health Perspective,” will provide a perspective on how actuaries can add value to an Own Risk and Solvency Assessment (ORSA) and illustrate Operational Risk Management (ORM) practices. A perspective on how regulators approach ORSA will also be presented, along with a regulatory standpoint on insights from the ORSA pilot and feedback. Presenters will describe ORSA basics, including the purpose, process, and the actual report, as well as the trends driving ORM practices. Cybersecurity threats will also be discussed. Register now.
Jan. 27 webinar: “An International Discussion on Risk Adjustment.” The European Risk Adjustment Network (RAN) is an informal annual gathering of risk adjustment experts (academic and governmental) from several European countries and Israel who meet to exchange ideas on the latest research in applied risk adjustment. These insights provide relevant lessons to other countries that have evolved a risk adjustment mechanism for their health care programs. The Academy’s Health Practice International Committee and the International Actuarial Association Health Section (IAAHS) are pleased to offer a webinar that provides members with a look at the information coming out of this annual meeting. Panelists will provide a report on the discussions, including specific reports from each country in Europe that can be applied to the ACA’s risk adjustment program implemented recently in the United States. This webinar is free for Academy members—register now.
Save the Date: At the Feb. 4 webinar, “CMS Discussion of National Health Spending in 2014,” panelists from the Centers for Medicare & Medicaid Services will discuss their recent findings regarding national health spending. Check the Academy’s online calendar for information on registration, which will open soon.
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