Having trouble viewing this email? View it in your browser.
June 10, 2015
Academy Activities
In late May, the Health Practice Council (HPC) published a new issue brief, Implications of Proposed Changes to the ACA in Response to King v. Burwell, which examines proposals that would provide transitional coverage for individuals who would lose subsidies if the Supreme Court rules that they are not available in states participating in the federally facilitated marketplace. The brief also explores provisions that are included in some of the proposals to replace the Affordable Care Act (ACA) more broadly, including eliminating the individual and/or employer mandates, establishing the ability to sell insurance across state lines, and allowing association health plans.
On June 5, the Health Care Cost Work Group published an issue brief that addresses health care cost growth in Medicare by providing a framework for understanding and evaluating the options for reforming Medicare and their potential effects on cost growth, quality of care, and access to care.
On May 19, the Health Solvency Work Group submitted a comment letter to the NAIC’s Investment Risk-Based Capital Working Group on the evaluation of asset risk factors for the health risk-based capital formula.
On May 8, the Risk Sharing Work Group submitted comments to the Center for Consumer Information and Insurance Oversight on the methodology proposed to evaluate the sufficiency of EDGE server data.
Legislative/Regulatory Updates
On May 26, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would modernize the Medicaid managed care regulations to promote similar standards among both private and public marketplaces. Comments are due by July 27.
On June 4, the Republican Study Committee, a large caucus of conservative lawmakers in the U.S. House, released a repeal and replace plan for the ACA, The American Health Care Reform Act (AHCRA). The plan mandates individuals get a standard tax deduction of $7,500 a year or $20,500 for families buying health insurance. This deduction would apply to everyone with private insurance. The plan specifically excluded any contingencies for the impending decision in the King v. Burwell case.
On June 9, the CMS published a final rule addressing changes to the Medicare Shared Savings Program including provisions relating to the payment of Accountable Care Organizations participating in the Medicare Shared Savings Program.
In the News/Media Activities
The national news media has turned to the Academy for insight into the Supreme Court’s decision in King v. Burwell expected in June, as well as 2016 health insurance rate requests following the Department of Health and Human Services’ publication of 2016 rate filing information reflecting double-digit increases for some plans sold on ACA health insurance exchanges.
A follow-up piece by McClatchyDC also published by numerous local papers cites the Academy’s issue brief as it outlines the potential implications of the court’s decision. And a Kaiser Health News story published by Time magazine, The Atlanta Journal-Constitution, and National Public Radio also cites the Academy’s issue brief in breaking down the implications of the case.
Separately, more than 300 media outlets nationwide have published an Associated Pressstory that cites HPC Vice President Catherine Murphy-Barron’s comments on possible premium rate changes in some states, saying, “The increase is not the right thing to be looking at, it’s the general level of the premiums of everyone in that market at that tier.” The story appeared in The New York Times, The Washington Post, Chicago Tribune, San Francisco Chronicle, CNBC, and numerous other national and local outlets.
Senior Health Fellow Cori Uccello provided perspective on the factors affecting 2016 rates in a subscriber-only story for the Inside Health Insurance Exchanges May 2015 newsletter. In light of the ACA risk adjustment program, Uccello noted the importance to insurers of knowing how their risk profiles compare to those of the whole market.
The National Law Reviewmentions the Academy in a story examining the CMS’ proposed new rule for Medicaid managed care regulations. The story notes that the proposed rule would require Medicaid managed care rate setting to be actuarially sound “to incorporate standards previously included in non-binding guidance issued by the American Academy of Actuaries.” The story also ran in JD Supra. See the May 27 Academy Alert for more information on the proposed rule.
Other work from the HPC gaining media attention this month includes the issue briefPotential Implications of the Small Group Definition Expanding to Employers with 51-100 Employees, which was cited in a Live Well Nebraska story and a Third Wayblog post that looks at the effects of the ACA’s redefinition of “small group,” as well as a Commonwealth Fund Blogpost that explores the implications of the ACA provision.
Join us for the next two webinars in this series, which will provide a unique opportunity to learn about the successes and challenges that various countries have experienced as they’ve worked to identify and address particular cost drivers.
Exploring Global Health Care Cost Drivers: Australia and Singapore
Webinar: Sept. 2 (for U.S. participants), 9:30 p.m. EDT (no fee charged for Academy members)
Exploring Global Health Care Cost Drivers: Canada and Chile
Webinar: Nov. 4, 10:00 a.m. EST (no fee charged for Academy members)
Sponsor: American Academy of Actuaries and the International Actuarial Association Health Section
For a complete listing of upcoming and recent health care reform events, click here.
Have ideas to share? We want to hear from you. Email us at: health@actuary.org
PLEASE DO NOT REPLY TO THIS EMAIL. THIS EMAIL ADDRESS IS NOT MONITORED.
If you would like more information or to contact the Academy, please visit us at www.actuary.org/content/about-us
Sign up to follow the Academy on Twitter.
Rather not receive Academy emails? Unsubscribe by emailing membership@actuary.org.
1850 M Street NW • Suite 300 • Washington, DC 20036 • 202.223.8196 • www.actuary.org
Copyright 2015 American Academy of Actuaries. All rights reserved.