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May 13, 2015
Academy Activities
Senior Health Fellow Cori Uccello submitted written testimony for a U.S. House Ways and Means Subcommittee on Health hearing on alternatives to the individual and employer mandates under the Affordable Care Act (ACA).
On May 13, an audience of more than 400 attended the second webinar in the international series on health care costs jointly sponsored by the Academy’s Health Practice Council (HPC) and the International Actuarial Association (IAA), “Exploring Global Health Care Cost Drivers: South Africa and the United States.” The webinar provided a unique opportunity to learn about the successes and challenges that both South Africa and the United States have experienced as they’ve worked to identify and address particular cost drivers. Slides and a recording of the webinar will be available shortly.
Legislative/Regulatory Updates
On April 16, President Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) H.R.2 into law after the U.S. Senate passed the legislation on April 14. This legislation eliminates Medicare’s sustainable growth rate formula and sets up a new payment system as well as reauthorizing the Children’s Health Insurance Program for two years.
On April 24, the Centers for Medicare & Medicaid Services (CMS) issued guidance on the operational processes it will use to evaluate issuers’ EDGE server data. CMS will evaluate the enrollment and claims data, and notify any issuer failing to meet expected data quantity thresholds, based on issuers’ previously submitted baseline enrollment and claims counts.
On April 27, Sen. Tim Scott (R-S.C.) introduced bipartisan legislation, the Protecting Affordable Coverage for Employees Act (PACE), which would allow states to maintain the current small group definition of 1-50 employees. Under the ACA, beginning in 2016, the definition of small group market would change from 1-50 to include up to 100 employees. A similar bill was introduced in the House by Rep. Brett Guthrie (R-Ky.).
On April 28, U.S. Rep. Joe Courtney (D-Conn.) introduced bipartisan legislation, the Middle Class Health Benefits Tax Repeal Act, which would repeal the excise tax on high-cost health insurance plans scheduled to go into effect in 2018. The legislation currently has 82 co-sponsors.
On May 5, the U.S. Senate passed a bicameral budget agreement reached with the U.S. House (passed April 30) for fiscal year 2016. The budget will lay the groundwork for repeal of the ACA through a legislative process that requires fewer votes and can’t be filibustered. President Obama has said he will not sign any ACA repeal legislation.
In the News/Media Activities
The Hill, a news site read widely in the nation’s capital, published an op-ed by HPC Vice President Catherine Murphy-Barron on April 20 pointing out some of the broader challenges that the King v. Burwell case before the Supreme Court raises for the individual market. Murphy-Barron explained that the Academy’s proposal for rate filing flexibility, outlined in a Feb. 24 letter to Health and Human Services (HHS) Secretary Sylvia Mathews Burwell, “would not resolve or mitigate the potential massive disruption in the individual market due to what could be millions of individuals dropping coverage, and the higher average costs of those retaining coverage, among other effects of discontinuing premium subsidies.”
Senior Health Fellow Cori Uccello was quoted in a Politico Prostory reporting that some states will allow health insurers to submit alternate 2016 premium proposals to be used if ACA premium subsidies are eliminated as a result of the King v. Burwell case. The story notes that the Academy’s Feb. 24 letter to HHS Secretary Burwell advised HHS to consider such a policy. “It’s just a matter of being prepared,” said Uccello. (The Politico Pro story is available only to subscribers.)
An AIS Healthstory on challenges facing the federal Small Business Health Options Program (SHOP) cited the Academy issue brief, Potential Implications of the Small Group Definition Expanding to Employers with 51-100 Employees. The story noted the Academy’s analysis that “larger small groups will have to adhere to provisions such as essential health benefits and metal-tiering plan classifications that previously were reserved for the 1- to 50-employee segment, likely pushing plenty of the 51- to 100-worker firms to self-insure,” rather than purchase coverage through the SHOP exchange.
HPC Member Donna Novak was quoted in a Portland (Ore.) Business Journalarticle about the potential effects on insurers of not receiving expected risk corridor payments. Novak provided background on risk-based capital rules regarding surplus increases that could be triggered when (or if) an insurer’s RBC ratio falls too low.
Dual Eligibles Summit
Conference: July 14-16, Arlington, Va. (fee charged)
Sponsor: World Congress
For a complete listing of upcoming and recent health care reform events, click here.
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