Health Reform & ACA Implementation

Implementation of the Affordable Care Act, the health care reform law passed in 2010, and other health care reform issues.

Individual and Small Group Markets Committee issue brief highlighting the various policy considerations and the potential implications of allowing the sale of insurance across state lines. (February 13, 2017)
Individual and Small Group Markets Committee issue brief highlighting the various policy consideration and potential implications of establishing association health plans (AHPs). (February 13, 2017)
Individual and Small Group Markets Committee issue brief providing an overview of three potential high-risk pool approaches to covering the costs of high-risk enrollees and examining the implications of various design features, including eligibility criteria, benefit coverage, funding sources, and regulatory responsibility. (February 10, 2017)
Written testimony on the effectiveness of the individual mandate under the Affordable Care Act (ACA) to a U.S. House Ways and Means Oversight.  (February 6, 2017)
Individual and Small Group Markets Committee issue paper examining the experience in the Affordable Care Act (ACA) individual market, outlining the conditions necessary for a sustainable market, examining whether these conditions are currently being met, and discussing the implications of potential changes to improve the ACA market rules or replace ACA with an alternative approach. (January 18, 2017)
Health Practice Council letters to both the U.S. House and Senate on potential adverse consequences of repealing provisions of the Affordable Care Act (ACA) without having a replacement approach in place, and the challenges faced by eliminating the reimbursements to insurers for cost-sharing reduction subsidies.
(December 7, 2016)
Risk Sharing Subcommittee and Premium Review Work Group letter to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule for the 2018 benefit and payment parameters. The comments address proposed changes to the risk sharing mechanisms, market reforms, and rate review provisions. (October 6, 2016)
Health Practice Council letters to both the U.S. House and Senate on potential adverse consequences of legislation to weaken the Affordable Care Act’s (ACA) individual mandate. (September 22, 2016)
Written testimony on the general factors underlying premium rate setting and the major components driving premium changes for 2017 under the Affordable Care Act to a U.S. House Ways and Means Committee hearing on rising health care premiums. (July 22, 2016)
Individual and Small Group Markets Committee issue brief providing an overview of the general factors underlying premium rate setting and highlighting the major components driving premium changes in 2017 under the Affordable Care Act (ACA). (May 9, 2016)
Risk Sharing Subcommittee letter to the Centers for Medicare & Medicaid Services (CMS) with comments on its recent discussion paper, HHS-Operated Risk Adjustment Methodology. The letter includes comments on partial year enrollment, use of pharmacy data, use of concurrent versus prospective model, high-risk enrollee pooling, recalibration of the model, and the transfer formula.  (April 22, 2016)
Subcommittee Issue Paper on ACA Risk Adjustment Program
Risk Sharing Subcommittee issue paper that reviews the first year of experience under the Affordable Care Act’s (ACA) risk adjustment program with focus on experience in the individual market. (April 12, 2016)
Risk Sharing Subcommittee presentation to the Health Actuarial Task Force (B) on its report on the risk adjustment program. (April 5, 2016)
Premium Review Work Group letter to CCIIO with comments on the 2017 unified rate review template (URRT). (March 30, 2016)
Risk Sharing Subcommittee letter to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule on benefit and payment parameters for 2017. (December 20, 2015)
Premium Review Work Group practice note on Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act, providing information on general rate filing requirements and considerations related to the URRT adn actuarial memorandum. (December 3, 2015)
Active Benefits Subcommittee letter to the IRS regarding Notice 2015-52 on the excise tax for high-cost employer-sponsored health coverage under the Affordable Care Act (ACA). (October 1, 2015)
Premium Review Work Group letter to CCIIO with suggested changes to the unified rate review template (URRT) and rating methodology. (September 22, 2015)
Academy Senior Health Fellow Cori Uccello written testimony on potential implications of expanding small-group definition to companies with 51-100 employees to a U.S. House Energy & Commerce Subcommittee on Health hearing on affordable health care.  (September 9, 2015)
Individual and Small Group Markets Committee issue brief providing an overview of the factors underlying the general premium rate setting and highlighting the major drivers behind why 2016 premiums could differ from those in 2015 under the Affordable Care Act (ACA). (August 5, 2015)