With the enactment of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act, which made a number of adjustments to PPACA, attention now shifts to the implementation phase of health care reform.

The Academy's Health Practice Council has established a number of work groups charged with providing input on implementation of a variety of provisions in the new law. Actuaries bring a unique perspective that is crucial to the development of workable health care reform regulation. On this page, you will find links to HPC comment letters related to the various provisions included in PPACA, as well as other resources related to the new law and its implementation.

Please bookmark this page and check back with us frequently. As implementation proceeds, we'll be updating and adding information regularly.

The Academy's Critical Issues in Health Reform series and other documents related to the health care reform dialogue can still be found on the Health Reform Now page.

Accountable Care Organizations (ACOs)
Actuarial Value
Consumer Operated and Oriented Plan Programs (CO-OPs)
Early Retiree Reinsurance Program
Exchanges
Grandfathering Provisions
Medical Loss Ratio Reporting and Rebates
Medicare
Near-term Benefit and Eligibility Changes
Premium Review
Risk Adjustment, Reinsurance and Risk Corridors
Other

Newly Released Documents

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)
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)
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)
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)