Actuaries Continue to Urge Stabilization Measures for the Individual Health Insurance Market

Date: 
September 27, 2017
WASHINGTON—The American Academy of Actuaries warns that there are serious challenges to the stability and the sustainability of the existing individual health insurance market that need to be addressed. In the wake of the decision by the U.S. Senate majority this week to put aside current efforts to repeal and replace the Affordable Care Act (ACA) and with the approach of the 2018 open enrollment period, now is the time to take action.

“While most insurers have already made decisions on whether to participate in the market next year and have finalized 2018 premium rates, we will face the same issues next year if policymakers and regulators don’t take steps to stabilize the market,” said Academy Senior Health Fellow Cori Uccello. “Continued uncertainty as insurers start to consider 2019 participation, products, and premium rates will inevitably have repercussions for consumers, providers, and the health care system as a whole.”

The Academy’s Health Practice Council urges policymakers and regulators to focus on the following actions that would help stabilize the health insurance market:
  • Permanently fund cost-sharing reduction (CSR) reimbursements;
  • Enforce the individual mandate;
  • Support enrollment outreach and education;
  • Provide external stability funding; and
  • Avoid legislative and regulatory actions that increase market uncertainties.

The Academy has outlined objective conditions for and steps to support sustainable and stable markets and has published explainers on risk pooling in the individual market, how changing market rules could affect risk adjustment, and why CSR reimbursements should be funded on a permanent basis. In addition, the Academy has examined several reforms that have been considered as part of ACA repeal and replacement proposals, including association health plans and selling insurance across state lines. These resources are publicly available on the Academy website at www.actuary.org under the public policy tab.

“Taking the time to address these issues now could help secure insurer participation for 2019 and stabilize the individual health insurance market,” added Uccello.
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The American Academy of Actuaries is a 19,000-member professional association whose mission is to serve the public and the U.S. actuarial profession. For more than 50 years, the Academy has assisted public policymakers on all levels by providing leadership, objective expertise, and actuarial advice on risk and financial security issues. The Academy also sets qualification, practice, and professionalism standards for actuaries in the United States.