HealthCheck, December 2017

Academy activities, legislative/regulatory updates, and more.

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December 13, 2017

Academy Activities

The Health Practice International Committee released an issue brief, End-of-Life Care in an Aging World: A Global Perspective, this month. Using case studies from a variety of countries, this issue brief explores health care challenges facing an aging population, and possible solutions to address the increasing health care costs and needs of the elderly at the end of life.

The Health Practice Council (HPC) submitted a letter to the U.S. House and Senate Dec. 12 providing comments on the potential consequences of eliminating the Affordable Care Act’s (ACA) individual mandate, under the Tax Cuts and Jobs Act. The HPC had submitted a previous letter on Nov. 21 to the Senate providing similar comments the tax reform legislation being considered by Congress.

The Academy made public policy presentations at the NAIC Fall 2017 National Meeting, Dec. 2–4 in Honolulu. John Schubert, member of the HPC, gave an update to the Health Actuarial (B) Task Force on the Academy’s recent public policy work at the federal, state, and international levels. Warren Jones, chairperson of the Long-Term Care (LTC) Valuation Work Group, gave an update to the NAIC’s Long-Term Care Actuarial (B) Working Group on the Academy’s recent LTC activities, including work on issue briefs and work group activities surrounding LTC valuations and LTC combo valuations. Read the Academy alert.

The Risk Sharing Subcommittee and the Premium Review Work Group submitted comments to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule for the 2019 benefit and payment parameters. The comments addressed proposed changes to the risk-sharing mechanisms, special enrollment periods, essential health benefits, minimum essential coverage, and medical loss ratios.

The Health Care Delivery Committee’s Comparative Effectiveness Work Group published an issue brief providing an actuarial overview of comparative effectiveness research, including measuring its impact and its potential to reduce health care costs.

Attendees of the Academy’s Annual Meeting and Public Policy Forum, held in Washington, D.C., Nov. 14–15, took in a packed program including health breakout sessions on key issues. Click here to see the topics covered during the health sessions and to see the presentation from the Congressional Budget Office (CBO) in the first session, “Modeling the Individual Mandate.”

Legislative/Judicial/Regulatory Updates

check markFollowing the expiration of federal funding for the Children’s Health Insurance Program (CHIP) on Sept. 30, states are beginning to exhaust their CHIP funds and are faced with the decision to terminate coverage, close enrollments, or find other solutions. As a last resort, the Centers for Medicare & Medicaid Services (CMS) has already approved redistribution grants allowing nearly 20 states that have exhausted their FY2017 carryover CHIP funds to continue their programs, with several more approvals expected soon. A continuing resolution passed by the U.S. Congress on Dec. 7 to fund the government through Dec. 22 includes emergency stopgap funding for CHIP through the end of the year; however, longer-term congressional action is still required.

check markA tax reform bill that passed in the U.S. Senate on Dec. 2 by a 51-49 vote included a provision to repeal the individual mandate for health insurance coverage enacted under the ACA; a tax bill that passed in the U.S. House of Representatives previously, on Nov. 16, did not include a provision to repeal the individual mandate. Due to this and other differences between the two bills, the two chambers have gone to conference to find agreement on final tax legislation. Read the Academy alert.

check markEighteen states and the District of Columbia filed a lawsuit on Nov. 28 against a rule by the Trump administration that allows employers to opt out of offering insurance coverage for contraception.

check markAn amended Section 1115 Medicaid waiver was submitted to HHS by North Carolina on Nov. 20.

check markThe Arizona Supreme Court ruled Nov. 17 that a tax imposed on hospitals in order to finance the state’s Medicaid program is not in violation of the state’s constitution.

check markCMS released a proposed rule on Nov. 16 that would seek to lower Medicare spending on prescription drugs.

check markThe CBO released an updated estimate on the effects of repealing the individual mandate. CBO found that repealing the mandate would increase the number of Americans without health insurance coverage by 4 million in 2019, and 13 million in 2027. CBO also found that repealing the individual mandate would reduce federal deficits by $338 billion over the next decade.

check markVoters in Maine approved a ballot measure on Nov. 7 to expand Medicaid, following five previous failed attempts by the Maine Legislature to expand Medicaid. Another state health-related referendum was rejected by voters in Ohio that would have prevented state agencies from purchasing prescription drugs at higher prices than paid by the U.S. Department of Veterans Affairs. Read the Academy alert.

Life and Health Valuation Law Manual Available

Be one of the first to have the 2018 Life and Health Valuation Law Manual and order your copy today. Available for delivery in January, the manual is designed to help appointed actuaries comply with the requirements of the NAIC model Standard Valuation Law and the Model Actuarial Opinion and Memorandum Regulation. The manual has online and CD-ROM versions, allowing you to order the one that best meets your needs.

In the News/Media Activities