Academy Activities

On June 4, the Academy’s Health Practice Council released an updated version of a new issue brief that provides an overview of the factors underlying premium rate setting, and highlights the major drivers behind why 2015 premiums could differ from those in 2014, due largely to the Affordable Care Act (ACA). The brief was updated to reflect new information included in the final rule for exchange and insurance market standards for 2015 regarding the reinsurance and risk corridor programs.

In late May, as part of its new Essential Elements series, the Academy released What Drives the Growing Cost of Health Care, a paper that examines a number of drivers of health care cost growth, as well as a number of approaches that are being explored to help lower both the cost and utilization of health care services.

Legislative/Regulatory Updates

On June 4, the Senate confirmed Sylvia Mathews Burwell as the secretary of the Department of Health and Human Services. Nominated by President Obama on April 11, following the resignation of former-Secretary Kathleen Sebelius, Burwell received bipartisan support in the Senate, with a final confirmation vote of 78 to 17. Burwell formerly served as the director of the Office of Management and Budget.

The HHS published a final rule on May 27 addressing components of the ACA, including the federally facilitated exchanges, the Small Business Health Options Program (SHOP), the risk-sharing mechanisms, and minimum essential coverage. The Academy released an alert on this rule on May 16. The rule is effective on July 28, except for amendments to 45 CFR 155.705, which became effective May 27.

In the News/Media Activities

The Academy’s issue brief, Drivers of 2015 Health Insurance Premium Changes, was praised as “a helpful explainer of 2015 premium rate drivers” in the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms blog. A wide variety of outlets also covered the publication of the brief, including Life and Health Advisor, Politico Pulse, The Morning Consult, InsuranceNewsNet, Inside Health Policy, BenefitsLink Health & Welfare Plans Newsletter, LifeHealthPro, Insurance & Financial Advisor, Health Policy News Stand, and AHIP Coverage.

Discussing the brief with Modern Healthcare magazine, Cathy Murphy-Barron, chairperson of the Academy’s Committee on Federal Health Issues, emphasized that rate filings must be understood in the context of the limited and state-specific information on which they are based.

The media has called on Senior Health Fellow Cori Uccello to comment extensively about the conclusions of the new issue brief this month. Uccello was quoted in The Redding (Calif.) Record Searchlight, and on LimaOhio.com, regarding the uncertainty insurers face in 2015 rate filings. “Although insurers will have some information regarding the risk profile of their 2014 enrollees, such as their distribution by age and gender, available health status information is still very limited,” she said. Uccello was also quoted in The Miami Herald, The Fort Worth Star-Telegram, The Charlotte Observer, and in numerous other media outlets.

Additionally, in a (subscriber only) Health Plan Week article, Uccello highlighted some key points of interest in the Center for Medicare & Medicaid Services’ (CMS) May 27 final rule on ACA premium stabilization programs. Uccello pointed to the final rule’s language regarding how reinsurance collections would be distributed and CMS’s intention to reduce the 2015 reinsurance attachment point.

Health Care Costs Work Group Chairperson Audrey Halvorson’s explanation of risk pools was carried by The Yuma Sun and CopaMonitor.com. Arizona leads the nation in the percentage of children who enrolled through the federal marketplace, but had fewer enrollees than average in every other age group.

The MV/AV Practice Note Work Group’s practice note, Minimum Value and Actuarial Value Determinations Under the Affordable Care Act, was praised as providing “useful background on two important concepts” of the ACA in an Employment Matters Blog posting.