Academy Activities

The Health Practice Council (HPC) sent letters to the U.S. House and Senate on Dec. 7, highlighting the potential adverse consequences of repealing provisions of the Affordable Care Act (ACA) without having a replacement approach in place. The letters drew extensive media coverage, with stories by more than 500 media outlets, including the New York Times, CNN Money, The Hill, Kaiser Health News, National Public Radio’s “All Things Considered” national news radio program, and the Los Angeles Times. The Washington Post directly cited from the Academy’s letters in a Dec. 10 editorial arguing for the immediate need for a replacement plan in case the ACA is repealed.

The U.S. House Committee on Oversight and Government Reform’s subcommittee on government operations held a Nov. 30 hearing to examine premium increases for enrollees of the federal long-term care insurance (LTCI) program. Laurel Kastrup, chairperson of the Academy’s Health Financial Reporting and Solvency Committee, presented testimony on behalf of the Academy on the importance of actuarial input to considering, designing, and evaluating any potential LTCI reform approaches. Watch the video of the hearing here.

The LTC Criteria Work Group released an issue brief on Nov. 29 examining the essential criteria that should be used to analyze LTC financing reform proposals. The criteria cited as essential include: coverage; comprehensiveness of benefits; quality of care; understandability and choice; affordability; risk management and cost control; and financial soundness and sustainability.

On Nov. 14, the Stop Loss Factors Work Group sent a report to the NAIC Health Risk-Based Capital (HRBC) Working Group (E) reviewing the risk-based capital formulas currently used for medical excess of loss business. David Olsho, chairperson of the Academy’s work group, gave a summary of the report at the NAIC Fall 2016 National Meeting, at which the stop loss factor proposal (2016-17-CA) to incorporate a tiered factor approach on stop loss premiums was exposed for 30 days. The HRBC Working Group also exposed the Medicare Part D factor proposal (2016-16-CA) based on an Academy report that was published in August.

Legislative/Regulatory Updates

President Obama signed the 21st Century CURES Act into law on Dec. 13, after the U.S. House of Representatives and Senate each passed the measure after Thanksgiving. The bill dedicates more than $6 billion, with more than $4 billion dedicated to the National Institutes of Health, to implement key federal and state-level health care priorities.

The IRS issued proposed regulations on Dec. 9 that modify a 2013 definition of “net premiums written” for purposes of the Health Insurance Provider Fee. Comments are due by March 9, 2017.

The CHRONIC Care Act (S. 3504) was introduced in the U.S. Senate on Dec. 6. The bill aims to improve care coordination and health outcomes for Medicare beneficiaries with chronic conditions, including efforts to identify those patients with chronic conditions and allowing flexibility in Medicare Advantage plans and Accountable Care Organizations so they can better serve the needs of this population. The Academy’s Medicare Subcommittee sent a letter to the U.S. Senate Finance Committee in January with comments on the Bipartisan Chronic Care Working Group’s Policy Options Document.

The NAIC’s Health Actuarial (B) Task Force (HATF) adopted the Joint Academy/Society of Actuaries Cancer Claims Cost Tables Work Group’s new report and 2016 cancer claim cost valuation tables on Nov. 17. HATF discussed implementation of the 2016 Cancer Claim Cost Valuation Tables at the NAIC Fall 2016 National Meeting in Miami on Dec. 9.

In the News / Media Activities

CNBC’s “Squawk on the Street” broadcast an interview with Andy Slavitt, the Centers for Medicare & Medicaid Services’ acting administrator, discussing health care and ACA issues, in which Slavitt cited the Academy’s letters to the U.S. House and Senate. The video is available on CNBC’s website, along with a story discussing Slavitt’s comments. A clip of Slavitt’s speech at the Academy’s Annual Meeting and Public Policy Forum last month was replayed for a forward-looking discussion of health care and the Trump administration on C-SPAN’s “Washington Journal” Dec. 12 edition (mentioned at the 30:35 mark).

LifeHealthPro ran an article on the Stop Loss Factors Work Group’s recent report to the NAIC Health Risk-Based Capital (E) Work Group on risk-based capital formulas currently used for medical excess of loss business.

Senior Health Fellow Cori Uccello discussed the potential consequences of premium rate increases on nonsubsidized ACA plan holders in a Wall Street Journal story.

A LifeHealthPro story covering the Nov. 30 House LTCI hearing quoted Laurel Kastrup, who testified on behalf of the Academy on the importance of actuarial input to considering, designing, and evaluating a potential LTCI policy approach.

A Health Payer Intelligence story about plans for the incoming 115th Congress to take up legislation to privatize Medicare quoted Michael Thompson, chairperson of the Medicare Subcommittee, on the options available to policymakers for ensuring Medicare Part A’s long-term sustainability.

A McKnight’s story cited the Academy’s 2013 issue guide on the potential implications of shifting Medicare to a premium support program.