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.
Risk Adjustment, Reinsurance and Risk Corridors
Medical Loss Ratio Reporting and Rebates
Premium Review
Early Retiree Reinsurance Program
Near-term Benefit and Eligibility Changes
Grandfathering Provisions
Other
Risk Adjustment, Reinsurance and Risk Corridors
Risk Adjustment issue brief released
The Academy Health Practice Council released a new issue brief, Risk Assessment and Risk Adjustment. The brief provides an overview of risk adjustment and outlines general considerations for implementing a risk adjustment mechanism under PPACA.
Medical Loss Ratio Reporting and Rebates
Letter to HHS on MLR credibility
The Academy provides input to HHS on credibility issues for the purpose of calculating rebates under the new MLR requirements.
Letter to NAIC on Contract Reserves
The Academy writes a letter to the chair of the NAICs Accident and Health Working Group offering input on the potential inclusion of a change in contract reserves in the numerator of the MLR rebate calculation.
Letter to the NAIC on Supplemental Health Care Exhibit exposure draft
The Academy writes a letter to the chair of the NAIC's Health Care Reform Solvency Impact Subgroup on an exposure draft of a new proposed financial reporting exhibit the Supplemental Health Care Exhibit.
Letter to HHS regarding MLR provisions
The Academy writes a letter to the Department of Health and Human Services in response to its request for comments on the PPACA provision that requires medical loss ratio reporting and rebates.
Letter to the NAIC regarding statistical credibility
The Academy writes a letter to the chair of the NAIC's Accident and Health Working Group responding to his request for input on defining an appropriate way to maintain statistical validity within the rebate process. The Academy sent a subsequent letter to respond to a request from the NAIC for more information on statistical credibility.
Letter to the NAIC regarding MLR considerations and potential disruption in the individual market
The Academy writes a second letter to the chairs of the NAIC's Health Care Reform Solvency Impact Subgroup and the Accident and Health Working Group regarding the medical loss ratio provisions and the potential for individual market disruption under the Patient Protection and Affordability Act.
Letter to the NAIC regarding medical loss ratio provisions in health reform law
The Academy writes a letter to the Chairs of the NAIC's Health Care Reform Solvency Impact Subgroup and the Accident and Health Working Group regarding considerations related to the Patient Protection and Affordability Act Medical Loss Ratio Provisions (2718).
Premium Review
Letter to Mass. legislature on SB 2447
The Academy writes a letter regarding Massachusetts Senate Bill 2447, which includes a provision that would limit rate increases to medical CPI.
Letter to the NAIC on draft rate-filing disclosure form
The Academy writes a comment letter on the NAIC's exposure draft of a rate-filing disclosure form that is intended to facilitate the reporting of unreasonable rate increases to HHS.
Letter to HHS regarding rate review
The Academy writes a letter to the Department of Health and Human Services in response to its request for comments on the PPACA provision that establishes a review process for unreasonable rate increases.
Letter to the NAIC regarding premium review
The Academy writes a letter to the chairs of the NAIC's Health Care Reform Solvency Impact Subgroup, the Accident and Health Working Group, and the Rate Review Subgroup regarding the Patient Protection and Affordability Act (PPACA) provision that establishes a review process for unreasonable rate increases.
Early Retiree Reinsurance Program
Letter to HHS on Early Retiree Reinsurance
The Academy writes a letter to the Department of Health and Human Services in response to an interim final rule on the PPACA provision that creates a temporary reinsurance program for early retirees.
Near-term Benefit and Eligibility Changes
Letter to HHS on Annual/Lifetime Limits and Pre-Ex
The Academy writes a letter to HHS in response to an interim final rule on ACA provisions that eliminate lifetime limits, restrict annual limits, eliminate preexisting condition exclusions, and prohibit rescissions.
Letter to HHS on dependent coverage
The Academy writes a letter to HHS in response to an interim final rule on the PPACA provision that extends dependent coverage to age 26.
Grandfathering Provisions
Letter to HHS on grandfathered coverage
The Academy writes a letter to HHS in response to an interim final rule on the ACA provision related to the status of health insurance coverage as a grandfathered plan.
Other
Health Reform Glossary
Health Reform Implementation: Understanding the Terminology
(August 2010)
Presentation to NCOIL on the CLASS Act
Steven Schoonveld presents during the July 11 National Conference of Insurance Legislators (NCOIL) Summer Meeting. His presentation focused on educating lawmakers about the CLASS Act (the new voluntary, long-term care services program).
Presentation on Health Reform Implementation
Academy Senior Health Fellow Cori Uccello presents during a June 15 American Enterprise Institute event, offering an actuarial perspective on health care reform implementation.
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