Publication Announcement

With the slower pace of the health care reform regulatory process, HealthCheck will move to monthly publication. Beginning with this issue, HealthCheck will be published on the last Friday of each month—unless circumstances warrant more frequent publication.

Legislative and Regulatory Updates

The Department of Health and Human Services (HHS) on Dec. 23 issued proposed regulations [1] on the disclosure and review of unreasonable rate increases under Section 2794 of the Public Health Service Act. Under the regulations, 2011 rate increases that are 10 percent or higher will have to be publicly disclosed and reviewed to determine whether the increase is unreasonable. States are directed to perform the requisite review; if a state does not have the resources to provide a thorough actuarial review, however, HHS will conduct the review. After 2011, state-specific thresholds would be established that reflect the trends in each state.

The HHS released its fifth set of Frequently Asked Questions (FAQs [2]) relating to the implementation of the Affordable Care Act (ACA) on Dec. 22. The new FAQs address value-based insurance design related to preventive benefits, dependent coverage of children to age 26, preexisting condition exclusions for children in the individual market, grandfathered health plans, and mental health parity.

President Obama indicated a willingness to consider improvements to the health reform law—including eliminating the 1099 reporting requirement—in his Jan. 25 State of the Union address. During his speech, the president urged policymakers to move beyond efforts for repeal. He also stressed the need to address the growth of health care spending and suggested revisiting the issue of medical malpractice reform.

In The News/Media Activities

The Academy issued its 2011 Actuarial State of the Union news release [3] on Jan. 24, a day before President Obama delivered his address. The Academy's release outlined, from an actuarial perspective, a domestic policy agenda to improve Americans' financial security and restore the nation's fiscal health. Among the issues explored by the actuaries, the Academy said that addressing the long-term financial challenges facing the nation's retirement programs, including Medicare, should be foremost on this year's legislative agenda. The Academy also looked at health security and reemphasized the need to keep the goals of health care reform at the center of efforts to implement the new health law and any other potential congressional action.

Academy Senior Health Fellow Cori Uccello discussed the Academy's State of the Union policy outline with "Metro Watch" host Gloria Minott (WPFW 89.3 FM in Washington) on Jan. 25. Uccello told Minott that with respect to Medicare—and the entire health system in general—one of the biggest issues on which to focus is curbing health spending growth. She said that the new health law can start the nation in the right direction, particularly provisions in the law that refocus the health system on paying for quality care that is coordinated across different health providers. But Uccello added that more needs to be done along these lines.

The Academy's July 2009 letter [4] to congressional leaders regarding the long-term sustainability of the Community Living Assistance Services and Supports Act (CLASS Act) and its related Critical Issues in Health Reform FAQ [5] were both cited in a Jan. 19 Heritage Foundation research report [6]. The Academy's adverse selection concerns with the CLASS Act also were referenced in a second report [7] by the foundation on Jan. 21.

Upcoming Health Care Reform Events

National Health Policy Conference [8]

Conference:	Feb. 7-8 in Washington (fee charged)
Sponsor:	AcademyHealth

For a complete listing of upcoming and recent health care reform events click here [9].