Academy Activities

The Rate Review Practice Note Work Group on July 23 released an exposure draft of a practice note [1] on the preparation and review of rate filings under the Affordable Care Act (ACA). Comments on Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act are due by Sept. 4.

Actuaries from more than 1,800 registered sites and all practice areas tuned in to the Health Practice Council’s July 11 webinar for an analysis of the Supreme Court’s June 28 decision to uphold the individual mandate under the ACA. The speakers outlined the decision, discussed the next steps in the federal and state implementation process, and highlighted future Academy activities to address long-term health costs. Presentation slides [2] and an audio [3] recording of the webinar can be downloaded from the Academy website [4] at no cost.

The Stop-Loss Work Group in a July 29 comment letter [5] responded to 13 questions from the Employee Benefits Security Administration on small employers’ use of stop-loss insurance and how it may affect the market for fully insured small health coverage under the ACA.

Legislative and Regulatory Updates

The Department of Health and Human Services (HHS) on July 20 released the final rule [6] that establishes data collection standards used to define essential health benefits. The new regulation, which takes effect Aug. 20, requires issuers of the three largest small group market products in each state to report information on covered benefits to the HHS.

The ACA calls for states to establish health insurance exchanges to serve as marketplaces for individuals and small businesses to purchase health coverage. The Center on Budget and Policy Priorities reports that, to date, 11 states and the District of Columbia have passed laws allowing for the establishment of state insurance exchange programs. An additional 29 states introduced health exchange legislation, but that legislation either has stalled or been defeated. Three states have had exchange programs established as a result of executive orders. Seven states have taken no action on the issue. States must declare their intent to establish a health insurance exchange by November. If a state elects not to operate an exchange, the federal government will establish and operate the exchange on the state’s behalf.

The House approved legislation to repeal the ACA on July 11. H.R. 6079 [7], the Repeal of Obamacare Act, is the 33rd attempt by the House to repeal the ACA. The legislation, which was approved by a 244–185 vote, is not expected to pass the Senate.

In The News/Media Activities

Academy Long-Term Care Committee member Steve Schoonveld’s July 18 presentation [8] to the National Conference of Insurance Legislators was featured in a July 23 LifeHealthPro article, “‘Refine’ Long-Term Care Insurance, Actuary Says [9].”

The June 29 issue of Insurance Journal recapped the Academy’s perspective on the Supreme Court ruling and quoted Senior Health Fellow Cori Uccello in “Actuaries Say Individual Mandate Key to Viable Health Insurance Market [10].”

In “What Now for Health Care Reform? [11],” Pacific Institute CEO Sally Pipes cited a 2009 Academy study to make the case for health savings accounts in the June 29 issue of the Orange County Register. The same Academy study was referenced in a similar piece by Joshua Archambault, director of health care policy at the Pioneer Institute. “The State is Ignoring Proven Care Options [12]” appeared in the July 2012 issue of Healthcare News.

Upcoming Health Care Reform Events

Payment Reform: State and Private Sector Collaborations [13]

Webinar: Aug. 6, 1–2:45 EDT (no fee charged)
Sponsor: National Institute for Health Care Management

For a complete listing of upcoming and recent health care reform events click here [14].