Health Policy Papers

Proposals to expand access to public health insurance plans are being put forward as a way to supplement efforts to strengthen insurance markets under the Affordable Care Act (ACA) or to replace the ACA marketplaces and/or other health insurance programs altogether. Goals of these proposals vary and include increasing access to affordable coverage, exerting downward pressure on provider prices, increasing plan availability, and reducing the number of uninsured. This issue paper from the American Academy of Actuaries Health Practice Council briefly outlines four approaches aiming to achieve such goals and highlights the key design elements that would need to be specified for an approach to be fully evaluated and implemented. (March 4, 2019)
Academy research study, Estimating the Potential Health Care Savings of Reference Pricing, exploring the possibility of using reference pricing to address health care costs, and building upon existing research by estimating the impact of expanding reference pricing to a broader set of health care services. (November 1, 2018)
Academy Essential Elements paper on the tax treatment of pensions and insurance protections, and the potential public policy trade-offs of changes to the tax code. Essential Elements is a series designed to make actuarial analyses of public policy issues clearer to general audiences.
(November 13, 2017)
Individual and Small Group Markets Committee issue paper examining the experience in the Affordable Care Act (ACA) individual market, outlining the conditions necessary for a sustainable market, examining whether these conditions are currently being met, and discussing the implications of potential changes to improve the ACA market rules or replace ACA with an alternative approach. (January 18, 2017)
Subcommittee Issue Paper on ACA Risk Adjustment Program
Risk Sharing Subcommittee issue paper that reviews the first year of experience under the Affordable Care Act’s (ACA) risk adjustment program with focus on experience in the individual market. (April 12, 2016)
Cancer Claims Cost Tables Work Group presentation to the NAIC's Health Actuarial Task Force on the progress of the valuation table and expected next steps. (August 14, 2015)
Medicare Supplement Work Group report to the NAIC on recommendations for potential modifications to the Medicare Supplement refund formula.  (November 12, 2014)
Health Practice Council fact sheet providing and overview of the three risk-sharing mechanisms included in the Affordable Care Act (ACA) - the permanent risk-adjustment program, temporary risk corridors, and the transitional reinsurance program. (December 4, 2013)
Health Practice Financial Reporting Committee white paper providing an overview of provisions in the Affordable Care Act - the premium-stabilization programs, new taxes and fees, advanced payments, and existing actuarial liabilities - that may create a certain amount of volatility on future financial statements. (June 25, 2013)
Issue guide on Medicare premium support and the potential implications of shifting Medicare to a premium support program. (February 11, 2013)
Update of a June 2011 fact sheet by the Health Care Quality Work Group providing an overview of the Medicare Shared Savings Program and the Pioneer ACO program. (December 19, 2012)
Guide to help voters understand what premium support is and the potential implications of shifting Medicare to a premium support program. (October 9, 2012)
Decision brief highlighting some of the issues that federal and state policymakers and regulators should consider as they are making their Medicaid expansion decisions. (September 10, 2012)
Voter guide to help explain why broad participation is necessary in the health insurance system to avoid higher premiums. (June 28, 2012)
Joint Academy/SOA research brief on risk-mitigation programs under the Affordable Care Act appear to reduce financial risks to health plans but overly restrictive limitations on premium rate increases can lead to high federal risk-corridor payments. (June 4, 2012)
Voter guide on Medicare to help explain the essential components of the program. (April 23, 2012)
Health Practice Council fact sheet providing an overview of the Medicare Shared Savings Program and how accountable care organizations (ACOs) are addressed in the Affordable Care Act. (June 16, 2011)
Health Practice Council brief providing definitions for commonly used terms associated with health care reform implemenation. (August 1, 2010)
Critical Issues in Health Reform
In 2009, the Academy's Health Practice Council introduced a new series of policy statements -- Critical Issues in Health Reform -- to provide an actuarial perspective to policymakers as they grappled with developing comprehensive reform proposals to slow the increase in health care costs, provide affordable and accessible coverage for the uninsured, and promote quality care. These policy statements addressed a variety of issues related to health care reform, providing the implications of various proposals being considered and their potential impact on the health insurance market.
(March 23, 2010)
Health Policy Council call to action urging the President and Congress to restore the long-term solvency and financial sustainability of Medicare. (February 1, 2010)