Archive of Affordable Care Act

Cost of the Newly Insured Under the Affordable Care Act

The Society of Actuaries is pleased to make available draft material examining the cost of the newly insured under the Affordable Care Act. The draft material is being exposed for a comment period bef

Read MoreView Comments (1)
11Apr2012
Fiscal Effects of the Affordable Care Act Thumbnail

Fiscal Effects of the Affordable Care Act

by Ian Duncan, University of California - Santa Barbara An important new paper by Charles Blahous of George Mason University (and a Social Security and Medicare Trustee) has just been published. 

Read MoreLeave a Comment
Actuarial principles at play in Supreme Court health care case Thumbnail

Actuarial principles at play in Supreme Court health care case

by Sara Teppema, SOA senior staff fellow, practice research On Tuesday of this week, the U.S. Supreme Court wrapped up the second of four sets of arguments in the historic case involving the 2010

Read MoreView Comments (6)
06Mar2012
Latest national healthcare expenditures Thumbnail

Latest national healthcare expenditures

by Ian Duncan, University of California - Santa Barbara The recent release of National Healthcare Expenditure data for 2010 shows a very slight uptick.  What is more interesting, though, is the lo

Read MoreView Comments (2)
19Jan2012
On the edge of a new age of healthcare financing Thumbnail

On the edge of a new age of healthcare financing

by Ian Duncan, University of California - Santa Barbara When I entered health actuarial work 31 years ago, the absolute cost of health benefits was much lower (although as a percentage of average n

Read MoreView Comments (3)
05Jan2012
Essential health benefits – How will they be defined? Thumbnail

Essential health benefits – How will they be defined?

by Dan Pribe, consulting actuary, Optuminsight Imagine you’re a committee member for your state’s Medicaid program.  Your committee must decide the Essential Health Benefit (EHB) package provided to Medicaid beneficiaries while keeping within the budget your state legislature has provided.  Through some rather contentious meetings, you’ve all agreed to a package which includes most medications and services, but excludes some very expensive ones such as Elaprase, a medication costing nearly $400,000 per year to cover Hunter’s Syndrome, an extremely rare metabolic disorder affecting about 500 people in the United States.  Now imagine you come home from work a few weeks later and in some weird twist of fate your spouse informs you that your child has been diagnosed with Hunter’s syndrome.  You realize that if you had been on Medicaid, you’d be out of luck. While this particular situation is highly unlikely, it does draw our attention to how the EHB package required under the Patient Protection and Affordable Care Act (ACA) will be determined.  (more…)

Read MoreView Comments (2)
20Dec2011
Come one, come all! Actuaries as ringmasters Thumbnail

Come one, come all! Actuaries as ringmasters

by Mary Hegemann, senior consulting actuary, Wakely Consulting Group Comparing politicians to the circus is not a new concept, but the Affordable Care Act (ACA) has brought this comparison to a whole new big tent.  Some state politicians are quite the attractions, refusing to budge when it comes to planning for ACA implementation.  I feel like actuaries need to be the little monkeys at the circus clanging cymbals while riding a bicycle trying to get everyone’s attention (oh wait, maybe that was Curious George).  It’s not that doomsday is coming.  It’s that politics are getting in the way of preparation, and by the time the politics get sorted out, we may end up with an elephant-sized mess. Take risk adjustment for example.  Under the ACA, beginning in 2014 risk adjustment will be incorporated in the individual and small group markets in all states.  States without exchanges will default to having the feds administer risk adjustment.  States with exchanges can choose to administer risk adjustment on their own or to have the feds administer it for them.  (more…)

Read MoreView Comments (1)
Book Review: Health Care Will Not Reform Itself Thumbnail

Book Review: Health Care Will Not Reform Itself

Credit: Jared RodriquezWe are vociferous readers at the Society of Actuaries and we want to pass on our review of a book that has gained renewed interest in health care circles. In his New York Times best seller, Health Care Will Not Reform Itself: A User’s Guide to Refocusing and Reforming American Health Care, Kaiser Permanente CEO George Halvorson addresses the inadequacies with the U.S. health care system and improvements that can be achieved through health care reform, which is “within our reach.” This book came out in 2009 as Congress prepared to debate the Patient Protection and Affordable Care Act. As the ACA heads to the Supreme Court it is interesting to look back at the arguments Halvorson put forth. (more…)

Read MoreLeave a Comment
Will the role of retirement benefits (DB and DC) in competitive labor markets change? Thumbnail

Will the role of retirement benefits (DB and DC) in competitive labor markets change?

by Anna Rappaport, Anna Rappaport Consulting In my view, pensions and 401(k) plans have not been a major factor in individual decisions about taking jobs, although DB benefits can be a big factor in decisions about when to retire or leave, particularly at older ages. DC benefits have not been much of an influence on the timing of leaving. In contrast, health insurance has been an important factor in labor market decisions for many years in the U.S. Many people do not consider a job without good health insurance, and health insurance can be a significant factor in decisions about changing jobs and when to retire. In 2014, if the Health Insurance Exchanges are implemented as scheduled under the Affordable Care Act (ACA) , people without employer health insurance will have a new set of marketplace options. My view is that health benefits will be much less important at that point. I am interested in learning whether people think that pensions will become much more important in labor market competition and whether they agree with me about health benefits. I am interested in other ideas about how employers may compete for employees when the ACA is implemented. Please share your ideas below.

Read MoreLeave a Comment
2014: “Big bang” for health product pricing Thumbnail

2014: “Big bang” for health product pricing

SOA board member Alice Rosenblatt discusses the Department of Health and Human Services proposed rules on Standards Related to Reinsurance, Risk Corridors and Risk Adjustment.

Read MoreLeave a Comment