In the second half of 2018 the Affordable Care Act continues to be a roller coaster of changes involving policy, services and funding. Here's a summary of news and research that impacts your work. Feel free to email me at [email protected]. I welcome your questions and comments.
States Take Steps to Stabilize Insurance Markets
Individual Mandates, Section 1332 Waivers
New Jersey, Vermont and the District of Columbia have passed some form of guaranteed issue law, and several other states are exploring similar measures.
Here's the story:
Short-Term Health Plans
Trump Administration Issues Final Rule
The rule expands the availability of short-term, limited-duration insurance (STLDI). Issued by the U.S. Departments of Health & Human Services, Labor and Treasury, it will go into effect 60 days after published in the Federal Register. Read it
here.
Association Health Plans
Research from the Society of Actuaries
Proposed regulations would expand the availability of Association Health Plans for small businesses and self-employed individuals. This study focuses on quantifying the impact on enrollment in ACA-compliant plans and the effect on the morbidity of the individual market risk pool. Read here.
Department of Justice Declines to Defend Individual Mandate
The U.S. Attorney General dealt a blow to the ACA when he told Congress the administration has determined the mandate is unconstitutional in the wake of the decision to repeal the tax penalty. Get the details
here.
Changes Are Coming to Medicare
Medicare Advantage and Medigap
Modifications to Medicare Advantage add new flexibility to benefits and are aimed at keeping people in their homes and out of the hospital.
Read more.
Why Actuaries Should Care About Public Health
Looking for Solutions
Understanding public health issues enhances actuarial practice and offers an opportunity to make a positive difference. In fact, the breadth and variety of public health issues cries out for actuarial solutions.
Read more here.
Insight into Diversity and Inclusion
Path to Real Change
What are the barriers to achieving more diversity in the actuarial profession? A new study suggests several ways to expand our ranks with people of color.
Learn more.
Podcasts
Startups have been bending the medical claims cost curve in a number of fresh, innovative ways, including concierge health services and new technology. What can larger, more-established companies learn from them?
A huge and complex facet of the health care equation,
public health is ripe with opportunities for actuaries who can evaluate program effectiveness, help prioritize dollars, and shape the future well-being of the U.S. population.
The
Affordable Care Act eliminated rating differences based on gender and mandated a difference between premium rates for the oldest and the youngest adults to be no greater than 3:1. What's been the impact of these changes?
Genomic testing is not genetic testing; it's being used to help inform decision-making in the treatment of some disorders. Payers face several important considerations around the funding of these tests.
The Medicare Advantage bid development process requires actuaries to reconcile data from many different sources, causing headaches and stress if it's done at the wrong time. Here's a better way. Listen.
