Tracking Health Insurance for Actuaries
Greetings!
In the quickly-changing world of health insurance, 2020 is off to a fast start. Issues related to federal policy reform remain top-of-mind in Washington just as the Affordable Care Act is headed for another court showdown. Meanwhile, the Society of Actuaries continues to produce groundbreaking research that puts us at the forefront of industry leadership. You'll find several links below. As a member of the SOA's Board of Directors, I am here to serve our global membership. Reach out to me if you have questions or concerns. -- Dave Dillon
The Individual Mandate
Federal Appeals Court Decision
In December 2018 a Texas federal court judge ruled the Affordable Care Act unconstitutional. Not surprisingly that ruling was challenged. Now, in an opinion unexpected by legal analysts, an appeals court in New Orleans has issued its opinion. Read the story.
Price Transparency
Media reports of consumers getting surprise medical bills rose to a crescendo last year, spurring members of Congress to initiate legislation. But thus far, lawmakers have failed to iron out a bill that will satisfy all the various stakeholders involved. President Trump, meanwhile, bypassed Congress altogether, wielding his regulatory power to effect change. Learn more.
Longevity Illustrator
Who among us hasn't talked with family or friends about how long we expect to live? A consumer-friendly tool helps generate a life-expectancy estimate. Learn about the Actuaries Longevity Illustrator here .
Cost Trends
Thomas Getzen, Professor Emeritus at Temple University & Executive Director of the International Health Economics Association, was commissioned by the Society of Actuaries to construct a resource model to project long-term healthcare cost trends . See the model and its 2019 update.
CMS has published the draft 2021 actuarial value (AV) calculator and user guide . In addition, the agency published its rate review bulletin with the timeline for submission of information about rate filings in the 2020 calendar year.

Federal health officials report 2020 enrollment in individual plans under the Affordable Care Act reflects stable, continuous demand for coverage. Read the most recent enrollment figures from CMS.
The Strategic Implications of MACRA
The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law in April 2015. As a driving force behind the movement to emphasize value over volume in how clinicians are paid, Congress and the CMS have continually made refinements to address the law’s administrative challenges. In this Society of Actuaries white paper , the authors provide valuable insights for actuarial professionals who are involved in payer and provider organizations.
NAIC Report
The National Association of Insurance Commissioner's Valuation Analysis Working Group (VAWG) has issued its completed review of the VM-20 Reserve Supplements and the Principle-Based Reserve Actuarial Reports filed for calendar year-end 2018. The review report is informative as it contains insights into regulator expectations, addresses areas of concern, and notes best practices.
MEDIA COVERAGE

PODCASTS

Drug prices are a thorn in the side of U.S. health care, rising much faster than the medical cost trend. What's driving these costs and what can actuaries do to apply their expertise in finding a solution?

Nate Worrell is breaking new ground exploring the intersection of actuarial science and good nutrition, taking fresh new view of food as an influence on health outcomes.

What's the best way for actuaries to sharpen their skills in the changing business world? Geisinger Chief Actuary Kurt Wrobel advises keeping a close eye on the horizon in order to identify the skill set we'll need in the future.

As the insurance market has changed, the consumer and carrier view of Supplemental Benefits also has changed, dramatically. Opportunities for actuaries are abundant.

Health reimbursement arrangements (HRAs) are becoming increasingly common as more employers are seeking an alternative to traditional health benefits. How do they compare to health insurance under the Affordable Care Act? What are the advantages and disadvantages? As an issue centered on consumer value, how do actuaries define and measure the concept?

Blockchain technology can have a significant role in the future delivery of health care. But experts say in order for it to drive innovation, it must operate in an ecosystem of data security, validity and seamless access.

The Society of Actuaries has a robust and extensive research program. Here is an overview of how SOA research is funded and a look at some of the recent and upcoming research projects.

Pharmacy rebates impact the healthcare market in several ways. Lawmakers and regulators are considering several potential changes regarding the transparency of these rebates. Here's what actuaries need to know when pricing or reserving health products.

Listen as Marty Makary, M.D. discuss his new book, "The Price We Pay: What Broke America's Health Care - and How to Fix it."