Description: Health care reform will require health insurers to change the way they make decisions on what to sell while remaining financially sound. The new regulatory reality of expanded access to coverage leaves insurers with fewer options for managing costs and business risk. With the introduction of risk adjustment mechanisms in the exchanges, the most profitable members will not necessarily be the lowest cost ones, but rather, the members which the health plan is relatively more effective at servicing. While Patient Protection and Affordable Care Act 'PPACA' prohibits underwriting and using any health status information for denying coverage or varying the premium rates, this article describes how the use of consumer data will affect the way health insurers make decisions on what products to sell.

Description: The discussion will review major elements of the reinsurance market as health care reform replaces traditional markets. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Discussion of various alternatives for financing health care.: It discussed providers,the uninsured employers of uninsured workers, employers through taxes , assessment on health insurance and general revenues.

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: Highlights of health related articles from the North American Actuarial Journal. A paper on health care reform and efficiency is published in a recent issue of the NAAJ.

Description: This article describes the SOA's Risk Adjustment Research project, in the context of health care reform, and the preliminary data analysis that has been completed by the Research Task Force.

Description: Discussion of state medicaid expansion due to provisions of the Affordable Care Act.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate and influence health care policymakers on issues including principles for health care reform, Medicare, wellness programs, and solvency.

Description: This session discusses what will happen to supplemental coverages under health care reform. Topics include traditional group ancillary benefits, health care reform supplements, and traditional individual/group niche products? From Record of Society of Actuaries Vol. 20, No. 3A.

Description: An article in which Robert Laszewski, a Washington health policy strategist, tells us, actuarial science has never been more important to our country.