Description: The article discusses the sustainability of the ACA individual market from a public entitlement standpoint. A key point of measuring sustainability is the reliance on market forces rather than federal budget constraints. The article explains why an actuarial viewpoint of sustainability is necessary to a greater extent than other public assistance and social insurance programs. The article challenges actuaries to be a bold, objective voice in a space that is full of opinionated but often uninformed viewpoints.

Description: In the Leadership & Development Section’s Leadership Inspiration Contest, entrants were asked to tell us what inspired them to be a better actuarial leader. This is Fraser Smart's entry from the “Defining Moment/Event” category.

Description: A comment letter to policymakers produced jointly by the SOA and AAA presents findings from their actuarial analysis of the proposed CLASS Act. The analysis indicates that the proposed structure and funding approaches will be unsustainable, and will cover only a very small proportion of the intended population. The opt-out and guaranteed issue provisions of the plan pose a risk that soon the program will either need increased premiums and/or significant reductions.

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: This article discusses reasons why the Society of Actuaries is not vocal in expressing its opinion.

Description: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

Description: A summary of concerns about the Community Living Assistance Services and Supports Act, including flaws in the underlying premises, opportunism, inadequate sales incentives, insufficient benefits, adverse selection, and cashflow and solvency issues.

Description: A review of the development and responsibilities of the "appointed actuary" for Canadian insurance companies and other designated roles in Canada.

Description: A defense of the CLASS Act from the perspective of the private long term care insurance industry.