Description: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.

Description: The Society is taking a hard look at its members’ needs and our future as a profession. Two recent studies have focused attention on the building of our future: Report of the Task Force on the Future of the Actuary and Report of the Task Force on Strengthening the Profession. Both reports discuss the importance of our profession in health care matters. But, neither report is designed to address the practical issues involved with building toward our future in health care.

Description: There have been a variety of proposals related to expanding eligibility for Medicare, ranging from a publicly funded program to a full buy-in option. This session will explore the actuarial implications of various buy-in proposals and the potential impact that such policy changes could have on the health care market landscape. In particular, we will discuss the ways in which program eligibility requirements, plan designs, provider reimbursement arrangements, network design, rating rules, and subsidies could affect premium levels and membership volume in a Medicare buy-in market, as well as the potential side effects on providers and existing health care markets.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

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: This presentation uses a dataset provided by a private insurance company which contained demographic, cost, and diagnostic data which allows the determination of which factors drove costs up and how these factors will affect the total cost for future years.

Description: This article provides an overview of the key provisions and impacts of the Affordable Care Act's Cadillac Plan Excise Tax.

Description: An article that provides an actuary's opinion of why health insurance reform will work and believes that Congress should use insurance reform as the cornerstone for successful legislation.

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.