Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

Description: Results of an SOA survey regarding the expectation for 2015 accruals for 3Rs and cost sharing reduction payments

Description: This article discusses the challenges and unknowns relating to the regulatory inclusion of pediatric dental benefits within the essential benefits list of the Affordable Care Act (ACA).

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.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: This article includes a summary of 2012 Health section activities as well as upcoming events, including the Health '12 Meeting, two HARI research projects (ACOs and risk adjustment), the value of health section membership, and our Canadian Outreach.

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: The chairperson reports on Health Section activities: papers by the joint workgroups with the AAA's Health Practice Council to inform the public and congressional staff, papers on capital requirements under proposed health care reform and on proposed taxing of Cadillac plans, new research on IBNR reserving methods and on measuring the quality and efficiency of health care delivery systems.