Description: This session will present the findings published in the report released by the SOA on the March 23, 2020, the 10th anniversary of the ACA.This session will provide an assessment and commentary on the viability of the individual and Medicaid marketplaces under the ACA since its inception. Observations will be based on a data-driven analysis of the associations between market characteristics and measureable outcomes indicative of viability. Viability will be measured in the context of achieving the ACA's goal of providing sustainable access to affordable healthcare to the uninsured and underinsured, and will be considered from the perspectives of various stakeholders.

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

Description: The report looks at the different outcomes for the 50 states from the ACA, in terms of cost and availability of health insurance coverage. It identifies 11 key observations since the passage of the ACA.

Description: In May 2019, the Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin clarifying how payments to subcontracted vendors should be accounted for in the medical loss ratio (MLR) calculation required by 42 CFR §438.8 as established by the Medicaid and Children’s Health Insurance Program managed care final rule published in May 2016. In the bulletin, CMS focuses on the responsibilities of a subcontractor in providing data and the proper accounting of subcontractor payments for purposes of MLR reporting. While the provisions outlined in this bulletin apply to all subcontractor relationships, CMS specifically highlights pharmacy benefit manager arrangements that may include “spread pricing” and rebate retention.

Description: Technical report to accompany Fifty States, Fifty Stories: A Decade of Health Care Reform Under the Affordable Care Act.