Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: Recap of Q&A sessions held to discuss the findings and methodology of a SOA study on the cost of the newly insured under the ACA.

Description: Affordable Care Act and Payment Reform

Description: The editorial shares observations and lessons learned from the process of implementing the Affordable Care Act.

Description: This article provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will Republican health care reform look like?

Description: The Affordable Act's risk corridor program is a temporary feature that applies to individual and small group QHPs from 2014 through 2016. Designed to protect insurers against pricing uncertainty, the program appears straightforward but has many subtle consequences. In this article, we review the need for risk corridors, the calculation itself, and the implications that result.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: This session discusses the impact of rising costs and increased litigation on managed care. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 133

Description: In order to encourage health insurance issuers to offer health insurance coverage on the Exchange and on the individual and small group markets, while ameliorating the potential impact on any particular health insurance issuer of providing coverage without pricing for pre-existing conditions or the gender of the insured, the Affordable Care Act includes three risk-sharing programs: the Transitional Reinsurance program, the Risk Corridor program and the Risk Adjustment program (collectively referred to as the “3Rs”). The financial and tax reporting of each health insurance issuer is affected by the implementation of these risk-sharing programs because each health insurance issuer is required to pay for the programs’ costs, and some issuers are or will be eligible for benefits under them.