Description: The article is a case study of various actuarial concepts invovled in the design and implementtion of the AQC - a global budget provider payment arrangement implemented by Blue Cross Blue Shield of MA.

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.