Overview of reinsurance and high-risk pools in the individual market

While there is significant uncertainty regarding current healthcare reform legislation, reinsurance and high-risk pool (HRP) programs are likely to play a role in attempting to stabilize individual market enrollment and premiums. In this paper, Milliman consultants Fritz Busch and Paul Houchens examine the following issues related to reinsurance and HRPs. • The historical uses of […]

Possible changes to Medicare Part D reinsurance programs

The Medicare Payment Advisory Committee (MedPAC) has previously suggested changes to the Medicare Part D reinsurance and risk corridor program. But several factors—the current state of the Part D market, recent attempts to curtail Medicare spending, and large increases in reinsurance payments—may increase the likelihood that MedPAC and the Centers for Medicare and Medicaid Services […]

Update on canceled plans: Will changes to 2014 reinsurance and risk corridor programs provide financial relief?

On November 14, 2013, the president announced changes to healthcare reform, including the potential reinstatement of certain canceled health policies, as well as suggesting that changes might be made to the federal risk corridor program. Since then, the administration has provided more specifics on the proposed changes to the risk corridor calculations. In addition, they […]

Discussing ACA’s three Rs: Reinsurance, risk corridors, and risk adjustment

The October 2013 edition of Health Watch focuses on the “three Rs” of the Patient Protection and Affordable Care Act (ACA): reinsurance, risk corridors, and risk adjustment. Milliman consultants contributed three articles on these issues: • The cover article, “Risk corridors under the ACA” by Doug Norris, Mary van der Heijde, and Hans Leida, examines […]

Pairing risk adjustment to support state 1332 waiver activities

Section 1332 of the Patient Protection and Affordable Care Act (ACA) allows states, starting in 2017, to waive certain ACA market rules to allow for more tailored commercial individual and small group market solutions. When states consider market reforms such as reinsurance under the 1332 Waiver with the aim of stabilizing the market and providing […]