Tag Archives: American Health Care Act

How might healthcare reform 2.0 affect dental care benefits?

The Affordable Care Act (ACA) made pediatric dental care an essential health benefit that issuers must offer on state exchanges. If proposed changes to the ACA are enacted, the dental benefits industry must again determine how to proceed in an evolving landscape. In this paper, Milliman’s Joanne Fontana discusses several key components of ACA that, if amended or removed, would affect dental benefits. She also provides considerations for dental insurers that can turn another potential round of reform into opportunity.

Exploring the future of CSR subsidies

The potential nonpayment of cost-sharing reduction (CSR) subsidies to health insurers could create instability in the Affordable Care Act’s individual market. Issuers are now contemplating their exchange participation plans for 2018, and the future of cost-sharing reductions will play a key role in their decision. This report by Milliman’s Pedro Alcocer, Frederick Busch, and Jason Karcher explores the possible legislative and regulatory outcomes and potential issuer responses.

What implications must the health insurance industry consider regarding the American Health Care Act?

In 2010, then-President Obama signed into law the Patient Protection and Affordable Care Act (ACA). In 2017, it’s déjà vu all over again, as the House of Representatives has passed the American Health Care Act (AHCA), which would significantly amend large portions of the ACA if it becomes law. While this bill has not yet been through the Senate and will almost certainly change before President Trump can sign it into law, the policies proposed in this legislation would make many changes to the health insurance sector.

In this paper, Milliman actuary Jason Karcher explores the effects that the May 4, 2017, version of this House bill may have on different markets and stakeholders in the healthcare and insurance ecosystem.

Considerations for Patient and State Stability Fund stakeholders

As the health care reform debate continues in Washington, D.C., it is worth revisiting one of the key components of proposed American Health Care Act (AHCA). The Patient and State Stability Fund (PSSF) is a grant program included in AHCA intended to stabilize individual and small group state insurance markets and lower patient costs. The PSSF would appropriate a total of $100 billion to states over the period 2018 through 2026. In this paper, Milliman’s Paul Houchens, Kathleen Ely, and Thomas Murawski discuss elements of the PSSF as proposed by the American Health Care Act (AHCA) on March 6, 2017. The authors also explore the following considerations for stakeholders.

• Value of reinsurance option
• Short application window
• State-specific impact of AHCA provisions
• High-risk pools
• State-run cost-sharing subsidies
• State-run premium subsidies
• Reduced Medicaid enrollment and benefits
• PSSF grant allocation methodology
• Promotion of and payment for preventive care
• Impact to healthcare providers