Insurance Market Reform

On May 31, 2011 the U.S. Department of Health and Human Services announced new steps to reduce premiums and make enrollment easier for individuals in the Pre-Existing Conditions Insurance Plan (PCIP) created under the ACA.

A study from the Health Care Reform Actuarial Working Group of the National Association of Insurance Commissioners looked at historical data from health insurers, underwriters and states to examine the effects of excluding brokers (or “producers”) from the administrative portion of the Medical Loss Ratio (MLR) calculations.

New findings from the 2010 Commonwealth Fund Biennial Health Insurance Survey indicate the need for covering more young adults.

The Department of Business and Consumer Services, Oregon Insurance Division, has applied for the Health Insurance Consumer Assistance Program Grant that will help consumers navigate health insurance.

The Department of Business and Consumer Services, Oregon Insurance Division, has applied for the rate review federal health care grants under health care reform.

A recent preliminary survey by HealthScape Advisors LLC showed that 46 percent of individual plans surveyed would likely have to give rebates to their policyholders if they do not change their spending patterns in 2011.

This issue discusses the responsibilities, opportunities, and challenges for state Medicaid agencies in implementing programs to encourage providers to adopt electronic health records, focusing on the Medicaid Electronic Health Record Incentive Program.

Starting September 1, 2011, the rule requires independent experts to examine any proposed increase of 10 percent for most individual and small group health insurance plans.

On May 11, 2011 HHS announced the launch of The Medicare-Medicaid Coordination Office's Alignment Initiative, an effort to more effectively integrate benefits under the two programs.

This report explains what the acturial values mean for consumers in the ACA.