Risk Pros Weigh-in on BCRA

In an attempt to provide a nonpartisan, actuarial examination of the the Better Care Reconciliation Act of 2017 (BCRA), the American Academy of Actuaries sent a 12-page letter today to Senate leadership and copied all other members of Congress and the nation’s governors. The letter is from the Academy’s Individual and Small Group Markets Committee and Medicaid Subcommittee.

The actuary group states that for a sustainable, stable individual health insurance market, lawmakers should focus on:

  • Continued funding of the cost-sharing reduction (CSR) reimbursements.
  • Enforcement of the individual responsibility penalty (the “individual mandate”).
  • Increased external funding through increased premium subsidies or to offset costs for high-cost enrollees.
  • Avoiding legislative or regulatory actions that could increase uncertainty or threaten stability

The letter also urges lawmakers to consider the BCRA’s impact on the stability and long-term viability of Medicaid, with attention to five key areas:

  • Approaches to setting state caps.
  • Treatment of Medicaid expansion populations.
  • Growth rate methodology.
  • Program flexibility provided to states.
  • Continuing actuarial soundness requirements.

The letter is publicly available at actuary.org.

ASSOCIATION NEWS

LAAHU/VCAHU Senior Products & Marketing Summit
Don’t forget…The Los Angeles Association of Health Underwriters and the Ventura County Association of Health Underwriters have teamed up for a joint Senior Products & Marketing Summit. The event has moved to a larger venue, which allows for two learning tracks of education, additional sponsors and exhibitors to be a bigger part of the day. The summit will take place August 24, 2017, 8:30am-4:30pm at the Sportsmen’s Lodge in Studio City. There’s still time to register or inquire about sponsorship opportunities.

LAAHU Represents!
The Los Angeles Association of Health Underwriters recently cleaned up at the National Association of Health Underwriter’s 87th Annual Convention in Orlando, Florida. According to LAAHU president elect Bobbi Kaelin, the chapter took home seven awards, including three Emerging Leader Awards (Gus Altuzzara, Elizabeth Underhill and Neil Booth), the Media Relations Award, the Large Chapter Member Retention Award, Presidential Citation and Pacesetter award. LAAHU was also one of only five chapters in the country to be platinum certified. Way to go LAAHU!

MENTAL HEALTH

Kaiser Defends Mental Health Access Issues
Despite three warnings and a multimillion-dollar fine a few years ago, the California Department of Managed Health Care says Kaiser Permanente still doesn’t provide enrollees with “timely access” to behavioral health treatment, in violation of state law. In a formal response to the watchdog agency, Kaiser listed more than 10 changes it has made to improve members’ access to mental health care, including contracting with providers outside of the organization and aggressively recruiting and hiring clinicians. The plan cited internal audits finding that they complied with timely access laws more than 90 percent of the time and said “a corrective action plan is not warranted.”  The matter has now been referred back to the state Office of Enforcement for further action, which could include an additional fine. California’s timely access laws require insurers to provide patients access to a medical appointment within 48 hours for an urgent problem, or within 10 business days for a non-urgent issue.  Read the full story at California Healthline, a production of Kaiser Health News. (By the way, Kaiser Health News isn’t affiliated with Kaiser Permanente.)

EDUCATION

Cal State Fullerton One of the Best Insurance Universities
The International Insurance Society (IIS) has recognized California State University Fullerton and 19 other universities as Global Centers of Insurance Excellence (GCIE). The new certification program recognizes outstanding risk management and insurance programs that play an integral role in promoting insurance knowledge and research, according to IIS. The universities and colleges must meet stringent criteria focused on course offerings, graduate and industry employment rates, as well as professional involvement. The universities must also demonstrate that students are learning primarily from a designated full-time faculty with appropriate academic qualifications and research expertise. Visit IIS’s website for a complete list of the GCIE universities and more information on the program.