CMS Releases 2016 ACA Marketplace Reinsurance And Risk Adjustment Data

On June 30, 2017, CMS released the results for the third year (2016) of the reinsurance and risk adjustment programs, two of the Affordable Care Act’s “three R” premium stabilization programs. The 2016 results from the risk corridor program, the “third R” will be announced later this year. ACA’s “Three R” Progams Are Modeled After Medicare Part D, But Are Weaker And More Controversial Than Their Part D Counterparts The ACA’s three R programs were modeled after similar premium stabilization programs that have operated for about a decade for Medicare Part D prescription drug plans. The Part D program also has a risk adjustment program (which adjusts premiums prospectively rather than insurer income retrospectively), a reinsurance program (which is much more generous than the ACA program and permanent rather than temporary), and a risk corridor program (also permanent, and initially more generous than the ACA program.). The part D premium stabilization programs played an important role in attracting insurers to the prescription drug program initially and have helped to keep premiums stable and premium increases low since the program was launched in 2006. They have undoubtedly been an important factor in maintaining the popularity and bipartisan support for Part D. The ACA premium stabilization programs have proven far more controversial than the Medicare Part D programs. The risk corridor program has been criticized as an Insurer “bail-out” and ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage Payment Policy Medicare Part D premium stabilization programs reinsurance risk adjustment risk corridors Three R's Source Type: blogs