The Actuary Magazine

Commercial Health Care: What’s Next?

Disclaimer: The Society of Actuaries makes no endorsement, representation or guarantee with regard to any content, and disclaims any liability in connection with the use or misuse of any information provided in this series of articles. Statements of fact and opinions expressed herein are solely those of the authors and are not those of the Society of Actuaries.


By Dave Dillon

JUNE 2017

The stated purpose of the Affordable Care Act (ACA) was to provide affordable health care to all Americans. The ACA has seen many successes since its passage in March 2010, including a marked reduction in the number of uninsured and a reduction in uncompensated care.

While the ACA has reduced the uninsured rate, the health insurance markets have seen significant volatility and instability. With this as the background, the new administration has an opportunity to reshape the health insurance market.

On May 4, 2017, the U.S. House of Representatives passed the American Health Care Act (AHCA) to repeal and replace the ACA. While the AHCA may not ultimately become law, many of its proposed provisions are attempts to address key issues that are still affecting the commercial health insurance market.


It is in this climate of impending change that the Society of Actuaries (SOA) Health Section Council is introducing a new initiative, Commercial Health Care: What’s Next?

This initiative is designed to be an anthology series of white papers and articles that will focus on education and research related to not only specific provisions of the AHCA, but all key issues that impact health care reform.


The initiative will focus on the following key underlying issues that all health actuaries and other interested parties should understand about the current health insurance market and how things may evolve in the future:

  • The impact of age-rating limitations
  • High risk/reinsurance pools
  • Impacts to the small employer market
  • The impact of the individual mandate
  • Modified benefit structures/changing the definition of health insurance
  • Health savings accounts/high-deductible health plans
  • Market stabilization
  • Tax credits/subsidies

Other topics may be added as the health insurance market evolves over the coming year.


The SOA has been fortunate enough to receive commitments from an outstanding group of volunteers to assist with this initiative. The current initiative team includes:

  • Armen Akopyan, ASA, MAAA, vice president, Cambia Health Solutions
  • Cecil D. Bykerk, FSA, FCA, HONFIA, MAAA, president, CDBykerk Consulting LLC
  • Michael Cohen, Ph.D., consultant, Wakely Consulting Group
  • Sabrina Corlette, J.D., research professor, Georgetown University’s Center on Health Insurance Reforms
  • Christopher Coulter, FSA, CERA, MAAA, actuary, Cambia Health Solutions
  • Dave Dillon, FSA, MAAA, vice president and principal, Lewis & Ellis Inc.
  • Greg Fann, FSA, FCA, MAAA, senior consulting actuary, Axene Health Partners
  • Beth Fritchen, FSA, MAAA, partner, Oliver Wyman
  • Travis (T.J.) Gray, FSA, MAAA, consulting actuary, Milliman
  • Josh Hammerquist, FSA, MAAA, vice president, Lewis & Ellis Inc.
  • Danielle Hilson, FSA, MAAA, consulting actuary, Wakely Consulting Group
  • Jackie Lee, FSA, MAAA, vice president and principal, Lewis & Ellis Inc.
  • Hans Leida, FSA, MAAA, Ph.D., principal and consulting actuary, Milliman
  • Liz Leif, FSA, FCA, MAAA, president, Leif Associates Inc.
  • Pete Nakahata, principal, PTN Consulting Group LLC
  • Doug Norris, FSA, MAAA, Ph.D., principal and consulting actuary, Milliman Inc.
  • Julie Peper, FSA, MAAA, principal and senior consulting actuary, Wakely Consulting Group
  • Erica Rode, ASA, MAAA, Ph.D., associate actuary, Milliman
  • Trey Swacker, FSA, MAAA, senior director and actuary, Aetna

Other outstanding actuaries and consultants will assist this team of volunteers by providing insights regarding the specific topics. Additionally, SOA staff—Joe Wurzburger, FSA, MAAA, Health staff fellow, and Rebecca Owen, FSA, MAAA, Health research actuary—will provide further insights and guidance.


Over the next few months, this series of education and research articles will be released monthly. We look forward to you joining us as we begin to inform and educate about such an important issue that affects the daily lives of U.S. citizens.

Dave Dillon, FSA, MAAA, is vice president and principal at Lewis & Ellis Inc. He has been appointed to chair the Commercial Health Care: What’s Next? strategic initiative by the Health Section Council.


Putting the ACA Back Together Again

Premium subsidies, incentives and interconnectivity of ACA policies
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New Rules to Expand Association Health Plans

How will they affect the individual market?
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Coverage for One and for All?

Impact of the individual mandate and guaranteed issue in the individual market
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Creating Stability in Unstable Times

A look at risk adjustment and market stabilization
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Small business owner

The Entrepreneur and the Specter of Health Care

How reform will affect small employers
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Risk Pool

The Next Generation High-Risk Pool

Can this be a lifesaver for the individual market?
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The Old and the Beautiful

How age and gender affect costs and premiums in commercial health care
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