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Milliman Insights: Dealing with King v. Burwell - Health Plan Issues Pre/Post Supreme Court 
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One of the most important provisions of the Patient Protection and Affordable Care Act (ACA) makes premium subsidies (referred to in the legislation as “Advance Payment of Premium Tax Credits,” or APTCs) available to low- and moderate-income individuals. These subsidies, in conjunction with guaranteed issue requirements and the individual mandate, have resulted in nationwide exchange enrollment of about 7.3 million members, over half of whom were previously uninsured.

There is an expectation that enrollment will grow considerably larger during the upcoming 2015 open enrollment period, yet the legality of providing these subsidies in states with a federally facilitated exchange (FFE) has been questioned given ambiguities around language in the enabling legislation. On November 7, 2014, the U.S. Supreme Court decided to hear the King v. Burwell plaintiff’s appeal of the legality of APTCs. What is the significance of this event for health plans?

The uncertain status of APTCs in FFEs will eventually be resolved, but the Supreme Court is not expected to take up the case until spring 2015, and won’t deliver a decision until the process for filing plans and premium rates for 2016 is already well under way. So issuers in FFE states will continue to make decisions and set assumptions with increased uncertainty surrounding the market forces that will be at play in 2016. Issues that health plans should consider as this situation develops include: How many people will use FFEs? What will the morbidity of these individuals look like? Will health plans still have sufficient incentives to participate in the exchange? What effects will this have on off-exchange enrollment? What will happen to cost-sharing reduction plan variations? What impacts does this have on the employer market?

Please join us in this special HealthcareWebSummit 30-minute edition with Milliman's Jason Karcher, on Thursday, December 18th, 2014 at 1PM Eastern, as he discusses Milliman insights on key health plan issues pre and post the Supreme Court King v. Burwell decision.
Learning Objectives
In this special 30-minute edition, participants will be able to:
  1. Overview underlying issues relating to APTCs for FFE states that are to be addressed by the Supreme Court
  2. Review the major relevant findings in the lower court rulings pertaining to King v. Burwell
  3. Understand the uncertain environment for FFE state health plan decision making during 2015 pending the subsequent Supreme Court ruling
  4. Address six key issues health plans need to address in order to best position and prepare for this uncertain environment
  5. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow-up questions, and networking with attendees, faculty and other professionals through a dedicated LinkedIn group.
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Strategy and Planning Executives and Staff
  • Legal, Regulatory and Policy Executives and Staff
  • Actuarial Executives and Staff
  • Health Reform and Transformation Executives and Staff
  • Business Intelligence and Research Analysts
  • Managed Care and Revenue Cycle Executives and Staff
  • Product Development Executives and Staff
  • Health Plan Operations Executives and Staff
  • Marketing Executives and Staff

Attendees would represent organizations including:

  • Health Plans 
  • Benefit Consultants
  • Health Insurance Exchanges
  • Provider Networks
  • Government Agencies
  • Employers
  • Business Process Organizations 
  • Solutions Providers 
  • Associations, Institutes and Research Organizations 
  • Media
  • Other Interested Parties

Milliman Insights: Dealing with King v. Burwell - Health Plan Issues Pre/Post Supreme Court 
  Individual Registration Fee - Special 30 Minute Edition Pricing: $95. Post-event materials with video syncing slides and recorded audio, plus presentation pdf file: $45 for attendees; $160 for non-attendees after the event. Register online or download the event brochure. Attendees will also receive a complimentary trial subscription to Health Insurance Marketplace News.
Register Now   Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!
Jason Karcher

Jason Karcher

Jason Karcher, ASA is an Actuary with Milliman based in Brookfield, Wisconsin. Jason designs actuarial solutions to help clients navigate the complex world of modern health care. Jason recently co-authored the Milliman paper: Legality of ACA subsidies: What does the Supreme Court’s recent decision to hear this case mean for health plans?

Jason joined Milliman in January 2013. Prior to that he served with Allstate Financial as an Actuarial Associate, and before that was an Advanced Mathematics Instructor. Jason holds an M.S., Mathematics with the University of Illinois, Chicago and a B.S., Mathematics with the California State University-Long Beach.

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