Risk Adjustment and Reinsurance (RARE) Workgroup
Convened by the Office of the Health Insurance Commissioner with support from Wakely Consulting and our stakeholder partners
The Affordable Care Act (ACA) brings many new enrollees to the health insurance marketplace. Because these new members have unknown health history and future medical needs, and because the ACA instructs insurers to accept all applicants, the new enrollees may undermine the stability of the commercial market. For instance, some insurers may attract an unusually high-needs population whose medical costs could compromise insurer reserves. As a result, insurers may raise premiums to handle this uncertainty.
To combat this uncertainty, the Affordable Care Act directs states to develop risk adjustment and reinsurance programs and directs the federal government to build a risk corridor program among the payers. The goal of these programs – the Three R’s – is to allow insurers to compete on the value of their services, not on the relative health of their members.
Key Documents and Information
May 3 Kickoff Meeting Presentation
Kickoff Meeting May 5, 2012
Upcoming Meeting Details
RARE Workgroup Meeting Information
Syed Mehmud (IT & Data Team Lead)
Ross Winkelman (Policies & Parameters Team Lead)
James Woolman (Administration & Finance Team Lead)