Implementation Timeline 2010 2011 2012 2013 2014 2015 2016 2017 Temporary High Risk Pool Program Temporary Reinsurance Program For Early Retirees Immediate Reforms: • Extended Dependent Coverage • No Lifetime Limits • Internal/External Review • Restricted Annual Limits • No Pre-Existing Conditions for Children • Restrictions on Rescission • Disclosure of Justifications for Premium Increases • First Dollar Coverage of Preventive Services Medical Loss Ratios with Rebates Market Reforms • Guaranteed Issue • No Pre-Existing Condition Exclusions for Adults • Rating Rules • Essential Benefits Plans • No Annual Limits for Essential Benefits Exchanges Subsidies Individual/Employer Mandates Co-Op Plans & Multistate Plans Risk Adjustment Individual Market Reinsurance Program & Risk Corridors 2010 2011 2012 2013 2014 2015 2016 2017
Premium Stabilization Programs: The Three R’s Reinsurance Program (temporary) Risk Adjustment Program (permanent) Risk Corridor Program (temporary)
Addressing Risk: Reinsurance (2014-2016) Large Group Small Group Plans Plans $ $ Individual Third Party $ Plans Administrators $ Reinsurance $ Entity
Transitional Reinsurance Per-Enrollee Reinsurance Payments to the Administrative Cost Levied Year Payments US Treasury Expenses on Each Insurer* $63/ per 2014 $10 Billion $2 Billion Variable person (HHS Estimate) $44/ per 2015 $6 Billion $2 Billion Variable person (HHS Estimate) $26.25 Buck 2016 $4 Billion $1 Billion Variable Consultants Estimate
Addressing Risk: Risk Adjustment (Ongoing) Non- Risk Exchange Grandfathered Plans Plans $ $ $ $ Risk Adjuster
Addressing Risk: Temporary Risk Corridors
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