Health Equity From an Actuarial Perspective— Benefit Design - Cori E. Uccello, MAAA, FSA, FCA, MPP

Uccello, MAAA, FSA, FCA, MPP Senior Health Fellow, American Academy of Actuaries Presentation to Center on Budget and Policy Priorities Marketplace Affordability Project September 20, 2023 About the Academy • The American Academy of Actuaries is a 19,500-member professional association whose mission is to serve the public and the U. [...] They are experts in: ➢ Evaluating the likelihood of future events ➢Reducing the impact of undesirable events ➢Designing ways to reduce the likelihood of undesirable events • Health actuaries are trained in all aspects of the finance and delivery of health benefits. [...] Their responsibilities can include: ➢ Projecting future health care utilization and spending ➢Designing health benefit packages ➢Developing premiums 3 American Academy of Actuaries Health Equity Committee • Created to contribute actuarial perspective to health equity • Focus: ➢Evaluate actuarial practices in the context of health equity ➢Educate actuaries and other stakeholders on health equity is. [...] screening) tests may require cost-sharing ➢ Chronic care management may require cost-sharing and be subject to the deductible ➢ Even with zero cost-sharing, other barriers can affect access to care (e.g., transportation) 9 Services covered • Goal of the payer: Comply with federal/state requirements and attract customers while keeping premiums affordable • The Affordable Care Act (ACA) requires cov. [...] 15 symposium 13 Why aren’t more equity-enhancing features included in benefit designs? • There is pressure to identify cost savings in order to add new or innovative benefits ➢ Estimates of new benefits costs may ignore related reductions in other spending ➢ One-year health insurance term discourages benefits if offsetting benefits would not be realized until future years • Adoption of equity-enha.