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Claims Costs Report Puts Actuaries in Political Hot Seat

Jacqueline Fellows, for HealthLeaders Media, April 3, 2013

A recent report from the Society of Actuaries (SOA) projecting a double-digit rise in insurer's costs because of the Patient Protection and Affordable Care Act (PPACA) thrust the normally low-key group into unfamiliar territory: politics.

Groups who oppose the PPACA seized on the report's finding that medical claims costs will rise by 32% on average, as well as vary widely by state. Others questioned factors that the SOA left out of its study, such as not including the varying level of subsidies consumers can use to buy insurance on the exchanges.

Kristi Bohn, SOA's consulting staff health fellow, says the group started this study over a year ago to provide guidance on costs of newly insured, who will be entering the marketplace through federally required health insurance exchanges, compared to those currently insured.

"This is a little too technical for most people's interest levels so I was surprised that it was picked up so much," says Bohn. "We weren't trying to be political; we're not a political organization."

The report bolsters claims from the Association of Health Insurance Plans (AHIP) that premiums will rise under the PPACA. Bohn is quick to point out, however, that the SOA's findings don't implicitly make that conclusion.

"Premiums will be interesting," she says, suggesting perhaps that insurers may work to keep premiums from rising by changing up their networks or making them smaller.

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