Risk Adjustment and Reinsurance

A Work Plan for State Officials

This brief presents states with a work plan that outlines the decisions and actions needed to implement the risk adjustment and reinsurance provisions of the Affordable Care Act.

The paper includes various implementation timelines based on several scenarios that reflect the flexibility states have in administering these programs. This work plan is meant for states that elect to allow the U.S. Department of Health and Human Services to define and administer most of these programs, as well as those that choose to customize and administer these programs themselves. States will need to adjust work plans based on the goals, resources and other specifics of their health insurance marketplace.