Analysis of HHS Proposed Rules on Reinsurance, Risk Corridors and Risk Adjustment

Provisions Critical to the Successful Implementation of ACA.

The proposed rules on Reinsurance, Risk Corridors and Risk Adjustment from HHS apply standards for these programs in order to lessen the financial risk issuers and state health benefit exchanges face under the Affordable Care Act (ACA) and to mitigate the impact of adverse selection. The intention is for issuers to compete for customers based on cost and quality, rather than attracting the healthiest, lowest-cost enrollees. The summary of these rules, as well as the authors’ analysis of their implications, is meant for policy-makers and state officials familiar with these complex issues.