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What Risk Adjustment Does — The Perspective Of A Health Insurance Actuary Who Relies On It

March 31, 2016 

For decades before the Affordable Care Act (ACA), American health insurers were very good at avoiding enrolling people who were likely to be high-cost in the individual (or “non-group”) health insurance market. That all changed on January 1, 2014 with the ACA.  Despite the “guaranteed-issue” requirement, we can’t assume insurers truly offer coverage to everyone in the individual market.

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