This week we have heard from community associated plans and large national for-profit plans a consistent message of inadequate rates in 2024 leading to concerns around actuarial soundness of 2025 rates. Wakely has conducted a survey of acuity adjustments and other approaches to mitigate uncertainty during the Medicaid unwinding. This paper summarizes approaches taken by actuaries in 27 states, and considerations for how they stand up to the biggest enrollment shift in Medicaid since the implementation of the Affordable Care Act.
