The Patient Protection and Affordable Care Act (PPACA), in conjunction with the Health Care and Education Reconciliation Act of 2010, represents a historic effort by the U.S. government to reform the healthcare system. Milliman was retained by the Medicaid Health Plans of America (MHPA) to provide an independent analysis of the impact of the PPACA health insurer fee on state Medicaid programs and Medicaid health plans.

The purpose of this report is to:

• Summarize the annual fee on health insurance providers under PPACA.
• Examine how the health insurer fee affects how state Medicaid agencies set Medicaid managed care rates.
• Quantify the financial impact of the health insurer fee on Medicaid programs under three Medicaid managed care growth scenarios.

This client report was prepared for Medicaid Health Plans of America.