Eating breakfast, but its time to get started. Feel free to continue eating. Breakfast is important, but welcome to the Nations Capital. Were very pleased to welcome you to d. C. And to the academys annual meeting and Public Policy forum. Id like to extend a special welcome to our firsttime attendees and particularly to new academy members. We hope that all of you will find our program over the next day and a half informative and stimulating. I would encourage you to take some time to connect with each other and interact with our speakers, so you get the very best and the very most you can out of our time together here. Were very proud to offer a tremendous lineup of speakers. They represent a wide range and deep range of Public Policy issues and professionalism issues. What better place to do this than the Nations Capital . And just days before a national electi election. Was halloween recently. I hope we were all scared a little bit in a positive and lifeaffirming way. Many of us find the upcoming election even scarier which is not the way it ought to be. We are going to offer comic relief this evening with the capitol steps. If youve ever seen them, they are going to poke fun at the election and National Politics in a way that will blow your mind. But setting the humor and hype aside, its important to remember the results of these elections for president , for congress, for the other down ticket races around the country do, in fact, matter. Our elected leaders shape the policies that shape our lives, including the professional lives of the actuaries. We are privileged to be part of informed discussions of Public Policy developments in the areas that each of us practice in. Speakers like cms acting administrator andy slavitt who well introduce in just a few minutes will provide us with a perspective essential, particularly for health actuaries in our practice and citizens. Actuaries serving inside and outside Government Service have an expertise essential to sound policy making. Our knowledge needs to be shared. Thats in the public interest, with those who shape the legal and regulatory environment. We do that all year through the academys very robust Public Policy program. Now, in sharing our expertise with policy makers, it is absolutely critical that the academys work be nonpartisan. We need to be unbiased in all aspects of our work. Thats why in the academys Program Guide for this meeting, there are printed copies of the antitrust policy and conflict of interest policy. I have the pleasure of recognizing some of the members in attendance whose efforts have benefited the academy and the profession. Among those here today we have former Academy President s as well as previous recipients of the Jarvis Farley and robert j. Meyer serveieice awards. We have the pleasure today increasing the ranks of those people, and tomorrow with additional presentations of honorees. First things first. When i call your name, if you could stand and be recognized. Weve got a lot of people who have done a lot of good work we are going to be recognizing. I would ask you to please hold your applause until all the names have been called. First we have six past president s today, david hartman, ken hoeman, jim mcginidy, mary d. Miller, Dave Sandberg and tom thierry. Thank you. We also have with us today some past Jarvis FarleyService Award recipients. I would like to recognize donna claire, fred kilborn, ethan craw and bill odoe. Thank you. From our government actuaries, actuaries who are a bit more directly involved in Public Service. Four past recipients of the robert j. Meyer awards, steve go goss. We have four past recipients who registered. Ron gresh. Mary d. Miller. And sheldon summers. Now, i have the very great honor of adding a new name to the roles of those who received the mie meyers award. The academy established this award in 1994, to honor a fellow actuary who distinguished herself through many years of service in the public sector. The award is named after bob miers to honor his lifelong commitment to Public Service. For those of you who may not be old enough to remember, bob meyers was the first chief actuary for the Social Security administration from 1947 to 1970. He helped to structure and fund the largest social Insurance Program in our nations history. Bob wasles president of the academy in 1971 he wrote some material i had to study to pass my examinations to become an actuary. Each year the myers award made contributions to the common good through service to government or other public organizations. I believe bob myers would recognize recipients who through decades of Public Service. The 22nd recipient of the myers award is joan weiss. We are going to say things about joan so please, we want to make sure they get the good picture of you. Pension plans that serve millions of participants benefited from joans unflagging actuarial stewardship, spanning her career with Pension Benefit Guaranty Corporation and joint role of enrollment of actuaries. Joans dedication and professionalism earned respect and praise from her colleagues and peers in the actuarial profession. Not only does her service embody the spirit of Public Service that the robert j. Myers public Service Award represents, but she has worked to inspire that same spirit within others. She served as a mentor for actuaries and shared her knowledge with peers in the profession through service on the academys Social Security committee, our committees on actuarial Public Service and on the actuarial standards Board Pension Committee. We applaud and thank her for her work and the example she has set. So please, lets recognize joan. Thank you. You can totally lift it. Thank you, everybody. Dear colleagues and friends, this honor has both surprised and humbled me. After many years of Government Service, im excited to receive this recognition. I want to thank those who nominated me, the committee who chose me and the academy itself. I also want to note that any successes i may have achieved are due to all the others who have supported me and encourage immediate over the years. These people include my supervisors and coworkers everywhere ive worked, my fellow actuaries and my nonactuarial friends. A previous recipient of the myers award said, i didnt dream of becoming an actuary. Thats true of me, as well. I always liked math and i knew i wanted to find a way to use it in my career. Studying for a ph. D. In economics, i considered becoming a college professor. A key turning point occurred for me when a friend who was studying to become an actuary suggested i might enjoy actuarial science. I passed the first few exams, the university of michigan let me interview for jobs with their graduate students, and just like that, i was on my way to becoming an actuary. My career as an actuary began in the private sector, but my interest turned to Public Service. Then, as now, i feel that Public Service is important in its own right because of the power of government to improve peoples lives and to do things that really help people. I hope that my years of service have made a difference. Perhaps to those who, due to the existence of the Pension Benefit Guaranty Corporation, continue to receive the pensions they have earned. Listening to the perspectives of others was perhaps the most important lesson i learned through my years of Public Service. My volunteer service with the academy, the actuarial standards Board Pension Committee and the so side of actuaries helped me to become a better listener and therefore, a better Public Servant. It always helped me to hear different view points and take them back to my job. Reenforcing that being an actuarial Public Servant is more than being just a technician. In closing, i hope this award in some small way inspires actuaries and others to a career in Public Service in the spirit of robert myers. Working with younger actuaries at pbgc, and encouraging them to improve their skills and gain credentials, even when the credentials were not an explicit job requirement, was one of the most fulfilling aspects of my years in Public Service. The greatest honor i can think of would be if one of these younger actuaries could receive the myers award from the academy some day. Finally, i offer thanks to my partner peter chakin who works from our home. He always has a smile for me and a hot meal waiting for me when i return home after a long day of work. His support and encouragement were constant and invaluable. I want to again thank all of you for this honor. The myers award is one of the two highest awards that the academy presents. Tomorrow, i will have the honor of presenting the other award, the Jarvis Farley award to bob mylander in recognizing three members with the outstanding volunteerism award for work theyve done in the past year. Volunteers make the work of the academy possible. We could not do the good work we do here in d. C. Without our volunteers. We couldnt do the work we do in states through public comments, providing testimony and working with legislators and regulators if it were not for our volunteers. And now we move to continuing to inform and Exchange Ideas with someone who has been at the center of many issues that are near and dear to the academys hearts. The volunteers of the academys Health Practice council, which i worked with for many, many years, have been very busy in recent years providing actuarial insight into the policy makers on programs like medicare and medicaid. Recently a great deal of our time has been taken up with the Affordable Care act. The primary federal agency for policy development and Regulatory Oversight of these systems is the centers for medicare and Medicaid Services. If youre not familiar with it, you should be. It has an incredibly Important Role in our lives and the lives of our nation. The agency is part of the u. S. Department of health and human services, and it oversees the implementation, administration and an enforcement of Health Insurance regulations affecting millions and millions of americans. Its my pleasure and my honor to be able to introduce this mornings keynote speaker, who is the centers for medicare and Medicaid Service acting administrator andy slavitt. As acting administra administra slavitt has helped and continues to help shape and deliver health care services, including medicaid, medicare, the Childrens HealthInsurance Program and the Health Insurance marketplace. If youre not a Health Insurance person, this affects 140 million americans directly through the health care. We are extremely fortunate that he can join us today to provide some insights on the challenges and opportunities ahead for a Health Care System. Since joining cms in 2014 as Principal Deputy administrators, he helped to strengthen the performance in the marketplace and overseen the 2014 open enrollment season. Since taking role of acting administrator in early 2015, hes been focused on strengthening cms role helping the Delivery System meet the evolving needs of consumers, including the way health cares paid for, ways to make the system succeed, and by advancing simplicity and transparency. Were going to have limited time for questions and answers once he speaks, so please keep your questio questio questio questions succinct to get in as many as possible. Please welcome acting administrator andy slavitt. Thank you so much. Good morning. You know, i do a fair amount of public speaking in this job because part of the job is to be with the public. When they told me its time to go talk to the actuaries, i had the flackback of all the times in my career when i was about to release quarterly numbers and somebody says, you might want to go talk to the actuary first. I have been honored through the course of my career and particularly so at cms to work with some of the finest actuaries around. Just tremendous respect for all of you. I want to thank tom, and really want to thank the academy for a couple of things. The objectivity, your technical leadership, expertise this membership brings to the hard questions of health care reform. It doesnt matter what happens politically. There will always be ongoing debates about Health Care Policy decisions, and your work and your voice are vital to our ability to get it right. Any study of American Health care reform will reveal a series of fits and starts. I think the pattern is many years we go many years with very little progress followed by some significant event which catalyzes change. The Affordable Care act was such an event as macra passed by bipartisan legislation. In between these spurts of progress, we tend to adapt and make adjustments as necessary to live within the new normal, all of us, no matter where we sit in health care. Normally in my speeches, i like to begin by extolling the virtus of accomplishment. Instead im going to talk about reminding us what it was like before the Affordable Care act, back when we were living in the old normal. The old normal, what was it like . Really was a Health Care System that had at its core design a system that many of our neighbors and frankly many of us just didnt work. Wasnt that long ago. Let me just go through the very quick Health Illness cycle of what that looked like. 15 of the country had no access to preventive care. No mammograms, no colonoscopy, no screenings. There was no reliable source of primary care let alone Care Management services for these people. Therefore, what do they do . They utilize the e. R. For needed services. When they got sick, millions of people just couldnt or chose not to be able to fill their prescriptions because they couldnt afford to. If they felt pain or needed surgery or other expensive care, they ignored it for as long as possible. And then the finances were all backwards. People with low incomes were chased down for bill charges from hospitals well in excess of commercial rates. As a result, health care became the second leading cause of personal bankruptcy. Whats the first leading cause of personal bankruptcy . Anybody know . Divorce. Or as my single friends say, marriage. As a result of that, hospitals and clinics, bad debt became part of their formula for how they operated. That meant cost shifting, raising the price for employers and really decreasing compensation to employees. There were other effects. Anybody who had a past illness was prevented from the ability to get insurance, and of course as a result, that meant that many people clung to jobs just very simply for the health benefits. Then finally, despite arguments that are sometimes persuasive for many, the American Forces alone should serve its best in health care. There was no transparent information, no incentive to build technology, no incentives for quality, no incentives for coverage, and therefore, little inclination for us to do things better. As a result, you and i, if youre like me, would attend meetings like this once a year where we would talk about the problems, talk about the progress we nedded to make, and then we would come back the next year and have the same exact conversation or pretty close to it. I can go on, but i think the point im trying to make is that the old normal was bad for patients. It was bad for our health. It was bad for hospitals, bad for physicians, but it was also bad for our economy, bad for medical trend, and bad for our country. Now, one law isnt going to fix that in an instant. But today when we count 20 million americans who are living in a new normal and now have access to coverage for the first time because of the aca, it represents an opportunity for us to move away from the dysfunction of the past. So i want you to look at it this way. Cutting the uninsured rate near in half doesnt just represent a set of numbers or even an impact on peoples lives. It also represents our countrys ability to set off on a path of progress, where we can finally move away from the fits and starts to a place where we can improve and then improve and then improve, but thats not the work of the law. Thats the work of all of us. So what do we need to do next . First the basics. Covering more and more people. Weve just begun. The most obvious way to do this is to expand medicaid everywhere. Millions of people, health outcomes, state budgets and health care finances will all immediately improve around the country. We know this. Even premiums on the exchanges declined by 7 in states where medicaid has been expanded. Second, we need to reach mi