Jason Karcher
FSA, MAAA
Actuary and Health Policy Consultant
Brookfield, WI, US
Jason Karcher is an actuary and health policy consultant with the Milwaukee office of Milliman. He joined the firm in 2013.
Experience
Jason’s primary area of focus is assisting clients with understanding actuarial implications of new legislation, regulation, and litigation.
He has worked extensively with Affordable Care Act (ACA) regulations, as well as implications of broader health care reform on health care markets, including impacts on payers, providers, and members in both public and private coverage. Jason has worked with states on Medicaid budgeting and has been involved with several activities necessary to support Medicare Advantage bid pricing. Additionally, he has supported providers with understanding changes to Accountable Care Organization regulations.
Publications and Presentations
- The terms, they may be a-changin’: A primer on proposed changes to short-term medical plans. Milliman Insight, April 2018.
- Association Health Plans after the final rule. Milliman Insight, August 2018.
- Is copper the new bronze? Six things every health plan should know about HR 6311 and ACA risk pools. Milliman Insight, August 2018.
- The short-term/limited duration insurance rule and the potential impact on health insurance markets. Milliman Insight, August 2018.
- “Pathways to Success” MSSP proposed rule: Integrity. Milliman Insight, November 2018.
- “Pathways to Success” MSSP final rule: Key revisions of the proposed rule. Milliman Insight, January 2019.
- A breakdown of ACA risk adjustment validation. Milliman Insight, October 2019.
- Medicare for All sounds expensive. How expensive? Here are three questions you need to answer. Milliman Insight, January 2020.
- A look behind the curtains: A review of the debut of the ACA’s risk adjustment data validation program. Milliman Insight, February 2020.
- Looking Past Politics: Professionalism is key when piloting projections around the perils of political punditry. The Actuary, February / March 2020.
- Changing With the Times: The Past and the Future of ACA Risk Adjustment. Health Watch, June 2020.
- Every commercial health insurance issuer’s guide for understanding pharmacy benefit managers and medical loss ratio reporting. Milliman Insight, October 2020.
- Understanding the evolution of reference-based pricing and considerations for employers evaluating the approach. Milliman Insight, February 2021.
Professional Designations
- Fellow, Society Actuaries
- Member, American Academy of Actuaries
Education
- MS, Pure Mathematics, University of Illinois at Chicago
- BS, Mathematics, California State University, Long Beach
Publications
Read their latest work
Article
The federal Medicaid matching rate: The changing landscape from the state perspective
28 March 2025 - by Jason Karcher, Jill A. Bruckert, Mac (Jianbin) Xu
With potential cuts to Medicaid/CHIP federal funding, we present the implications for the federal matching rate landscape and the impact to states.
Video
Navigating health policy post-election – What lies ahead?
19 November 2024 - by Rebecca Smith, Jason Karcher
Whether you're seeking clarity on the new administration’s direction or a breakdown of the likely policy shifts in healthcare, our team is here to empower your strategy.
Video
Breaking bid: What just happened?
18 September 2024 - by Emily Vandermause, Hayley M. Rogers, Jason Karcher, Madeleine Cline
The 2025 Medicare Advantage bid cycle has been one of the most tumultuous yet, as stakeholders took a stab at addressing significant changes to the risk models, the Inflation Reduction Act, significant Star Rating changes, bid resubmissions, unexpected PDP demonstrations, and potential regulatory uncertainty from the Supreme Court.
Article
Out of whose pocket? Many beneficiaries will spend less than expected to reach the IRA’s new $2,000 out-of-pocket spending limit
27 August 2024 - by Jason Karcher, Jacob S. Magnusson, Michelle (Klein) Robb
We dive into ramifications of the Inflation Reduction Act on out-of-pocket spending limits for health insurance markets and Medicare Part D.
Article
Supreme Court's 2024 rulings: A new era for health insurance and retirement benefits regulations
31 July 2024 - by Jason Karcher, Nina Lantz, Ginny Boggs
Explore the 2024 Supreme Court rulings on health insurance and retirement benefits regulations, and learn about the end of Chevron deference, new statute of limitations rules, and the requirement for jury trials in civil penalties.
Video
Medicare Advantage, Part D, and duals regulatory changes
21 February 2024 - by Nicholas Johnson, Jason Karcher, Sam Shellabarger, Ryan Swenson
A deep dive into the policies influencing Medicare Advantage, Part D, and the dual-eligible market.
Article
Weathering the reform storm: The Inflation Reduction Act’s changes to Medicare and other healthcare markets
18 August 2022 - by Madeleine Cline, Jason Karcher, Jake K. Klaisner, Michelle (Klein) Robb
The Inflation Reduction Act will have countless implications for all industry stakeholders and will alter the Medicare landscape in 2023 and beyond.
Article
At-home COVID-19 testing costs for commercial health plans
29 March 2022 - by Jason Karcher, Jordan Pettibon, Hanna E. Holzer
We estimate the financial impact of the federal requirement for employers and individual insurance plans to cover self-administered and self-read COVID-19 tests.
Article
Bypassing the cliff: Implications of federal action to prevent most Medicare payment cuts in 2022
17 December 2021 - by Jason Karcher, Andrew Bourg
Besides providers, the action affects health plans such as Medicare Advantage organizations and Part D plan sponsors, plus insurers, employers, and patients.
Article
Impacts of regulatory options in independent dispute resolution on costs under the No Surprises Act
10 November 2021 - by Jason Karcher, Cory Gusland
The potential for increased health savings or spending will depend strongly on how entities manage the process of independent dispute resolution.