Jason Karcher

FSA, MAAA

Actuary and Health Policy Consultant

Brookfield, WI, US

Main +1 262 784 2250 | Office +1 262 796 3437

Jason Karcher is an actuary and health policy consultant with the Milwaukee office of Milliman. He joined the firm in 2013.

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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

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Publications

Read their latest work

Article

2027 Advance Notice: Examining the influence of fee-for-service Medicare spending trends on federal payments in Medicare Advantage

05 March 2026 - by Jason Karcher, Brian Larsen

We review the impact of FFS spending trends on federal payments in Medicare Advantage.

Article

Medical loss ratio requirements: Challenges posed by vertical integration

09 February 2026 - by Michelle (Klein) Robb, Jason Karcher

Medical loss ratio requirements: We discuss the challenges posed by vertical integration for regulatory agencies tasked with assessing insurer efficiency.

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 Feller

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 Feller, 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.

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Experience

Jason’s primary area of focus is assisting clients with understanding actuarial implications of new legislation, regulation, and litigation.

Read their latest work

Article

2027 Advance Notice: Examining the influence of fee-for-service Medicare spending trends on federal payments in Medicare Advantage

05 March 2026 - by Jason Karcher, Brian Larsen

We review the impact of FFS spending trends on federal payments in Medicare Advantage.

Article

Medical loss ratio requirements: Challenges posed by vertical integration

09 February 2026 - by Michelle (Klein) Robb, Jason Karcher

Medical loss ratio requirements: We discuss the challenges posed by vertical integration for regulatory agencies tasked with assessing insurer efficiency.

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 Feller

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

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 Feller, 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.

Jason Karcher

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Experience

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Read their latest work

2027 Advance Notice: Examining the influence of fee-for-service Medicare spending trends on federal payments in Medicare Advantage

Medical loss ratio requirements: Challenges posed by vertical integration

The federal Medicaid matching rate: The changing landscape from the state perspective

Navigating health policy post-election – What lies ahead?

Breaking bid: What just happened?

Out of whose pocket? Many beneficiaries will spend less than expected to reach the IRA’s new $2,000 out-of-pocket spending limit

Supreme Court's 2024 rulings: A new era for health insurance and retirement benefits regulations

Medicare Advantage, Part D, and duals regulatory changes

Weathering the reform storm: The Inflation Reduction Act’s changes to Medicare and other healthcare markets

At-home COVID-19 testing costs for commercial health plans

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CHOOSE A LOCATION AND LANGUAGE

Jason Karcher

Experience

Read their latest work

2027 Advance Notice: Examining the influence of fee-for-service Medicare spending trends on federal payments in Medicare Advantage

Medical loss ratio requirements: Challenges posed by vertical integration

The federal Medicaid matching rate: The changing landscape from the state perspective

Navigating health policy post-election – What lies ahead?

Breaking bid: What just happened?

Out of whose pocket? Many beneficiaries will spend less than expected to reach the IRA’s new $2,000 out-of-pocket spending limit

Supreme Court's 2024 rulings: A new era for health insurance and retirement benefits regulations

Medicare Advantage, Part D, and duals regulatory changes

Weathering the reform storm: The Inflation Reduction Act’s changes to Medicare and other healthcare markets

At-home COVID-19 testing costs for commercial health plans

CHOOSE A LOCATION AND LANGUAGE