n Grandfathering provisions that allow small groups to keep their current plans under the old rating rules would help mitigate n In states that already have adjusted com- munity rating or pure community rating rules, premiums may exhibit less change. November 2009 Comment letter to the U.S. House of Representatives on the affordable Health Care for america act (H.R. 3962): http://www.actuary.org/pdf/ health/ahcaa_nov09.pdf Critical Issues in Health Reform: State-level ImpaCtS