Additional information 324 A downgrade in Aegon’s ratings may increase policy surrenders and withdrawals, adversely affect relationships with  distributors, and negatively affect Aegon’s results. Changes in government regulations in the countries in which Aegon operates may affect profitability. Annual Report 2013 Claims-paying ability and financial strength ratings are factors in establishing the competitive position of insurers. A rating downgrade  (or the potential for such a downgrade) of Aegon or any of its rated insurance subsidiaries may, among other things, materially increase  the number of policy surrenders and withdrawals by policyholders of cash values from their policies. These withdrawals may require the  sale of invested assets, including illiquid assets, at a price that may result in realized investment losses. These cash payments to  policyholders would result in a decrease in total invested assets and a decrease in net income. Among other things, early withdrawals  may also cause Aegon to accelerate amortization of DPAC, reducing net income. Aegon has experienced downgrades and negative changes to its outlook in the past, and may experience downgrades and negative  changes in the future. For example, during 2012, Fitch put a negative outlook on its long-term issuer default rating for Aegon N.V. and  its insurer financial strength ratings for Aegon USA. Since 2012, Standard and Poor´s put a negative outlook on its insurer financial  strength rating for Scottish Equitable (Aegon UK). A downgrade or potential downgrade, including changes in outlook, may result in  higher funding costs and/or affect the availability of funding in the capital markets. In addition, a downgrade may adversely affect  relationships with broker-dealers, banks, agents, wholesalers and other distributors of Aegon’s products and services, which may  negatively impact new sales and adversely affect Aegon’s ability to compete. This would have a materially adverse effect on Aegon’s  businesses, results of operations and financial condition. Aegon cannot predict what actions rating agencies may take, or what actions Aegon may take in response to the actions of rating  agencies, which may adversely affect Aegon’s businesses. As with other companies in the financial services industry, Aegon’s ratings  may be downgraded at any time and without notice by any rating agency. Aegon’s regulated businesses, such as insurance, banking and asset management, are subject to comprehensive regulation and  supervision. The primary purpose of such regulation is to protect clients (i.e. policyholders), not holders of Aegon securities. Changes in  existing laws and regulations may affect the way in which Aegon conducts business and the products offered. Additionally, the laws or  regulations adopted or amended from time to time may be more restrictive or may result in higher costs than current requirements. The  recent financial markets dislocation has resulted in, and may continue to result in further, extensive changes to existing laws,  regulations and regulatory frameworks applicable to Aegon’s businesses in the countries in which it operates. For example, in July 2010, the US Congress passed the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act),  which provides for comprehensive changes to the regulation of financial services in the United States by granting existing government  agencies and newly created government agencies and bodies (for example the Financial Stability Oversight, Federal Reserve Board,  Commodity Futures Trading Commission and Securities and Exchange Commission) authority to promulgate new financial regulations  applicable to systemically important non-bank financial institutions. The regulatory changes include or may include differing standards  of capital for companies deemed systemically important financial institutions ‘SIFIs’ and other companies, as well as initiatives of U.S.  State and international financial services regulators to develop international capital, accounting and solvency regulatory standards for  internationally active companies. The primary impact to Aegon USA of the Dodd-Frank Act and similar financial services reform  legislation by other countries in which Aegon operates will be the Derivatives Reform part of the Dodd-Frank Act, which aims to  increase transparency of derivatives and reduce systemic risk. Aegon USA entities will be considered Category 2 under the regulations  and will be required to begin clearing derivative transactions as they are phased in over time, beginning with the four categories of  interest rate swaps and two categories of indexed credit default swaps on June 10, 2013. In addition, Aegon USA will have new  reporting, initial margins and variation margins obligations under the Dodd-Frank Act and its regulations. However, Aegon cannot  predict how the regulations will affect the financial markets generally or how the regulations will affect Aegon’s operations or financial  condition. In the United States, the Patient Protection and Affordable Care Act (PPACA) was enacted in 2011 and upheld by the US Supreme  Court in 2012. PPACA significantly changes the regulation of health insurance in the United States, including in certain respects the  regulation of supplemental health insurance products. The extent to which employers or individuals may discontinue their purchase of  supplemental health insurance products as a result of these changes may significantly impact Aegon USA´s supplemental health  insurance products business.