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Sue Me Once, and Sue Me Twice, and Sue Me Once Again

It sure seems like a long, long time since ACA foes were suing to block executive actions to “fix” problems that Congress couldn’t or wouldn’t. Now, it’s the turn of ACA defenders, who are suing to block executive actions to...more

Association Health Plans … Someday … Maybe

The October 12, 2017 “Executive Order Promoting Healthcare Choice and Competition Across the United States” gets things rolling, but this ball will have to roll up hill for months before it can roll downhill. Here’s...more

When (and How) the Roll Is Called Up Yonder (Part II)

The Senate’s finest hours were not those spent in July 26, 2017 health care policy debate, which resumed July 27 at 10:00 am EDT. The bipartisan demagoguery did not diminish, but some Senators on each side rose above that...more

When (and How) the Roll Is Called Up Yonder (Part I)

Senate floor activity has made this the ACA’s biggest news week not involving Justice Roberts, but whatever news you have read, rest assured that it wasn’t really that simple. Let us preach on it. Shortly after noon EDT...more

M.C. Escher and Erwin Schrodinger Walk into A Bar … Or Are They Walking Out? And How Can The CBO Be Sure?

The pundits and political partisans apparently stopped reading before the heading on page 9 of the CBO’s June 26 report on the Better Care Reconciliation Act (BCRA) Discussion Draft, “Uncertainty Surrounding the Estimates,”...more

Hull Speed, Codgers, and Pre-Existing Conditions: What Does the Senate Bill Do?

Many other things being equal, the longer the sail boat, the faster it can go before its bow wave defeats further speed increase. However, as any boat approaches its “hull speed,” an increasing amount of energy is required...more

And . . . the . . . CBO . . . Scooooores!

Here are the highlights we took (quickly) from yesterday afternoon’s Congressional Budget Office Cost Estimate for the American Health Care Act. The AHCA “would reduce federal deficits by $337 billion over the 2017-2026...more

ACA Repeal Reality Check

We didn’t take ten weeks off because there was nothing to talk about. Rather, we concluded around Labor Day that anything useful to be said about ACA compliance, pre-election, would be interpreted as political advocacy, so...more

It’s Marketplace Appeal Season!

All of us of a certain age remember the Bugs Bunny cartoon in which Bugs and Daffy confused dimwit Elmer Fudd as to the current hunting season – i.e., wabbit (Bugs) or duck (Daffy) – ending with the proclamation of baseball...more

House v. Burwell: Insurer Cost-Sharing Subsidies Unauthorized

A U.S. District Judge has ruled that HHS unlawfully has spent billions of dollars to reimburse insurers for cost-sharing reductions granted to individuals who bought health insurance through an ACA Exchange such as...more

Self-Funded Plan Discrimination Against Mental Health Treatment: Is Yours Doing This?

On January 22, 2016, the court in Joseph and Gail F. v. Sinclair Services Company, D. Utah No. 2:14-cv-00505, held that a self-funded plan violated the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction...more

HHS 2017 Notice of Benefit and Payment Parameters

This is the annual hodge-podge of changes to the risk adjustment, reinsurance, and risk corridors programs, cost sharing parameters, cost-sharing reductions, and Healthcare.gov user fees, usually filling hundreds of Federal...more

PCORI Fee Inflation Adjustment

In Notice 2015-60 (October 9, 2015), the IRS announced that the PCORI fee will rise to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. For plan years ending on or after...more

Healthcare.gov: No 2015 Employer Subsidy Notices

On September 18, 2015, the Centers for Medicare and Medicaid Services (CMS) published a set of “Frequently Asked Questions Regarding the Federally-Facilitated Marketplace’s (FFM) 2016 Employer Notice Program.”...more

Final 2015 Forms 1094-B, 1095-B, 1094-C, 1095-C and Instructions

On September 16, 2015, the IRS finalized these ACA coverage reporting Forms and Instructions... We report here, with minimal analysis, changes that we recognized on first comparison to the 2015 Draft Forms and Instructions....more

Budgeting for Employer Mandate Tax Assessments

For October 1 fiscal year employers, it’s budget season. Calendar year employers aren’t far behind. Those doubting their employer mandate compliance need to accrue reserves for non-deductible assessments that the IRS may...more

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