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
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
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
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
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
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
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
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
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
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
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
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
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
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
9/22/2015
/ Affordable Care Act ,
Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Certifications ,
Department of Health and Human Services (HHS) ,
Employer Mandates ,
Federal Health Insurance Exchanges ,
Guidance Update ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare.gov ,
IRS ,
Public Health Insurance Marketplace ,
Reporting Requirements ,
Subsidies ,
Tax Credits ,
Tax Liability
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
9/21/2015
/ Affordable Care Act ,
COBRA ,
Employer Mandates ,
Health Insurance ,
HRA ,
Insurance Industry ,
IRS ,
Medicare ,
Minimum Essential Coverage ,
Multiemployer Plan ,
Reporting Requirements ,
Required Forms ,
Self-Insured Health Plans ,
TRICARE
...So, why did HHS need over five years to propose the set of rules published September 8? Here are a few highlights. For brevity’s sake, we omit foreign language service requirements, disability accommodation, compliance...more
9/11/2015
/ Affordable Care Act ,
Age Discrimination ,
Anti-Discrimination Policies ,
Association Discrimination ,
Comment Period ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Essential Health Benefits ,
Gender Discrimination ,
Health Insurance ,
Pregnancy ,
Proposed Regulation ,
Public Health Insurance Marketplace ,
Race Discrimination ,
Sex Discrimination ,
Sexual Orientation Discrimination ,
State Health Insurance Exchanges ,
Title IX ,
Title VI ,
Transgender
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
6/29/2015
/ Affordable Care Act ,
Annual Assessments ,
Budgets ,
Centers for Medicare & Medicaid Services (CMS) ,
Employer Mandates ,
Full-Time Employees ,
Health Insurance ,
Healthcare.gov ,
IRS ,
State Health Insurance Exchanges ,
Subsidies ,
Tax Assessment