News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) › Cost-Sharing › Health Insurance

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
King & Spalding

President Trump Signs Budget Reconciliation Bill with Significant Medicaid Changes into Law

King & Spalding on

On the afternoon of July 4, President Trump signed into law H.R. 1, the One Big Beautiful Bill Act – comprehensive budget reconciliation legislation that represents the core of President’s second-term domestic agenda and...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

ACA-Required Coverage of Contraceptive Care Remains Agency Focus

Ogletree, Deakins, Nash, Smoak & Stewart,... on

Once again, the U.S. Departments of Labor, Health and Human Services, and the Treasury have issued guidance on the Affordable Care Act’s (ACA) required coverage of contraception without cost sharing, clarifying the permitted...more

Ballard Spahr LLP

Prescription for Chaos: Copay Accumulator Programs Called Into Question

Ballard Spahr LLP on

Summary - Employers taking advantage of copay accumulator programs now face unexpected administrative complications following a recent federal court decision....more

Ballard Spahr LLP

Meet Me at the Corner of No Surprises and …

Ballard Spahr LLP on

Summary - The Departments of Labor, Health and Human Services, and the Treasury have issued guidance that coordinates application of the No Surprise Billing rules under the Consolidated Appropriations Act, 2021, with the...more

Sheppard Mullin Richter & Hampton LLP

Navigating the Wild West of the New ACA Preventative Care Ruling

Sheppard Mullin Richter & Hampton LLP on

On March 30, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a decision in Braidwood Management Inc. v. Becerra (“Braidwood”), invalidating the Affordable Care Act’s (“ACA’s”) mandate...more

Dickinson Wright

Federal Court Blocks Enforcement of Some ACA Preventive Health Service Requirements: What Plan Sponsors Should Consider

Dickinson Wright on

In a March 2023 ruling, a Texas federal district court vacated all actions taken by the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and Treasury (collectively, the “Departments”) to implement or enforce...more

Bradley Arant Boult Cummings LLP

Departments Issue Guidance on Preventive Services under the ACA Following the Braidwood Decision

Bradley Arant Boult Cummings LLP on

In light of the March 30 Braidwood Mgmt. Inc. v. Becerra decision, the Department of Labor, Department of Health and Human Services, and Department of the Treasury (the “departments”) have issued FAQ guidance on how the...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Federal District Court’s Ruling on Affordable Care Act Preventive Care Eases Employer Burden—at Least for Now

Ogletree, Deakins, Nash, Smoak & Stewart,... on

Employers, at least for now, may have some relief from some of the Affordable Care Act (ACA) requirements to cover preventive care services without cost sharing under a nationwide injunction issued March 30, 2023, by a...more

McDermott Will & Schulte

Tri-Agencies Address Preventive Services Coverage in the Wake of Braidwood

McDermott Will & Schulte on

In response to Braidwood Mgmt. Inc. v. Becerra, a recent case striking down part of the Affordable Care Act (ACA) preventive services mandate, the US Departments of Labor, Health and Human Services, and the Treasury...more

Groom Law Group, Chartered

ACA Preventive Service Requirements Partially Vacated

Groom Law Group, Chartered on

On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more

McGuireWoods Consulting

The Courts and Healthcare Policy - August 2021

McGuireWoods Consulting on

The courts continue to play an important role in health policy. 2020 saw several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

McGuireWoods Consulting

The Courts and Healthcare Policy - July 2021

McGuireWoods Consulting on

2020 saw the courts continuing to play an important role in health policy with several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

Kelley Drye & Warren LLP

Health Care Reform Changes and Other Updates

Kelley Drye & Warren LLP on

This Advisory provides a summary of recent developments impacting Affordable Care Act (“ACA”) requirements applicable to employers, as well as other recent changes impacting employer-sponsored health plans. ACA...more

Faegre Drinker Biddle & Reath LLP

Federal Circuit Holds U.S. Liable to Health Insurers for ACA Cost-Sharing Reductions

Faegre Drinker Biddle & Reath LLP on

Cost-Sharing Reduction (CSR) Payments Take Effect. Under Section 1402, the Affordable Care Act (ACA) implements a plan for reducing the amount of out-of-pocket costs, such as deductibles and co-payments, that lower-income...more

Faegre Drinker Biddle & Reath LLP

Considerations for Entry or Reentry Into the Individual Health Insurance Market

Faegre Drinker Biddle & Reath LLP on

Many health insurers and HMOs may be considering entering or reentering the individual health insurance market, either on or off a federal or state-based health insurance marketplace. Over the last two years, the individual...more

Pullman & Comley - Labor, Employment and...

CMS FAQ re Essential Health Coverage and the Coronavirus (COVID-19)

Pullman & Comley - Labor, Employment and... on

On March 12, 2020, the Center for Medicare & Medicaid Services Center for Consumer Information & Insurance Oversight issued an FAQ regarding coverage for diagnosis and treatment of COVID-19 under the Affordable Care Act. CMS...more

Seyfarth Shaw LLP

Sad Day for Coupon-Clippers

Seyfarth Shaw LLP on

Seyfarth Synopsis: Recently, the Trump Administration issued its proposed Notice of Benefit & Payment Parameter for 2021 regulations....more

Bricker Graydon LLP

Have you done your ACA affordability cost-share homework for the 2020 health plan year?

Bricker Graydon LLP on

Under the Affordable Care Act (ACA), applicable large employers are required to offer minimum essential coverage (that is both affordable and meets the minimum value standard) to at least 95 percent of their eligible...more

Faegre Drinker Biddle & Reath LLP

Health Insurers Win Important Ruling on Payment of ACA Cost-Sharing Reductions (CSR)

Faegre Drinker Biddle & Reath LLP on

A federal judge has ruled that health insurers under the Affordable Care Act are entitled to unpaid cost-sharing reduction (CSR) payments from the government. Insurers sued following the Trump administration’s October 2017...more

McDermott Will & Schulte

A Momentary Victory for the ACA: Federal Judge Issues a Nationwide Injunction against Trump Administration’s Contraceptive...

McDermott Will & Schulte on

On January 14, 2019, US District Judge Wendy Beetlestone in the US District Court for the Eastern District of Pennsylvania issued a nationwide preliminary injunction blocking the Trump administration’s carveouts to the...more

McGuireWoods Consulting

ACA Court Rulings: Midterms Hold Health Insurance in the Balance

McGuireWoods Consulting on

Over the past year, the courts considered cost-sharing reduction payments, the individual mandate, consumer protections, association and short-term health plans. Below is an overview of where ACA-related court rulings stand,...more

Mintz - Health Care Viewpoints

Court Rules that Federal Government Must Make Cost Sharing Reduction Payments to Insurers

Mintz - Health Care Viewpoints on

ACA plans scored a major victory last week when a federal court held that health plans participating on the ACA exchanges are entitled to unpaid cost sharing reduction (CSR) payments from the federal government. The case –...more

Baker Donelson

New 2019 ACA Payment Policies for Individual and Small Group Markets

Baker Donelson on

On April 9, the Department of Health and Human Services (HHS) released the long-anticipated final Notice of Benefits and Payment Parameters (NBPP) for plan year 2019, providing standards for health insurers and the health...more

Baker Donelson

Prospects for ACA Market Stabilization Measures Remain Uncertain

Baker Donelson on

With ongoing uncertainty and turmoil in the individual health insurance market, Congress has spent weeks debating whether to include a bipartisan Affordable Care Act (ACA) stabilization measure as part of the "must pass"...more

Mintz - Health Care Viewpoints

Health Care Weekly Preview from ML Strategies – March 2018

Mintz - Health Care Viewpoints on

Congress kicks off this week with three weeks to go before the March 23 omnibus spending deadline. At this point it’s still not entirely clear what will be tacked on to this spending package, but immigration, market...more

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