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Sunday, April 9, 2023

Court Ruling Impacts ACA’s Preventive Healthcare Benefits

The Affordable Care Act’s (ACA) preventive care mandate has been partially struck down by a federal district judge.  On March 30, 2023 the ruling made portions of the preventive care benefit unconstitutional nationwide.  The U.S. Department of Justice has appealed the decision, so there is likely more to come out of this ruling.

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Thursday, September 1, 2022

UPDATE: Employers Be Aware of the Family Glitch!

One of the chief aims of the Affordable Care Act (ACA) was to address the  challenge associated with finding and purchasing affordable individual health insurance, for those that have no other option for coverage. Some might recall when there was both an INDIVIDUAL and an EMPLOYER mandate, associated with the ACA.  While there is no longer a tax penalty associated with going uninsured (i.e., the individual mandate), there is very much still an opportunity for people to purchase subsidized health insurance coverage through the ACA’s exchanges.  And, with the expected and pending fix of the so called “family glitch”, millions of people will become eligible for subsidized coverage.  Importantly, and speaking of the ACA’s “employer mandate”, employers will need to rethink and possibly restructure premium cost sharing strategies associated with  their group health insurance plan offerings!  

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Thursday, June 4, 2020

PCORI Fee Update

Although a number of Affordable Care Act (ACA) taxes/fees were repealed by the 2019 SECURE Act (see – https://smstevensandassociates.com/aca-taxes-repealed/) , the PCORI fee (also known as the Comparative Effectiveness Research Fee (CERF)) was not, and was in fact extended for an additional 10 years.  So in addition to plan years ending prior to October 1, 2019, the PCORI fee will now apply to plan years ending in 2020-2029.

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Friday, December 20, 2019

ACA Taxes Repealed

There is never a dull moment in congress, particularly as it relates to healthcare reform!  While we have been reading and hearing, for most of the year, about congressional efforts to eliminate so called “surprise medical bills”, and reduce escalating drug prices, what we ultimately got were ACA tax cuts.  In total, $373 billion worth of ACA related tax cuts are coming as a result of the House and Senate passed spending/funding bill.

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Friday, December 6, 2019

IRS Announces ACA Deadline Extension

The IRS has announced a delay for furnishing 2019 related ACA notices to employees…

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Friday, July 19, 2019

***SPECIAL UPDATE***

Both the pace and scope of changes in the healthcare/health insurance space accelerated this past week (7/15/19-7/19/19) with several important developments. Here’s a recap of what all took place…

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Thursday, May 9, 2019

Accountable Care…The Savior of U.S. Healthcare?

Since the passage of the Affordable Care Act (ACA) in March of 2010, much has been discussed, debated, written, and deployed relative to healthcare FINANCING reforms (see insurance, Medicare, Medicaid, self-insured employers, fees/taxes, pre-existing conditions, essential health benefits, community rating, minimum loss ratio, etc.).  But very little has been written, or even revealed for that matter, about the ACA’s healthcare DELIVERY reforms and incentives.  This is too bad, since we know that $.80 to $.85 of every dollar of billed health insurance premium is directly related to healthcare delivery.  So it stands to reason that if we could reduce health CARE costs, health insurance PREMIUMS would follow suit.  Enter Accountable Care Organizations (ACO) into the equation.  Let’s examine what ACO’s are…who they are…and why many are looking to them to save America’s healthcare system from imploding.

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Thursday, April 12, 2018

ACA Modifications for 2018 and 2019

Earlier this week (4/9/2018) the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) issued final regulations and guidance that profoundly alter the Affordable Care Act (ACA) both immediately, and in 2019 and beyond.  The objective of the new guidance is “…to increase coverage access in the ACALEARN MORE

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Wednesday, January 24, 2018

More ACA (Tax) Delays

The recently signed (1/22/2018) “short-term spending bill”, also referred to as the “continuing resolution” (CR) does more than keep the United States government open and fully functioning until February 8, 2018.  It also delivers yet another set of Affordable Care Act (ACA) delays.  Employers offering group health insurance to their employees can breathe a collectiveLEARN MORE

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Friday, September 8, 2017

The ACAs Health Insurance Subsidies

In order to accomplish its objective of “affordable health insurance coverage”, the Affordable Care Act (ACA) created three (3) separate, cost reducing initiatives: 1. Premium Tax Credits – reduce out of pocket PREMIUM costs; 2. Cost Sharing Reductions (CSR) – reduce point of service out of pocket costs such as copays, deductibles, and coinsurance; andLEARN MORE