Readers and health care stakeholders may find it interesting (if not frustrating), that as of the date of this blog post (August 6, 2014) there have been a grand total of 42 changes* made to the Affordable Care Act (ACA) since its signing into law on March 23, 2010. Furthermore, the changes have not originated from a single source; nor have the changes been influenced/encouraged by a single political party. The fact is, of the 42 changes to date, 24 have been made unilaterally by the President; 16 resulting from acts of Congress; and perhaps the most notable – 2 – by the Supreme Court of the United States (SCOTUS). After taking last week off to enjoy a nice family vacation, I return this week to summarize these important changes.
[EasyDNNnewsToken:SMS_please_subscribe]On July 22, 2014, two separate U.S. appellate courts issued contrasting rulings pertaining to a key aspect of the Affordable Care Act (ACA). The issue at hand is language contained in the 2,700 page law addressing eligibility for subsidies (or tax credits) for those unable to afford the premiums for INDIVIDUAL health insurance. Specifically, the cases hinge of just four words – “…established by the state”, or in its entirety – “[ACA] subsidies shall be available to persons who purchase health insurance in an exchange established by the state”.
Since the overwhelming majority of states opted to defer to a federal or hybrid federal/state exchange (36) the language presented a significant problem. In effect, the language meant that only eligible individuals residing in one of the 14 states that opted to establish a state based exchange would be eligible for subsidies. The following graphic indicates (in white) those states that actually formed STATE based exchanges:
A little over a year ago, I posted a blog addressing the Affordable Care Act (ACA) – Patient Centered Outcomes Research Institute (PCORI) fee requirement, also referred to as the Comparative Effectiveness Research Fee (CERF).
Last year, affected plans were required to remit a fee equal to $1 per plan participant. This year, affected plans owe $2 per plan participant, based on their plan date. Since last years PCORI/CERF related post addressed the “who” and “what” of this particular ACA requirement; this post will address the “how”, as in how to calculate the average number of affected lives, and then calculate and remit the applicable fee.
Here are a few questions often posed pertaining to the Affordable Care Act (ACA):
“What does the future of health care/health insurance look like, once the ACA is fully implemented”?
“Will the ACA result in significantly fewer or more uninsured individuals”?
“After four years, what do we know about the affect of the ACA on premiums”?
This week's post offers my overall response, and associated concerns, related to these three, and perhaps other questions…
People who were previously denied health insurance coverage in the Individual health insurance market,
In February of this year (2014), I provided an overview of the IRS' final regulations pertaining to the Affordable Care Act's (ACA) employer mandate. Since this is such a confusing provision of the ACA, to say nothing of the fact that there have been not one, but two separate delays of this provision, I decided to recap some of the more pertinent aspects of the final regulations and associated transitional relief.
Readers who are not completely familiar with the employer mandate (also referred to both as – “employer shared responsibility” and “pay or play provision”) can access an overview,
Recently, the IRS issued guidance which places harsh penalties on employers that deploy the strategy of “dumping” employees into the Individual health insurance marketplace. The guidance followed the White House's objection to the idea of allowing employers the ability to provide employees with a lump sum of money with which to buy individual insurance on the exchange/marketplace. This builds on guidance released last year from the Department of Labor (DOL) which was more broad in scope. A previous blog post addressed the DOL guidance, which effectively “killed” the ability to use tax preferred funds from HRAs and FSAs to fund Individual health insurance premiums, regardless of the source of such coverage.
With the seemingly endless flow of guidance, updates, notices, and delays swirling about relative to the Affordable Care Act (ACA), a rather important piece of guidance may have been overlooked. Issued jointly by the Department of Labor (DOL) and Health and Human Services (HHS) earlier this month (May 2, 2014), this guidance provides an opportunity for individuals enrolled in COBRA coverage the option to dis-enroll in their COBRA coverage, and enroll in potentially lower cost individual health insurance coverage, FOR A LIMITED TIME.
This week's post addresses this guidance and provides additional information related to the transection of COBRA and the ACA.
French novelist and critic – Jean-Baptiste Alphonse Karr – famously said – “the more things change, the more they remain the same”. Based on recent news in Nebraska, relative to the roll out of the Affordable Care Act (ACA), aka Obamacare, I am going to reverse Mr. Alphonse Karr's famous quote to say – “the more things remain the same, the more they change”! If you're not in Nebraska, keep reading because this weeks blog post addresses the allowance of what now amounts to a nearly three year delay of several key provisions* of the ACA…for some.
Barely more than a month ago, the White House granted a two year extension to the previously announced one year “transition relief”.
I am often asked by HR professionals, CEO's, CFO's, Executive Directors, etc. the following question – “what should I be telling my employees about the Affordable Care Act (ACA)”? Between the 2,700 pages of the actual law, and the thousands of pages of regulations and guidance released to date, the question is very relevant, and extremely important. While I firmly believe folks occupying roles with the aforementioned titles should receive a thorough initial overview of the ACA, and ongoing guidance and updates; rank and file employees need only get the absolute critical aspects. So you might ask – “what are the critical aspects”? My list of employee centric, critical aspects is based on the following questions/criteria…
Despite numerous reports of the “closing” of the Affordable Care Act's (ACA) public health insurance exchanges/marketplaces on March 31, 2014, THEY'RE ACTUALLY STILL OPEN FOR BUSINESS! Media reports stating that “the exchanges are closed” are simply inaccurate. Much like group health insurance plans, ACA marketplace/exchange plans have two (2) enrollment periods:
Open Enrollment – which ran from 10/1/13 – 3/31/14 in the inaugural year of the launching of the public marketplaces / exchanges. IMPORTANT: The Department of Health and Human Services (HHS) announced on March 26, 2014 that it would extend the open enrollment deadline for consumers…
