Dec 17, 2018

ACA Ruled Unconstitutional By Texas Court-What’s Next?

HRA: Health Reimbursement Arrangements ACA

Hours before the end of annual enrollment in the federal health care exchanges under the Affordable Care Act (ACA), a Texas district court judge ruled that the ACA is unconstitutional because the ACA’s individual mandate was eliminated. (The individual mandate is reduced to zero on January 1, 2019.) In Texas vs. United States, Judge Reed C. O’Connor struck down the law, siding with a group of 18 Republican state attorneys general and two GOP governors that the tax bill passed by Congress last December effectively rendered the entire ACA unconstitutional. Judge O’Connor ruled that, because the U.S. Supreme Court upheld… Read more


Jun 21, 2018

Excited About Association Health Plans?

Association Health Plans

Not So Fast, Says New York and Massachusetts Many commentators and businesses welcomed the new final regulations on association health plans (AHPs) released by the US. Department of Labor (DOL) on Tuesday, (see here and here). The new rules allow small businesses and self-employed individuals to band together to purchase health insurance, even across state lines. This insurance potentially is more cost-effective than the current Affordable Care Act (ACA) marketplace policies, and the policies offered to the small group and individual markets.  These policies may be less expensive because the AHPs are not required to provide all of the essential benefits required under the… Read more


Jun 20, 2018

Association Health Plans Reinvigorated-New Options for Many Employers

White House: Executive Order Reinvigorates Association Health Plans

Association Health Plans have been reinvigorated by the new regulations released yesterday by the U.S. Department of Labor (DOL). As I mentioned in my blog entry yesterday, these regulations are the result of President Trump’s executive order last year instructing the DOL to allow for more flexibility related to the Affordable Care Act (ACA), and health insurance. As we are parsing the 198 pages of comments and final regulations, it is clear that the final regulations loosen many restrictions on “association health plans” (AHPs). Now, more small businesses, including self-employed (sole proprietors) employers, can either become members of, or even establish… Read more


Jun 19, 2018

Breaking News: New Association Health Plans Rules Expand Health Care Options

Association Health Plans

Today, the US Department of Labor (DOL) released new association health plans (AHPs) rules that allow small employers and self-employed individuals to join together to purchase health insurance coverage.  These rules are the result of President Trump’s executive order last year requesting the DOL to provide more access and choice in the health insurance market, including the AHP regulations. As the DOL stated in the press release accompanying the regulations “under the Department’s new rule, AHPs can serve employers in a city, county, state, or a multi-state metropolitan area, or a particular industry nationwide”. This includes self-employed individuals who now… Read more


Jun 14, 2018

Judge Says “No” to ACA Reimbursements for Insurers

Court Ruling

Today, a Federal Judge ruled that the Federal government does not need to reimburse insurance companies for over $12 billion in the “risk corridor” program under the Affordable Care Act (ACA). As background, the risk corridor program was designed to lessen financial losses for insurers during the initial years of the ACA. However, Congressional Republicans have likened this program to a “bail-out” for insurance companies and were instrumental in blocking its funding. The Federal Circuit Court agreed that Congress could lawfully withhold funding from this program. While this decision applies only to the cases brought by health insurers Moda Health Plan and… Read more


Dec 20, 2017

Health Care Implications of Tax Bill: No More Individual Mandate

Health Care and Taxes

Late yesterday, the U.S. Senate Republicans approved a tax bill, by a vote of 51-48. This bill was previously approved by the U.S. House by a vote of 227-203.  As the bill must be identical in both chambers, this bill now heads back to the U.S. House to correct three provisions. One of these provisions is the actual name of the bill. The Senate version’s short title, the “Tax Cuts and Jobs Act,” must be known as “An Act to provide for reconciliation pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018,”… Read more


Oct 13, 2017

One-Two Punch to the ACA: First An Executive Order, Now Trump Halts Cost Subsidies to Health Insurers

Healthcare

Late yesterday, the White House stated that it would immediately stop the funding for billions of dollars in Affordable Care Act (ACA) subsidies. The explanation is that, based on guidance from the Justice Department, the Department of Health and Human Services (HHS) has determined there is no appropriation for the payments and the government can’t lawfully make the payments. HHS was more specific, saying the payments “will be discontinued immediately” and citing a legal opinion from Attorney General Jeff Sessions. “We believe that the last Administration overstepped the legal boundaries drawn by our Constitution,” acting HHS Secretary Eric Hargan and Seema Verma,… Read more


Jul 13, 2017

Version 2.0 of Health Care Bill to be Introduced in the Senate Today

Senate Passes Tax Reform

As discussed in my blog yesterday, Republican Senators will be introducing a newly revised health care bill today. According to reports from multiple media sources, the bill will include cuts to Medicaid, expansion of the use of health savings accounts and tax credits, and additional funding for states to fight the rising opioid addiction epidemic. Additional funding is also expected to be included beyond the $62 billion currently allocated to states to help low-income individuals afford health care coverage. It is also expected to retain the 3.8% investment tax and the 0.9% Medicare surtax on upper-income earners (see details in… Read more


Jul 12, 2017

Summer Vacation Delayed-Senate to Focus on Health Care Bill

US Capitol Building

Late yesterday, Mitch McConnell, Senate Majority Leader (R.KY.) announced that the Senate will delay its summer recess for two weeks. The AP (7/11, Taylor) reported that McConnell promised “to wrap up” the Senate’s ACA repeal bill “next week, but a number of neglected items have been left in health care’s wake as that bill has been repeatedly delayed.” The article adds, “Little progress has been made on other legislation, and the Kentucky Republican says the chamber would work on the annual defense policy measure and, perhaps, must-do legislation to increase the government’s borrowing authority.” The revised health care bill, the… Read more


Jun 28, 2017

Senate Health Care Bill -No July 4th Celebration

US Capitol Building

Today, Senator Majority Leader Mitch McConnell (R. KY.) announced that the health care bill to repeal and replace the Affordable Care Act (ACA) will not be put up for a vote in the Senate until after the July 4th holiday. According to the New York Times (6/27, Steinhauer, Subscription Publication), it appears that he “miscalculated in the first round of play.” He is said to have “put his legislative thumb on the scale in favor of conservatives, quickly alienating” other senators including Sens. Susan Collins (R. ME) and Lisa Murkowski (R. AK). Other Senators have also opposed the Medicaid eligibility… Read more