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


Nov 7, 2018

Breaking News: Post-Election IRS Issues Final ACA Rule Regarding Religious Exemptions

ACA Affordable Care Act

The IRS has just released new final regulations regarding religious exemptions and accommodations from the contraceptive coverage mandate of the Affordable Care Act (ACA). The rule, to be officially published on November 15th, currently in unpublished form, is available here. This final rule, released post-midterm elections, will provide a way forward for religious organizations that object to certain contraceptive coverage required under the ACA. More details soon.


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


Jun 13, 2018

Will the ACA be Dismantled in Court? Justice Department Declines to Support ACA Provisions

Affordable Care Act (ACA)

President Trump’s administration continues in its mission to dismantle the Affordable Care Act (ACA). While attempts to repeal the ACA through legislation have not succeeded, the constitutionality of the ACA is again under assault. In an unusual move, Attorney General Jeff Sessions sent a letter to congressional leaders, telling them that the Justice Department will not defend the constitutionality of certain ACA provisions in the lawsuit filed in the Northern District Court in Texas by 20 State Attorney Generals. The letter stated in part that “The department in the past has declined to defend a statute in cases in which… Read more


Nov 16, 2017

Senate Adds Repeal of Individual Mandate to Its Tax Bill: Will This Change Doom the Bill’s Passage?

Health Care Law Binder

Over the past few weeks, the U.S. House and Senate have been working independently on tax bills. While these bills have included some health care related changes, the latest version of the Senate bill now includes the repeal of the Affordable Care Act’s individual mandate. This addition provides funding for the tax breaks included in the bill and will allow the Senate Republicans to eliminate at least a small portion of the ACA. The Congressional Budget Office (CBO) previously estimated that eliminating the individual mandate will reduce the federal deficit by about $338 billion over the 2018–2027 period. However, eliminating… 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


Oct 13, 2017

Executive Order Could Weaken ACA, Create Association Health Plans

Association Health Plan: Doctor

President Trump Takes Steps When Senate Won’t President Donald Trump signed an Executive Order that potentially weakens the Affordable Care Act (ACA). As quoted by the White House Press Office “The time has come to give Americans the freedom to purchase health insurance across state lines, which will create a truly competitive national marketplace that will bring costs way down and provide far better care.” Association Health Plans The Order is intended to allow employers to join together to form “association health plans” that can cross state lines. The Order also calls for expanded availability for lower cost, short-term policies, and increased use of… Read more