ACA
Risk Pooling, Risk Shifting and Risky (Health Insurance) Business
The efforts to dismantle the Affordable Care Act, piece by piece, continue. Over the past few months the Trump Administration: • Finalized regulations expanding Association Health Plans (“AHPs”) for unrelated employers; • Signed the Tax Cuts and Jobs Act of 2017, eliminating the individual mandate; • Finalized regulations expanding short-term limited duration (“STLD”) coverage; • Stopped payments to insurance […] Read more »
The Senate Tax Bill: A Benefits Perspective
The Senate has now passed its version of a revamp to the tax code (H.R. 1). The legislation makes significant changes to many provisions of the code, including dramatic changes to corporate and individual taxation. The bill now goes on to a conference committee to reconcile differences with the bill passed by the House of […] Read more »
Internal Revenue Service Prepares to Levy 2015 ACA Penalties
The Affordable Care Act (“ACA”) remains on the books, despite all of the rhetoric about potential legislative and/or administrative changes. And, in a significant new development, the IRS is poised to begin levying penalties on employers, under the ACA’s employer mandate, for 2015. This is important for a number of reasons: • Regardless of what happens […] Read more »
The (Ongoing) Saga of ACA: New Proposed Regulations
On October 27, the Centers for Medicare & Medicaid Services (“CMS”) issued new proposed regulations regarding the operation of health insurance exchanges under the Affordable Care Act (“ACA”). Much of this 365-page document consists of more routine updates to rules governing the operation of exchanges under ACA. In addition to these routine provisions, however, the […] Read more »
Healthcare Wars: Employers Caught in the Middle
As the political battles – and stalemate – over the Affordable Care Act continues, employers may find themselves with the worst of all worlds. The portions of the ACA that create the greatest burdens on employers, such as the mandates, taxes and administrative obligations under the ACA stay in place. At the same time, uncertainty in the individual markets creates blowback that hurts employers in a number of ways. Read more »
Multiple Personalities: The Administration’s Approach to the ACA
The Trump Administration and Republicans in Congress have been clear about their desire to “repeal and replace” the Affordable Care Act. But, while that legislative battle plays out, the ACA is still on the books and defines the rules for the American health care system. This blog post will not look at the repeal and […] Read more »
ACA Repeal and Medicare Beneficiaries
There is a lot of talk in Washington about repeal of the Affordable Care Act (ACA) – Obamacare. The question for Medicare beneficiaries is–how will any changes affect you? The most important direct impact is that Medicare beneficiaries could pay more for prescription drugs. Here’s why: • Under Medicare’s prescription drug coverage (Part D) there is […] Read more »
After Obamacare—What’s Next for Insurance Companies?
I have described the likelihood that, in a post-ACA world, the federal government will step back and the states will have more flexibility and responsibility. The next key player in this equation is the insurance industry.
The ACA created a substantial web of requirements and prohibitions that applied to insurance companies—including rules requiring that carriers insure all applicants, that premiums could not vary based on applicants’ health status, that (in effect) younger applicants subsidize the cost of older applicants, and that limited the companies’ profits from health insurance. Read more »