airline-money-benefits-ERISA

Spence v. American Airlines: Expanding the Playing Field for Fiduciary Liability?

A federal court in Texas has ruled that American Airlines breached its duty of loyalty under ERISA by failing to respond to activities undertaken by a plan investment manager (BlackRock) supporting ESG initiatives. The court was unable to find a breach of prudence—rather it relied solely on the obligation of “loyalty.”
View Post
Medicare Eligibility

Medicare Eligibility: A Boon and a Trap

Let’s take a break from the ACA repeal-and-replace debate to look at an issue that frequently confuses (and trips up) unwary seniors entering Medicare: the impact of Medicare coverage on other insurance and how to approach enrollment in Medicare. Basic Rules Eligibility for Medicare is really eligibility for two different types of insurance coverage: Medicare […]

View Post
401(k) Plans and Health Savings Accounts

401(k) Plans and Health Savings Accounts: A Questionable Comparison

As the Administration and Congress define their vision of “repeal and replace” we are seeing a number of efforts to increase the use individual accounts as a key component of any likely Trump/RyanCare proposal. Health Savings Accounts (HSAs) figure prominently in a number of Republican proposals as a way for individuals to pay for current […]

View Post
ACA repeal donut hole

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 […]

View Post
Financial Access to Trump/RyanCare

Access to Healthcare Under TrumpRyanCare

As the Administration and Congress move forward with new health care proposals (Trump/RyanCare), they are grappling with the true meaning of “repeal and replace.” This blog post will describe one way of looking at how different groups are likely to be impacted by repeal and replace under “Trump/RyanCare.” Market Access vs Financial Access The Affordable […]

View Post

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.

View Post

After Obamacare—What’s Next for the States?

If the federal government reduces its role in US health insurance markets in the post-ACA world, many of the rules imposed on insurance companies by the federal government under ACA will be eliminated or reduced. For example, the ACA contains rules on benefits that must be covered by individual and small group insurance policies and rules limiting insurance carriers’ ability to underwrite policies based on preexisting conditions. In a post-ACA world with a diminished federal role, regulation of insurance companies will be a state matter—which was the status of these areas before the enactment of ACA.

View Post

After Obamacare - What’s Next for Uncle Sam?

The role of the federal government will decrease in other ways. For example, federal subsidies to enable lower- and middle- income to purchase health insurance are likely to be scaled back, converted to tax credits or eliminated.

View Post