Tag: repeal
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 (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 »
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 »
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 […] 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 »
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. Read more »
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. Read more »