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Expert Commentary

Expert Commentary on Stand Alone Dental Plan Cost-Sharing from the Children’s Dental Health Project

Posted on February 19, 2014

The US Department of Health and Human Services (HHS) is currently finalizing the Notice of Benefit and Payment Parameters for 2015 , a rule that proposes, among other things, to tweak the cost-sharing limits and eliminate the actuarial value (AV) standards for dental plans offering pediatric dental coverage in the marketplaces.

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Comprehensive Immigration Reform and Health Care: CBO’s Analysis of S. 744

Posted on June 21, 2013

On June 18, the non-partisan Congressional Budget Office (CBO) released two analyses of the effects of the current Senate bill on immigration reform – the Border Security, Economic Opportunity and Immigration Modernization Act, S. 744, as designed by the bipartisan “Gang of Eight” Senators and then amended and approved by the Senate Judiciary Committee. The bill is now being considered on the Senate floor. The bill is still being debated, so the findings could change as the legislation moves forward. The first analysis examines the overall macroeconomic impact of S. 744,[1] while the second provides CBO’s estimate of the federal budget impact of the bill[2] as passed by the Senate Judiciary Committee.

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Explaining Recent Changes in CBO Projections of Health Insurance Coverage and Costs under the Affordable Care Act

Posted on June 5, 2013

In May 2013, the Congressional Budget Office (CBO) issued its latest update of estimates of health insurance coverage and costs under the Affordable Care Act. This Implementation Brief summarizes the changes in CBO’s estimates over time, focusing on three key sets of estimates…

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Timothy Stoltzfus Jost, Washington and Lee University School of Law

Posted on January 4, 2011

One important question that has arisen in the course of implementation of the Affordable Care Act (ACA) is the extent to which the states can impose obligations on grandfathered health plans that are not imposed on those plans by the ACA itself. Section 1251 of the ACA defines grandfathered plans as those in which an enrollee was enrolled as of the effective date of the ACA. It imposes on grandfathered plans some of the new ACA requirements (such as coverage of adult children to age 26) or prohibitions (such as the ban on rescissions or lifetime limits), but not others (such as the prohibition on cost-sharing for preventive care or the requirement that plans offer internal and external appeals). Section 1251 does not, however, expressly address the question of whether states can independently impose requirements or prohibitions on grandfathered plans. This entry discusses this issue.

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Robert C. Louthian III, McDermott Will & Emery LLP

Posted on December 20, 2010

Section 501(r) is Congress’ first attempt since 1969 to put more “teeth” into the exemption standards for tax-exempt hospitals. While well-meaning, the statute is poorly drafted and leaves the IRS in a difficult position of having to administer a statute with significant structural problems.

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Simon Lazarus, National Senior Citizens Law Center

Posted on December 2, 2010

Virginia Federal District Judge Upholds Health Reform Mandate: Decision Surprises Health Reform Opponents and Media Observers

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Nan D. Hunter, Georgetown University Law Center

Posted on June 7, 2010

It belabors the obvious to say that battles over the seemingly incommensurable values at issue in debates over abortion have distorted American politics for decades. Having the issue of abortion surface as a potential spoiler during the final months of Congress’ consideration of PPACA was no surprise.

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Tim Jones, Tennessee Department of Health

Posted on June 3, 2010

This law is an important step in substantially increasing federal support for basic public health infrastructure, of which epidemiology and laboratory capacity are critical components.

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Jeffrey Levi (2), Trust for America’s Health

Posted on May 25, 2010

The Prevention and Public Health Fund represents an unprecedented investment in public health by the federal government. It reflects an interest on the part of Congress in “modernizing the public health system.”

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Stephen A. Somers and Melanie Bella, Center for Health Care Strategies

Posted on May 14, 2010

Never-Before Authority for Innovation Throughout the health reform debate, when concerns about “true reform” of how we organize, finance, and deliver care arose, everyone seemed to look to the Center for Medicare and Medicaid Innovation (CMI) as the place that would provide the answers. Although that is a big expectation, CMI’s unprecedented authority is so [...]

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