Questions and Answers about the Administration’s Transition Plan to Address Health Insurance Policy Cancellations
Posted on November 18, 2013
On November 14th, 2013, the Obama Administration announced a plan to address a situation that began to emerge in earnest a number of weeks ago and that finally exploded into view within the past couple of weeks: people covered by individual insurance plans who were receiving notices from their insurers that their policies would be cancelled at the end of 2013 because they did not meet new coverage requirements set to take effect in January 2014. The number of people affected by policy cancellation notices is not clear, but most estimates suggest that one half or more of the 15 million people in the individual market could be affected. Manhattan Institute scholar Avik Roy placed the number at 4.8 million (so far). Washington Post reporter Sarah Kliff noted that the figure is hard to calculate but is likely to affect between 7 and 12 million people.
Posted on October 16, 2013
This Implementation Brief examines a Notice of Proposed Rulemaking (NPRM) issued by the Internal Revenue Service (IRS) on August 26, 2013 concerning the tax credit available to small employers that offer health insurance coverage to their employees…
Posted on October 10, 2013
By Taylor Burke Introduction On August 30, 2013, HHS published a final rule entitled “Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, and Eligibility Appeals.” This rule finalizes certain policies proposed in the Program Integrity NPRM published June 19, 2013, as well as certain policies proposed in the NPRM entitled “Essential Health Benefits [...]
Posted on October 3, 2013
On September 25, 2013, the Obama Administration published a Notice of Proposed Rulemaking in the Federal Register (78 Fed. Reg. 59122) that implements §1331 of the Affordable Care Act, which directs the Secretary to establish a Basic Health Program (BHP). The long-delayed proposed rule reflects extensive consultation with stakeholders, a Request for Information (76 Fed. Reg. 56767) published on September 14, 2011, and a series of “listening sessions” to gather input. The comment period runs until 5 p.m., November 25, 2013. This update provides a background on the BHP and summarizes the proposed rule…
Update: Appealing Individual Eligibility Determinations for Exchange Participation and Insurance Affordability Programs
Posted on September 19, 2013
Section 1411(f) of the Affordable Care Act requires the HHS Secretary to establish a federal appeals process covering appeals related to certain determinations made by Health Insurance Marketplaces: eligibility for enrollment in a QHP sold in the Marketplace; eligibility for premium tax credits and cost-sharing reductions; exemptions from individual responsibility to maintain minimum essential coverage; citizenship and lawful presence; the affordability of employer coverage; and inconsistencies involving information.
Update: The IRS’ Final Shared Responsibility Regulations: When Does Medicaid Eligibility Amount to “Minimum Essential Coverage”?
Posted on September 4, 2013
On August 30, 2013, the IRS published final regulations implementing the shared responsibility provisions of the Affordable Care Act (78 Fed. Reg. 53646-53664). The regulations address, among other matters, the complex question of when Medicaid eligibility amounts to minimum essential coverage (MEC) for purposes of the Act’s tax penalties. Because people with MEC are barred from receiving premium and cost sharing assistance for Marketplace plans, the final rules also have important implications in the area of health policy for children and adults with disabilities, who may need both basic insurance and supplemental Medicaid coverage for their more extensive health care needs. Many of Medicaid’s most important disability-related eligibility categories are optional with states and, therefore, monitoring whether and how agency policy on when Medicaid counts as MEC will be an important issue to watch over time.
Posted on August 21, 2013
On January 16, 2013, in the wake of the Newtown shootings, President Obama announced 23 executive orders aimed at reducing gun violence, including an instruction to the Department of Health and Human Services (HHS) to address any potential legal barriers to reporting to the National Instant Criminal Background Check System (NICS). On April 23, 2013, HHS issued an Advance Notice of Proposed Rulemaking (ANPRM) requesting public comments on whether the HIPAA Privacy Rule presents a barrier to reporting of individuals who should be prohibited from possessing firearms for specified mental health reasons (such as involuntary commitment to a mental institution).
Posted on August 12, 2013
Section 1557 of the Affordable Care Act (ACA) establishes a non-discrimination standard that is unprecedented in U.S. civil rights law. This Implementation Brief examines a recent Request for Information (RFI), issued by the U.S. Department of Health and Human Services (HHS), representing the initial step in implementation of the standard. Although the non-discrimination standard takes effect on the same schedule as other ACA provisions, the RFI signals only the beginning of what might be expected to be a complex regulatory development process.
Federal Policy Implementation under the Affordable Care Act: Six Issues Whose Final Resolution Awaits, as Implementation Moves Forward
Posted on August 6, 2013
Since the Act was signed into law on March 23, 2010, the Obama Administration has published more than 70 final rules implementing its provisions (See Appendix A). These final rules, which range from health insurance market reforms to regulation of the nutritional information available on food packaging, breathe life into the Act’s broad policies…In any law as large and complex as the ACA, it is inevitable that certain important policy issues still await resolution. The issues identified here do not impede implementation. But they are important issues nonetheless, and their resolution will strengthen health reform as it moves forward…
Update on Eligibility for Exemptions from the Personal Responsibility Tax Penalty and Designating Certain Health Benefits Coverage as Minimum Essential Coverage
Posted on July 31, 2013
On July 1, 2013, HHS issued final implementing regulations that specify which individuals may be eligible for exemptions from the Shared Responsibility penalty payment, a special tax established under the Affordable Care Act (ACA) that applies to non-exempt individuals who have access to affordable insurance but fail to purchase it. The final rule also explains the role of Exchanges in granting “certificates of exemption” from the penalty payments, and identifies the range of health benefits that the government will consider as satisfying the Act’s “minimum essential coverage” rule. The final rule shows some, but not a lot, of changes from its original proposed form.