Tag: Individual mandate
HHS releases shorter Exchange enrollment application forms
Posted by Nikki Hurt on April 30, 2013
In response to the comments received on the length and complexity of the 21-page health insurance application draft, the US Department of Health and Human Services (HHS) has shaved down the application and released their second iteration this morning. Under the Affordable Care Act’s (ACA) individual mandate, most Americans are required to have insurance by January 1st, 2014. The new application released by HHS is designed to make the enrollment process more streamlined and simple. Individuals wishing to enroll into the Exchange will submit a 5-page document entitled “Application for Health Coverage and Help Paying Costs (Short Form).” The family application, “Application for Health Coverage and Help Paying Costs” comes in at 12-pages in length. HHS has also provided a 5-page application titled “Application for Health Coverage” for anyone wishing to enter the Exchange, but is unsure of their eligibility.
Health Affairs study indicates financial burden of ACA
Posted by Nikki Hurt on April 18, 2013
A recent study released by Health Affairs found some families, particularly those that do not receive employer-sponsored health insurance or do not qualify for Medicaid, may experience financial hardship as a result of purchasing health insurance through the Affordable Care Act (ACA). The study focused on 393 families that purchased unsubsidized health insurance through the Massachusetts Commonwealth Health Insurance Connector Authority, and found that families with smaller incomes, multiple children, and poor health conditions had to pay more of their health care costs out-of-pocket. Authors of the study postulate that these findings can be generalized to families in similar situations across the country, indicating a potential financial risk associated with the health insurance individual mandate in the ACA.
CMS and IRS release rules on exemptions to individual mandate, penalties
Posted by Mark Dorley on January 31, 2013
The Internal Revenue Service (IRS) and the Centers for Medicare and Medicaid Services (CMS) have released 2 new proposed rules related to the individual requirement to purchase health insurance (mandate). The IRS rule clarifies the requirement that nonexempt individuals maintain minimum essential coverage or make a shared responsibility payment (penalty). The CMS rule lays out specific exemptions to minimum coverage requirement, most notably that any person otherwise eligible for Medicaid under the new ACA eligibility expansion, but who resides in a state that has chosen not to expand, will not be subject to the shared responsibility payment.
Stay tuned to HealthReformGPS for a detailed analysis of these rules in the future.
ACA Policy Implementation: A Snapshot of Key Developments and What Lies Ahead
Posted by Mark Dorley on December 5, 2012
Beginning January 1, 2014, millions of previously uninsured individuals will gain access to health insurance coverage under the Affordable Care Act (ACA). On November 20, 2012, the Obama Administration proposed a series of regulations that move the nation significantly toward full implementation. These proposed rules will be analyzed at greater length in coming GPS Implementation Brief updates. In the meantime, this overview summarizes the major federal implementation matters that the Administration has recently released or is expected to address in policy or program implementation in the coming weeks and months as the 2014 full implementation date approaches. Together, these matters address…
Update: Legal Challenges to the Affordable Care Act — Liberty v. Geithner Petition for Rehearing
Posted by Mark Dorley on October 25, 2012
One of a number of lawsuits filed in opposition to the ACA was Liberty University, Inc., et al. v. Geithner et al. Under this lawsuit in 2010, a private Christian university and a number of individual petitioners sued the government to block enforcement of the ACA’s employer requirement to provide health insurance coverage to employees, as well as the individual requirement to maintain health insurance coverage. The district court in the Western District of Virginia rejected all the plaintiffs’ claims, which included challenges based on the Commerce Clause, the Necessary and Proper Clause, the Tenth Amendment, the First Amendment, the Fifth Amendment, and the Religious Freedom Restoration Act (RFRA). On appeal, the Fourth Circuit held that the Anti-Injunction Act (AIA) barred federal courts…
When Should Uninsured Family Members of Employees with Access to Affordable Self-Only Employer Coverage Qualify for Premium Tax Credits?
Posted by Mark Dorley on October 3, 2012
This Implementation Brief on premium tax credits examines the question of how the Affordable Care Act (ACA or the Act) addresses the problem that arises when low- and moderate-income employees have affordable “self-only” employer coverage, but face prohibitively high costs for family coverage, well beyond levels considered “affordable” under the Act. Coverage for a full family is extremely expensive: according to the Kaiser Family Foundation, the average 2012 cost of family coverage approaches $16,000, placing unsubsidized family benefits beyond the reach of all but affluent families. Kaiser further reports that while…
Supreme Court asks for Government Response to Liberty University ACA Re-Hearing Request
Posted by Mark Dorley on October 1, 2012
The U.S. Supreme Court has asked the United States Solicitor General to file a response within 30 days to Liberty University’s request for a re-hearing in federal appellate court of its claims in the case of Liberty Univ. v. Geithner. In that case, the Fourth Circuit Court of Appeals ruled that the federal Anti-Injunction Act (AIA) barred it from entertaining Liberty University’s pre-enforcement challenges against the Affordable Care Act. Because the Supreme Court subsequently ruled in National Federation of Independent Business, et al. v. Sebelius that the AIA did not apply in the context of the ACA, Liberty University has…
CBO report finds more consumers will face ACA individual mandate penalty
Posted by Michal McDowell on September 19, 2012
According to a new Congressional Budget Office (CBO) report, about six million people will face tax penalties in 2016. This mean that two million more Americans than initially projected will face penalties from 2017 to 2022. These penalties translate into $7 billion. The CBO reported that 85 percent of the increase can is attributable to higher unemployment rates, lower wages, and “technical updates.” CBO attributed little to the Supreme Court decision to make optional Medicaid expansion.
This number makes up just a fraction of those who will remain uninsured after full Affordable Care Act (ACA) implementation – 30 million in total, according to CBO. Those exempt from the ACA’s minimum coverage provision include illegal immigrants, low-income individuals, those without affordable insurance options, American Indian tribe members, and individuals whose religious beliefs precludes them from entering the market.
CRS paper examines individual mandate provision
Posted by Michal McDowell on July 10, 2012
The Congressional Research Service (CRS) recently issued an updated report on the requirements and penalties associated with the Affordable Care Act’s (ACA’s) minimum coverage provision. The report examines the amount of the penalties that families and individuals must pay if they choose not to buy health insurance, the affordability provisions and exemptions to the penalty, and the information reporting requirements. The report also details what information must be provided to consumers beginning in 2013, the information needed about the individual mandate, the information that must be provided on employees’ W-2 forms, and information about the certification of exemptions provided by health insurance exchanges.
Supreme Court Issues Ruling in Landmark Health Reform Case
Posted by Mark Dorley on June 28, 2012
The U.S. Supreme Court has released the highly anticipated decision regarding the issues raised by parties in two cases: Florida, et al. v. Department of Health and Human Services and National Federation of Independent Business v. Sebelius.
President Barack Obama signed the Affordable Care Act (ACA) into law in March 2010. On March 26-28, 2012, the Supreme Court heard arguments regarding the following four issues:
1) Anti-Injunction Act: Whether the Anti-Injunction Act bars consideration of the ACA’s minimum coverage provision before the mandate’s penalties take effect in 2015
2) Minimum Coverage Provision: If the ACA’s minimum coverage provision exceeds Congress’ powers under Article I of the U.S. Constitution
3) Severability: If the minimum coverage provision is invalidated, whether the remainder of the ACA must also be invalidated or if it is severable from the rest of the law
4) Medicaid Expansion: Whether Congress exceeded its powers and violated the principles of federalism by conditioning a state’s receipt of any federal Medicaid funding on implementation of the ACA’s Medicaid expansion
The Court held that…