A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Public Health

Implementation Briefs

Update: Contraception Coverage Lawsuits Reach U.S. Supreme Court

Categories: Health Insurance, Public Health

Posted on January 6, 2014

As discussed in earlier Briefs, the ACA requires all individual and non-grandfathered group health plans to cover certain preventive services, including comprehensive contraceptive services. On August 3, 2011, the Departments of Treasury, Labor, and Health and Human Services (HHS) published an Amended Interim Final Rule incorporating HRSA’s guidelines to require mandatory coverage by non-grandfathered group and individual insurance plans of all preventive services (including contraception) without cost sharing beginning on August 1, 2012. Religious employers and other interested parties argued that requiring employers to sponsor insurance that included contraception violated religious liberty...

Update: Medicaid Preventive Services Coverage Incentive for Traditional Adult Beneficiaries Covered Under the Standard Medicaid Program

Categories: Implementation Update, Medicaid and CHIP, Public Health

Posted on February 21, 2013

Preventive services are optional for traditional Medicaid beneficiaries[1] ages 21 and older who are covered under the standard Medicaid program. Young adults ages 18-21 remain entitled to EPSDT benefits, which encompass periodic and as-needed health exams, all age-appropriate immunizations, and other preventive services.

A Summary of the Health-Related Provisions of the American Taxpayer Relief Act of 2012 (H.R. 8)

Categories: 112th Congress, Congressional Action, Long Term Care, Medicaid and CHIP, Medicare, Public Health, Tax Policy

Posted on January 8, 2013

Both the Senate and the House passed H.R.8 (89-8 and 257-167, respectively), the American Taxpayer Relief Act, on January 1, 2013. President Barack Obama signed the Act into law on January 3, 2013. The measure extends Bush-era income and other tax cuts for individuals and families making up to $400,000 and $450,000 respectively. For individuals and families above this income threshold, the bill increases taxes from 35% to 39.6%. H.R. 8 also postpones...

Update to Employer Wellness Programs: Notice of Proposed Rulemaking

Categories: Health Insurance, Implementation Update, Public Health

Posted on December 20, 2012

As described in a previous Implementation Brief, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) generally prohibits group health plans and group health insurance issuers operating in the group health market from discriminating against similarly situated individuals with regard to premiums, benefits or eligibility based on a health factor. HIPAA recognized an exception...

Contraception Coverage under the ACA’s Preventive Services Coverage Requirements, and Employer Implementation: An Update

Categories: Health Insurance, Implementation Update, Public Health

Posted on April 20, 2012

This update to our March 2012 implementation brief reviews recent implementation efforts by the Administration in connection with coverage of contraceptives as a required element of required preventive services for all individual and (non-grandfathered) group health plans under the Affordable Care Act. The earlier brief reviewed the Administration’s final rules defining the scope of contraception coverage, as well as the scope of the religious exemption that would apply to employers that seek an exemption from this coverage requirement. Reflecting prior law on this matter, the final rule preserved...

Contraception Coverage within Required Preventive Services

Categories: Health Insurance, Implementation Update, Public Health

Posted on March 2, 2012

Recent federal regulations requiring insurance coverage of contraception have generated controversy, especially as applied to religious employers. The requirement stems from an ACA provision requiring insurance coverage of preventive services. Section 2713 of the Public Health Service Act, as added by Section 1001 of the Patient Protection and Affordable Care Act (ACA), requires group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without cost-sharing for certain preventive services, including preventive treatments and services for women recommended by The Health Resources and Services Administration (HRSA) in guidelines. The preventive services provisions of the Act...

Update: Racial and Ethnic Disparities in Health and Health Care

Categories: Disparities, Implementation Update, Public Health

Posted on December 1, 2011

This post serves as an Implementation Update to our previous Implementation Brief on racial and ethnic disparities, originally posted April 15, 2010. The Update reflects changes made by HHS in their recently-released health survey standards.

Public and Allied Health Workforce

Categories: Implementation Update, Public Health, Workforce and Access

Posted on September 8, 2011

Strengthening and modernizing the health care workforce was a major goal of the Affordable Care Act (ACA). The law contains dozens of provisions related to health care workforce issues, including national workforce policy development (what the law refers to as workforce “innovations”), increasing the supply of primary care physicians and nurses, strengthening the dental health workforce, education and training of the workforce, and expanding teaching health centers. This Implementation Brief focuses on the provisions of the ACA dealing with the education, training, and support of public health and allied health care workers; previous Briefs have focused on the other topics.

IRS Notice and Request for Comments Regarding the Community Health Needs Assessment Requirements for Tax-Exempt Hospitals

Categories: Department of the Treasury, Implementation Update, Internal Revenue Service, Key Developments, Public Health, Rulemaking, Rules, and Guidance, Tax Policy

Posted on August 23, 2011

On July 7, 2011, the Treasury Department and the Internal Revenue Service (IRS) published a Notice and Request for Comments on a proposed policy regarding the Affordable Care Act’s new requirements related to tax exempt hospitals’ community health needs assessment (CHNA) obligations. Section 9007 of the Act added new Section 501(r) to the Internal Revenue Code, which delineates a series of statutory requirements, outlined in a previous implementation brief, applicable to nonprofit hospitals that seek tax-exempt status under Section 501(c)(3). The purpose of the Treasury/IRS Notice is to both describe the agencies’ approach to implementing hospital organizations’ CHNA obligations and to invite comments regarding their proposals. The CHNA requirements are effective for taxable years beginning after March 23, 2012. However, the Notice specifies that hospitals currently engaged in conducting CHNA-related activities -- including development and wide publication of a needs assessment and adoption of an implementation strategy -- can rely on the policies contained in the Notice as they move forward.

Chronic Disease Management

Categories: Health Care Quality and Delivery System Reform, Long Term Care, Medicaid and CHIP, Medicare, Public Health

Posted on February 23, 2011

More than 40% of the U.S. population has one or more chronic condition. Although the likelihood of having a chronic disease increases with age, approximately half of working-age Americans has at least one chronic condition. The prevalence of chronic diseases is increasing in both the elderly and non-elderly populations, with a significant increase in the number of people with multiple chronic diseases. Increased spending on chronic diseases in Medicare is a significant driver of the overall increase in Medicare spending over the last twenty years. Nevertheless, given the high cost of treating chronic diseases, the Affordable Care Act (ACA) includes many provisions to encourage chronic disease management as part of the overall emphasis on improving the efficiency of health care.

New Requirements for Tax-Exempt Charitable Hospitals

Categories: Public Health, Tax Policy

Posted on December 20, 2010

This implementation brief examines the addition of Section 501(r) to the Internal Revenue Code under the Affordable Care Act (ACA), which sets out new requirements for not-for-profit, tax-exempt hospitals.

Strengthening Public Health Surveillance Systems: Epidemiology-Laboratory Capacity Grants

Categories: Public Health

Posted on May 25, 2010

The health reform law amends the Public Health Service Act by establishing an Epidemiology and Laboratory Capacity Grant Program to award grants to state, local, and tribal health departments, and academic centers that assist such agencies.

Prevention and Public Health Fund

Categories: Public Health

Posted on May 17, 2010

The health reform law establishes a dedicated “Prevention and Public Health Fund” to provide for “expanded and sustained national investment in prevention and public health programs.”

Nutrition Labeling of Standard Menu Items at Chain Restaurants

Categories: Public Health

Posted on April 22, 2010

Requires restaurants (or "similar retail food establishments") and some vending machine operators to comply with new uniform nutrition labeling requirements.