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

Oklahoma judge rules on ACA tax subsidies

Posted on September 30, 2014 | No Public Comments

A federal judge in Oklahoma ruled that tax subsidies granted under the Affordable Care Act (ACA) cannot go to residents of states with a federally-facilitated health insurance exchange rather than a state-run exchange. The ruling is similar to the D.C. Circuit’s decision in Halbig v. Burwell earlier this month. The government has requested an en banc review of the US Court of Appeals for the DC Circuit in order to ensure an opportunity to resolve circuit split before the Supreme Court grants cert.

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DOL issues final rule on excepted benefits

Posted on September 30, 2014 | No Public Comments

The Department of Labor (DOL) issued a final rule regarding excepted benefits and stand-alone dental and vision plans. In the original proposed rule if the wraparound coverage met a number of requirements, it would have been considered an excepted benefit that would not disqualify the employee from getting subsidized coverage on the exchanges. However, this language is excluded from the final rule issued. The DOL said it intends to publish regulations on the topic of wraparound coverage in the future, taking into account the extensive comments received on the topic.

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Georgetown releases report on post-ACA network design

Posted on September 23, 2014 | No Public Comments

Researchers at Georgetown University’s Center on Health Insurance Reforms (CHIR) conducted a six-state case study to assess changes in the network design of plans offered through the health insurance marketplaces, as well as the response of state officials in the face of consumer and provider concerns. The report finds that insurers have narrowed their networks, relative to what they offered in the past, however states and insurers reported few consumer complaints about the ability to obtain medically necessary care in-network. Most of the study states are unlikely to take action to change their standards for network adequacy, however, half of the states studied will require insurers to provide better, up-to-date provider directories, so that consumers can better understand which providers are in which plan networks before they buy.

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OIG releases report on security of online Marketplaces

Posted on September 23, 2014 | No Public Comments

The Office of the Inspector General (OIG) conducted an audit of Healthcare.gov, the online Federal Marketplace, from February to June 2014, including vulnerability scans and simulated attacks. In doing so, they found that the site’s security had been improved since last October’s launch of the insurance marketplace. However, OIG still found some vulnerabilities and the report recommended ways to further improve the site’s security, which the Centers for Medicare and Medicaid Services (CMS) says have already been implemented.

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IRS issues final rule on ACA write-off limit

Posted on September 19, 2014 | No Public Comments

The Internal Revenue Service (IRS) finalized a half-million-dollar cap on deductions that the biggest insurance companies can take for executive pay. This final rule will affect certain health insurance providers giving remuneration that exceeds the deduction limitation. According to a recent analysis, the little-known Affordable Care Act (ACA) provision amounted to about $1.3 million per executive for the largest insurers in 2013. The rule details what companies and employees are subject to the limit and how it should be applied.

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Reports speculate on uninsurance rates

Posted on September 17, 2014 | No Public Comments

The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics released the results of its first quarter health insurance survey. The results show that the percentage of uninsured adults dropped to 18.4 percent from 20.4 percent in 2013. However, this modest reduction does not capture the influx of last minute sign-ups in March and is lower than other estimates that used data from later in the year.

A new Census report also examined uninsurance rates finding that forty-two million people in the U.S. lacked any health insurance for the whole of 2013- 13.4 percent of the population. The report breaks down the uninsured rate by race and estimates the proportion of the population insured through private, employer-sponsored, and public insurance. However, this report does not include data from the major expansion of coverage from the Affordable Care Act (ACA) starting in 2014.

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GAO report finds insurers aren’t separating abortion funds

Posted on September 17, 2014 | No Public Comments

A new Government Accountability Office (GAO) report found that 15 insurers in a sample of 18 are selling Affordable Care Act (ACA) plans that do not segregate funds to cover abortion from their ACA subsidies, despite the ACA requirement  that insurers collect separate payments from customers for abortion coverage. The report was commissioned by House Republican leadership amid concerns that  customers were able to use federal health care subsidies on insurance policies that cover abortion procedures. However, about half of the states have passed laws forbidding exchange plans from covering abortion at all, so this issue may not be nationally pervasive.

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KFF releases 2014 Employer Health Benefits Survey

Posted on September 10, 2014 | Public Comment (1)

The Kaiser Family Foundation (KFF) released its annual Employer Health Benefits Survey, which provides a snapshot of health coverage in the workplace. The 2014 survey results show that annual premiums for employer-sponsored family health coverage are up 3 percent from last year, continuing a recent trend of moderate premium growth.  Premiums increased more slowly over the past five years than the preceding five years (26 percent vs. 34 percent) and well below the annual double-digit increases recorded in the late 1990s and early 2000s. This year’s increase also is similar to the year-to-year rise in worker’s wages and general inflation.

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Studies examine insurance rates of children and parents under the ACA

Posted on September 10, 2014 | No Public Comments

Two studies by the Urban Institute show that the provisions of the Affordable Care Act (ACA) have in many cases helped to insure more parents, but have not been as successful at increasing coverage for their children. The studies found that nationally, between September 2013 and June 2014, the estimated uninsured rate for parents fell 2.4 percentage points from 16.7 percent to 14.3 percent. However, for the same time period, no statistically significant change was found in the estimated uninsured rate for children under age 17. Additionally, findings suggest that the majority of uninsured children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP)  but are not yet enrolled. The implications of these studies could be important as Congress considers whether to reauthorize funding for CHIP beyond 2016.

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CAP proposes model to control health care costs

Posted on September 8, 2014 | No Public Comments

The Center for American Progress released a report proposing an approach known as the “Accountable Care States” in order to control health care costs. The model will keep costs down by giving states flexibility and incentives to control costs. A state that designates itself an Accountable Care State will be accountable for health care costs, quality of care, and access to care with sizable financial rewards for keeping overall costs low. Using Congressional Budget Office (CBO) data, the report estimates that if half of the states participate, the Accountable Care States model would yield $1.7 trillion in savings on total health care spending over 10 years.

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