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

Brookings report finds ACA will shift incomes

Posted on January 28, 2014 | Comments Off

A report recently released by The Brookings Institution stated that the Affordable Care Act (ACA) will lead to a redistribution of incomes. Specifically, the report cited that individuals with incomes in the bottom 20% of the population will see a 6% increase due to the availability of subsidies and Medicaid expansion, while individuals in higher income brackets may see a slight reduction in their incomes based upon higher taxes and shifts in the insurance market. Of note, the authors of the report include “government and employer contributions to health insurance” in their determinations for income.

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CMS documents describe presumptive eligibility

Posted on January 28, 2014 | Comments Off

The Centers for Medicare and Medicaid Services (CMS) issued a bulletin and question-and-answer explaining hospital presumptive eligibility. The documents are intended to aid hospitals in determining individual eligibility for Medicaid, or presumptive eligibility, under the Affordable Care Act (ACA). The documents provide relevant information on eligible populations, entities that can make coverage determinations, qualification standards, and federal matching assistance that may be relevant for hospitals that may treat patients without insurance. All states are expected to include an amendment to their Medicaid State Plans implementing the new presumptive eligibility standards.

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HHS releases new FPL guidelines

Posted on January 27, 2014 | Comments Off

The US Department of Health and Human Services (HHS) updated the federal poverty level (FPL) guidelines for 2014. The guidelines, which are slightly higher than the 2013 levels, will not impact the eligibility thresholds used to determine subsidy eligibility for health insurance enrollment for 2014. For an individual, the the FPL is now set at $11,670, which represents a 1.6% increase from 2013.

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Supreme Court prevents enforcement of contraceptive mandate for religious organization

Posted on January 26, 2014 | Comments Off

A Supreme Court action issued Friday bars the federal government from enforcing the Affordable Care Act’s (ACA) contraceptive mandate on Little Sisters for the Poor, a non-profit organization of Catholic nuns that operates nursing homes. The organization claims that filing the requisite form to waive the contraceptive coverage mandate for organizations holding themselves out as religious entities would enable third party payers to cover contraceptives, which is against the organization’s beliefs. The Supreme Court’s ruling prevents any legal action against Little Sisters for the Poor until the appeal can be heard.

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Federal judge blocks prohibitive navigator laws in Missouri

Posted on January 24, 2014 | Comments Off

Yesterday, the US District Court for the Western District Court of Missouri released a decision blocking Missouri state laws that placed limitations and restrictions on state navigators and in-person assistors above and beyond those provided by the Affordable Care Act (ACA). Several states have placed additional requirements on navigators, or individuals intended to help consumers enroll in coverage under the ACA. This is the first lawsuit, however, challenging restrictive navigator laws in states operating a federally-facilitated marketplace.

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IRS documents address minimum essential coverage

Posted on January 24, 2014 | Comments Off

The Internal Revenue Service (IRS) released several documents concerning the maintenance of minimum essential coverage. The first document is a proposed rule issued concerning certain types of Medicaid coverage that do not satisfy the minimum essential coverage requirement under the Affordable Care Act (ACA). The proposed rule states that individuals with this coverage will not owe a shared responsibility payment. The proposed rule also outlines hardship exemptions and enrollment in employer-sponsored health insurance plans. In addition to the rule, the IRS released a notice stating that individuals with limited Medicaid coverage or limited coverage from military health benefits will not be subject to the individual shared responsibility payment.

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CMS finds 6.3 million eligible for Medicaid or CHIP

Posted on January 24, 2014 | Comments Off

The Centers for Medicare and Medicaid Services (CMS) issued a new report chronicling the numbed of individuals deemed eligible for Medicaid or the Children’s Health Insurance Program (CHIP) during the first three months of open enrollment. The report stated that 6.3 million Americans enrolled in Medicaid or CHIP in state-based Marketplaces or in-person at state Medicaid offices. The report does not, however, provide numbers for Medicaid enrollment in federally-facilitated Marketplaces, nor does it differentiate between individuals that are newly eligible for Medicaid as a result of expansion and those that were previously eligible under the original Medicaid criteria.

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RAND study purports keeping canceled plans will not undermine new Marketplaces

Posted on January 21, 2014 | Comments Off

The RAND Corporation released a study analyzing three proposals to address health insurance plan cancellations under the Affordable Care Act (ACA). To ameliorate this issue, the administration initiated a transitional policy, which permitted individuals to remain on health insurance plans that did not meet the coverage requirements of the ACA. Many lawmakers, however, disagreed with this approach. Ultimately, RAND found that each proposal would “slightly to moderately” impact premiums, enrollment, and federal spending associated with the ACA. Moreover, RAND concluded that none of the options studied would result in a death spiral or collapse of the private insurance market.

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CRS issues report on Unified Agenda

Posted on January 16, 2014 | Comments Off

The Congressional Research Service released a new report concerning the 2013 Unified Agenda of Federal Regulatory and Deregulatory Actions,or Unified Agenda, for the Affordable Care Act (ACA). In order to help promote congressional oversight, the Unified Agenda contains certain data points on all rules associated with a specific federal law. The Unified Agenda divides rules into three categories: active actions, completed actions, and long-term actions. The report, Upcoming Rules Pursuant to the Patient Protection and Affordable Care Act: Spring 2013 Unified Agenda, covers the fifth Unified Agenda pertaining to the ACA.

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Premium subsidies for FFM upheld

Posted on January 15, 2014 | Comments Off

A DC federal court judge ruled today that premium subsidies are permissible in federally-facilitated Marketplaces (FFM) established by the Affordable Care Act (ACA). In the case, Halbig v. Sebelius, the plaintiffs argued that premium subsidies, or advanced premium tax credits, to help individuals earning between 100-400% of the federal poverty level purchase insurance were only intended for states operating state-based marketplaces. The court, however, found that congressional intent was to offer premium subsidies for individuals enrolling in all marketplaces. Similar cases are still pending throughout the country.

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