Posted on January 4, 2011
One important question that has arisen in the course of implementation of the Affordable Care Act (ACA) is the extent to which the states can impose obligations on grandfathered health plans that are not imposed on those plans by the ACA itself. Section 1251 of the ACA defines grandfathered plans as those in which an enrollee was enrolled as of the effective date of the ACA. It imposes on grandfathered plans some of the new ACA requirements (such as coverage of adult children to age 26) or prohibitions (such as the ban on rescissions or lifetime limits), but not others (such as the prohibition on cost-sharing for preventive care or the requirement that plans offer internal and external appeals). Section 1251 does not, however, expressly address the question of whether states can independently impose requirements or prohibitions on grandfathered plans. This entry discusses this issue.
Posted on December 20, 2010
Section 501(r) is Congress’ first attempt since 1969 to put more “teeth” into the exemption standards for tax-exempt hospitals. While well-meaning, the statute is poorly drafted and leaves the IRS in a difficult position of having to administer a statute with significant structural problems.
Posted on December 2, 2010
Virginia Federal District Judge Upholds Health Reform Mandate: Decision Surprises Health Reform Opponents and Media Observers
Posted on June 7, 2010
It belabors the obvious to say that battles over the seemingly incommensurable values at issue in debates over abortion have distorted American politics for decades. Having the issue of abortion surface as a potential spoiler during the final months of Congress’ consideration of PPACA was no surprise.
Posted on June 3, 2010
This law is an important step in substantially increasing federal support for basic public health infrastructure, of which epidemiology and laboratory capacity are critical components.
Posted on May 25, 2010
The Prevention and Public Health Fund represents an unprecedented investment in public health by the federal government. It reflects an interest on the part of Congress in “modernizing the public health system.”
Posted on May 14, 2010
Never-Before Authority for Innovation Throughout the health reform debate, when concerns about “true reform” of how we organize, finance, and deliver care arose, everyone seemed to look to the Center for Medicare and Medicaid Innovation (CMI) as the place that would provide the answers. Although that is a big expectation, CMI’s unprecedented authority is so [...]
Posted on May 14, 2010
The new CMS innovation center, with unprecedented discretion and $10 billion, could lead the way in health system reform. HHS should develop bold, creative, and high-impact strategies, working with the health sector’s high-performance leaders. I suggest considering these five ideas.
Posted on May 6, 2010
Although health reform is barely a month old, implementation of the legislation is already getting underway. HHS has moved quickly to staff up for the task, creating a new Office of Consumer Information and Insurance Oversight, headed by Jay Angoff, the former insurance commissioner of Missouri. Implementation will also be overseen by the Department of Labor and Department of the Treasury, which have jurisdiction over group health insurance plans.
Posted on May 4, 2010
Perhaps more than for any other part of the health sector, the landscape has shifted dramatically for community health centers, and CHCs are now working in a new, dynamic environment. The landmark healthcare reform package – designed to improve access, quality and affordability – extends health insurance coverage while supporting the extensive expansion of primary [...]