Health Insurance
Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–Health Law Professors on the mandate
Posted on February 1, 2012
About this special series: On November 4, 2011, the Supreme Court granted certiorari in two cases arising out of constitutional challenges to the Affordable Care Act (ACA). The Court is set to hear oral arguments in the (now consolidated) cases over three days, beginning on March 26, 2012. As part of our continuing coverage of the litigation, HealthReform GPS will post periodic updates as the parties and their amici file briefs in the coming weeks. Amicus briefs, filed by individuals and organizations with an interest in the outcome of the litigation, are also known as “friend of the court” briefs. In ACA litigation, numerous amicus briefs are expected on the four questions the Court will hear. For a detailed explanation of the cases and the four issues, click here.
The oral argument dates are shown below:
- Monday, March 26: Department of Health and Human Services et al., v. Florida et al.–Anti-Injunction Act – 1 hour beginning at 10 a.m.
- Tuesday, March 27: Department of Health and Human Services et al., v. Florida et al.–Minimum Coverage Provision – 2 hours beginning at 10 a.m.
- Wednesday, March 28: National Federation of Independent Business v. Sebelius, Secretary of HHS et al. and Florida et al., v. Department of Health and Human Services et al.–Severability – 90 minutes beginning at 10 a.m. AND Florida et al., v. Department of Health and Human Services et al.–Medicaid – 1 hour beginning at 1 p.m.
For access to our entire list of amicus brief summaries, click here.
Spotlight on: The Health Law Professors on the Minimum Coverage Provision
Amici are 104 professors of law who teach in schools of law, medicine, public health, and management. Because these professors are experts in health law rather than constitutional doctrine, the purpose of this brief is to document facts about health care for the Court.
Amici support the position…
Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–AHA on the mandate
Posted on January 31, 2012
About this special series: On November 4, 2011, the Supreme Court granted certiorari in two cases arising out of constitutional challenges to the Affordable Care Act (ACA). The Court is set to hear oral arguments in the (now consolidated) cases over three days, beginning on March 26, 2012. As part of our continuing coverage of the litigation, HealthReform GPS will post periodic updates as the parties and their amici file briefs in the coming weeks. Amicus briefs, filed by individuals and organizations with an interest in the outcome of the litigation, are also known as “friend of the court” briefs. In ACA litigation, numerous amicus briefs are expected on the four questions the Court will hear. For a detailed explanation of the cases and the four issues, click here.
The oral argument dates are shown below:
- Monday, March 26: Department of Health and Human Services et al., v. Florida et al.–Anti-Injunction Act – 1 hour beginning at 10 a.m.
- Tuesday, March 27: Department of Health and Human Services et al., v. Florida et al.–Minimum Coverage Provision – 2 hours beginning at 10 a.m.
- Wednesday, March 28: National Federation of Independent Business v. Sebelius, Secretary of HHS et al. and Florida et al., v. Department of Health and Human Services et al.–Severability – 90 minutes beginning at 10 a.m. AND Florida et al., v. Department of Health and Human Services et al.–Medicaid – 1 hour beginning at 1 p.m.
For access to our entire list of amicus brief summaries, click here.
Spotlight on: The American Hospital Association (AHA) on the Minimum Coverage Provision
Amici are the AHA, the Association of American Medical Colleges, the Federation of American Hospitals, the Catholic Health Association, the National Association of Children’s Hospitals, and the National Association of Public Hospitals and Health Care Systems. The AHA represents 5000 hospitals, the AAMC represents…
Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–Senator Reid and Congresswoman Pelosi on the mandate
Posted on January 30, 2012
About this special series: On November 4, 2011, the Supreme Court granted certiorari in two cases arising out of constitutional challenges to the Affordable Care Act (ACA). The Court is set to hear oral arguments in the (now consolidated) cases over three days, beginning on March 26, 2012. As part of our continuing coverage of the litigation, HealthReform GPS will post periodic updates as the parties and their amici file briefs in the coming weeks. Amicus briefs, filed by individuals and organizations with an interest in the outcome of the litigation, are also known as “friend of the court” briefs. In ACA litigation, numerous amicus briefs are expected on the four questions the Court will hear. For a detailed explanation of the cases and the four issues, click here.
The oral argument dates are shown below:
- Monday, March 26: Department of Health and Human Services et al., v. Florida et al.–Anti-Injunction Act – 1 hour beginning at 10 a.m.
- Tuesday, March 27: Department of Health and Human Services et al., v. Florida et al.–Minimum Coverage Provision – 2 hours beginning at 10 a.m.
- Wednesday, March 28: National Federation of Independent Business v. Sebelius, Secretary of HHS et al. and Florida et al., v. Department of Health and Human Services et al.–Severability – 90 minutes beginning at 10 a.m. AND Florida et al., v. Department of Health and Human Services et al.–Medicaid – 1 hour beginning at 1 p.m.
For access to our entire list of amicus brief summaries, click here.
Spotlight on: Senator Reid and Congresswoman Pelosi on the Minimum Coverage Provision
Senate Majority Leader Harry Reid and House Minority Leader Nancy Pelosi, along with twenty other Democratic Senate and House Leaders filed an amicus brief on January 13, 2012 urging the Supreme Court uphold the minimum coverage requirement of the Affordable Care Act (ACA).
Legislators argue that Congress has the authority under the Commerce Clause…
Update to Consumer Operated and Oriented Plan (CO-OP) Program: Final Rule
Posted on January 18, 2012
The Centers for Medicare and Medicaid Services (CMS) issued its final rule implementing the Consumer Operated and Oriented Plan (CO-OP) Program on December 13, 2011. This rule finalizes the notice of proposed rulemaking (NPRM) issued by CMS on July 20, 2011, and takes into consideration the numerous comments received during the public notice and comment period ending September 16, 2011. Established by §1322 of the Affordable Care Act (ACA), the CO-OP program develops and creates new private, non-profit health insurance issuers to offer qualified health plans (QHPs) through state Exchanges as an alternative for consumers to traditional, for-profit plans. CO-OP plans are consumer-run, and accountable to their individual membership in a way that most traditional for-profit health plans typically are not. The ACA requires HHS to award funds for start-up loans and solvency grants to eligible CO-OP applicants in order to enable each state to have at least one CO-OP. In making these awards, HHS must take into account recommendations from the Advisory Board created by ACA §1322(b)(2). Two previous Implementation Briefs provided an overview of the CO-OP program and set forth the key provisions of the proposed rule; this update describes significant changes to the proposed rule as codified in the final rule.
Continue Reading "Update to Consumer Operated and Oriented Plan (CO-OP) Program: Final Rule" »
Constitutional Challenges Update: Florida et al. v United States Department of Health and Human Services
Posted on January 4, 2012
On November 14, 2011 the United States Supreme Court agreed to hear oral arguments on issues that have arisen as a result of more than two dozen legal challenges to the Affordable Care Act (ACA) that were filed upon or immediately following the March 2010 enactment of the health reform law. The Court will consider four constitutional issues related to the ACA: (1) whether Congress has the power under Article I of the Constitution to enact the coverage requirement; (2) if the coverage requirement is found unconstitutional, whether it is severable from the remainder of the ACA; (3) whether the ACA’s requirement that states expand Medicaid eligibility or risk losing federal funds is unduly coercive in violation of the Tenth Amendment; and (4) whether the individual coverage requirement is a tax for purposes of the Anti-Injunction Act, meaning that plaintiffs seeking to challenge the requirement must wait until it takes effect in 2014.
Oral arguments are set for March 26-28, 2012, and a decision is expected by the end of the Court’s term in late June of 2012.
Update: Essential Health Benefits
Posted on December 20, 2011
On December 16, 2011, the HHS Center for Consumer Information and Insurance Oversight (CCIIO) released an Essential Health Benefits Bulletin, whose purpose is to “provide information and solicit comments on the regulatory approach that the Department of Health and Human Services (HHS) plans to propose to define essential health benefits under section 1302 of the Affordable Care Act.” Comments on the Bulletin can be sent directly to EssentialHealthBenefits@cms.hhs.gov and will be accepted until January 31, 2011
Continue Reading "Update: Essential Health Benefits" »
RWJF report explores Exchange options for States
Posted on December 20, 2011
The Robert Wood Johnson Foundation (RWJF) released a report today that explores three ways that states can comply with the Affordable Care Act’s (ACA’s) health insurance exchange provision. First, states can establish an exchange of their own; second, states can default to a federal exchange; or third, states can create a hybrid exchange. On behalf of the National Academy of Social Insurance (NASI), the authors evaluated the considerations associated with each option to help states determine which model may work best for the unique needs of their residents. Although the underlying goals are the same in all three Exchange models, there are differences in the amount of flexibility and autonomy granted to the States with each. State Exchanges, for example, offer the greatest independence in functions like coordinating plan enrollment, eligibility, and financial management. States cede much of this autonomy with the Federal Exchange model. As its name implies, the Hybrid Exchange allows states to retain responsibility for certain core functions, while importantly, also providing an interim pathway for an eventual State Exchange. The authors conclude that regardless of the model, success can only be achieved through intensive collaboration between individual states and the U.S. Department of Health & Human Services.
Continue Reading "RWJF report explores Exchange options for States" »
Sen. Wyden (D-OR) joins Rep. Ryan (R-WI) on Medicare Plan
Posted on December 18, 2011
Democratic Sen. Ron Wyden of Oregon teamed up with Republican Rep. Paul Ryan of Wisconsin on a Medicare overhaul plan that would provide beneficiaries with a fixed amount to buy private coverage or pay for a traditional fee-for-service plan. Different from the Ryan plan introduced earlier this year, the Ryan-Wyden proposal would not do away with Medicare, but instead would leave it is an option for beneficiaries to purchase with their vouchers. However, this plan would not ensure that the voucher would make Medicare affordable, nor would it preclude private insurance policies from designing benefit plans to exclusively attract healthy beneficiaries.
Continue Reading "Sen. Wyden (D-OR) joins Rep. Ryan (R-WI) on Medicare Plan" »
HHS releases bulletin on essential benefits, allows for state flexibility
Posted on December 16, 2011
The U.S. Department of Health and Human Services (HHS) has issued a pre-rule informational Bulletin which lays out its proposed approach for determining the Essential Benefits package required of all qualified health plans (QHPs) under the Affordable Care Act (ACA). HHS deferred to States’ judgment by allowing a State to create a benchmark essential benefits package from a currently-available plan within the State, as long as the package includes benefits from the ten benefit categories laid out in the ACA. HHS proposes that States choose the benchmark plan from a list of plan types:
- One of the three largest small group plans in the State by enrollment
- One of the three largest State employee health plans by enrollment
- One of the three largest federal employee health plan options by enrollment
- The largest HMO plan offered in the State’s commercial market by enrollment
If a State does not select a benchmark plan, HHS intends to propose that the default benchmark be the benefits package from the largest small group plan within the State.
For more information on Essential Benefits, click here.
Continue Reading "HHS releases bulletin on essential benefits, allows for state flexibility" »
GAO compares PCIP implementation with CHIP
Posted on December 15, 2011
The U.S. Government Accountability Office (GAO) has issued a report comparing the early stages of the federal Pre-Existing Condition Insurance Plan (PCIP) with the Children’s Health Insurance Program (CHIP). The federal PCIP was authorized by the Affordable Care Act (ACA), and is intended to provide insurance for individuals with previously existing medical conditions who have been unable to obtain health insurance coverage for at least 6 months. GAO was tasked by the Senate with comparing early enrollment and implementation across both PCIP and CHIP. GAO found that like CHIP, enrollment in PCIP was slow in the beginning, but increased over time. GAO also found that enrollment in PCIP was generally lower in States that had high risk pools than in States that did not.
For more information on pre-existing conditions, click here.
Continue Reading "GAO compares PCIP implementation with CHIP" »
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- Constitutional Challenges Update: Florida et al. v United States Department of Health and Human Services posted on January 4, 2012
- The Center for Medicare and Medicaid Innovation: A Year’s Progress posted on January 26, 2012
- Chronic Disease Management posted on February 23, 2011
- Hospital Readmissions Reduction Program posted on November 1, 2011
- Update to Consumer Operated and Oriented Plan (CO-OP) Program: Final Rule posted on January 18, 2012
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Recent Posts
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–NFIB on Severability
- House approves CLASS repeal
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–Health Law Professors on the mandate
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–Solicitor General on Severability
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–Center for Constitutional Jurisprudence/Pacific Legal Foundation on Medicaid Expansion
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–AHA on the mandate
- HHS releases document listing largest three small group products by state
- GAO report suggests HHS address contractor performance and plan for needed measures
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–Senator Reid and Congresswoman Pelosi on the mandate
- Challenges to the Affordable Care Act: Highlights from the Supreme Court Briefs–BCBS of Mass. on the mandate
