Health Insurance
Update: Legal Challenges to the Affordable Care Act
Posted on September 23, 2011
Since the enactment of the Affordable Care Act (ACA), at least 27 lawsuits have been filed challenging the constitutionality of various provisions of the law. While nearly half of the lawsuits have been dismissed on procedural grounds, three district courts have found provisions challenged to be constitutional, and three have found them to be unconstitutional. Previous HealthReform GPS Implementation briefs/updates have discussed these lower court decisions. Following appeals of each of these rulings, the United States Courts of Appeals in the Fourth, Sixth, and Eleventh Circuits have now issued decisions as well. Most importantly, the appellate decisions continue to reflect a split in judicial opinion regarding the constitutionality of the Affordable Care Act’s individual mandate. Other important issues addressed by the appellate rulings concerned the constitutionality of the ACA Medicaid expansion and the question of whether the trial court in the Virginia cases (Liberty University v. Geithner and Commonwealth of Virginia v. Sebelius) had the authority to hear the cases at all.
Continue Reading "Update: Legal Challenges to the Affordable Care Act" »
Obama’s deficit reduction proposal to super committee includes health savings
Posted on September 20, 2011
President Obama sent “Living Within Our Means and Investing in the Future: The President’s Plan for Economic Growth and Deficit Reduction,” his plan to jumpstart economic growth and job creation, to the Joint Committee yesterday. The plan proposes additional savings on top of those signed into law under the Budget Control Act. Specific to health savings, the President recommended cuts to erroneous and wasteful spending under Medicare and Medicaid. He stressed that he would “veto any bill that takes one dime from the Medicare benefits seniors rely on without asking the wealthiest Americans and biggest corporations to pay their fair share.”
Continue Reading "Obama’s deficit reduction proposal to super committee includes health savings" »
GOP issues report on CLASS Act
Posted on September 16, 2011
House and Senate Republicans have issued a new report on the Community Living Assistance Services and Supports (CLASS) program, a long-term care insurance program created by the Affordable Care Act (ACA). The report, “CLASS’ UNTOLD STORY: Taxpayers, Employers, and States on the Hook for Flawed Entitlement Program,” was issued by the bicameral Repeal CLASS Working Group, and calls for the repeal of the CLASS program due to questions surrounding its financial sustainability.
Continue Reading "GOP issues report on CLASS Act" »
Health Affairs Blog warns of medical necessity definition discrimination
Posted on September 16, 2011
A new Health Affairs Blog by Professor Sara Rosenbaum, a frequent contributor to HealthReformGPS.org, points out an issue with the medical necessity definition proposed in a glossary section of insurance terms that must be disclosed to consumers under the Affordable Care Act (ACA). The glossary is part of a larger proposed rule on Summary of Benefits and Coverage information that must be disclosed to consumers by insurance companies. The rule defines medical necessity as “[h]ealth care services or supplies needed to prevent, diagnose, or treat an illness, injury, disease or its symptoms and that meets accepted standards of medicine,” and could be viewed as discriminatory toward persons with disabilities because it omits the word “condition.”
Continue Reading "Health Affairs Blog warns of medical necessity definition discrimination" »
IRS issues RFC on potential safe harbor for large employers
Posted on September 15, 2011
The Internal Revenue Service (IRS) has released a Request for Comment (RFC) on a potential safe harbor for large employers under the shared responsibility provisions of the Affordable Care Act (ACA). Under the ACA, employers with more than 50 employees must provide affordable health coverage to workers, or else face a penalty. This potential safe harbor would allow employers to base what constitutes affordable coverage on an employee’s wages rather than the employee’s household income, which is something more difficult for employers to know or easily determine.
Continue Reading "IRS issues RFC on potential safe harbor for large employers" »
Sebelius announces awards for future health centers
Posted on September 15, 2011
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has announced the awarding of $10 million to 129 entities around the country that intend on becoming community health centers. The money was made available by the Affordable Care Act (ACA) and will be used to develop new health centers, which provide access to care for many medically under-served Americans.
Continue Reading "Sebelius announces awards for future health centers" »
District court rules individual mandate unconstitutional
Posted on September 13, 2011
Judge Christopher Conner of the U.S. District Court for the Middle District of Pennsylvania has ruled that the individual requirement to purchase health insurance (individual mandate) under the Affordable Care Act (ACA) is unconstitutional. In his ruling, Judge Conner found that the individual mandate exceeds Congress’ power under the Commerce Clause of the U.S. Constitution. Judge Conner also agreed with the government’s position that because the individual mandate is so intertwined with both the guaranteed issue and pre-existing condition provisions, all must be invalidated if one is invalidated. Therefore, in his ruling, all three provisions were severed from the ACA.
For more information of legal challanges to the ACA, click here.
Continue Reading "District court rules individual mandate unconstitutional" »
CMS issues RFI on Basic Health Program
Posted on September 9, 2011
The Centers for Medicare and Medicaid Services (CMS) of the US Department of Health and Human Services (HHS) has issued a Request for Information (RFI) on the Basic Health Program (BHP). The BHP is designed to offer an alternative pathway to coverage for low-income families, and must provide at least the same level of mimimum essential health benefits offered to other consumers through plans sold in the State’s Exchange. The RFI seeks input from stakeholders on what they feel will be challenges and costs associated with the BHP, how the BHP might affect the Exchange, and innovative strategies States could use in contracting with standard health plans.
For more information on the BHP, click here.
Continue Reading "CMS issues RFI on Basic Health Program" »
Federal appeals court rules state of Virginia lacks standing in health reform challenge
Posted on September 8, 2011
The United States Court of Appeals for the 4th Circuit has ruled that the State of Virginia lacks standing to challenge the constitutionality Affordable Care Act (ACA). The Court found that the individual mandate did not apply to the State, and consequently, Virginia could not show that any injury resulting from the mandate’s enaction.
In a seperate but related opinion, the Court found that the tax anti-injuction act (AIA) negated its jurisdiction to hear hearing a lawsuit brought by Liberty University, also filed on the basis of ACA constitutionality.
For more information of legal challenges to the ACA, click here.
HHS issues amended final rule on rate review, association plans subject to reviews
Posted on September 6, 2011
The U.S. Department of Health and Human Services (HHS) has issued an amended final rule clarifying the definition of “individual market” and “small group market” with respect to the rate review process authorized by the Affordable Care Act (ACA). The definition now includes association plans in the types of health insurance products that are subject to the rate increase disclosure rules ad reviews, even if States do not chose to regulate association plans as part of their own individual or small group markets.
For more information on the disclosure and review of insurance premiums under the ACA, click here.
Stay Connected
Most Popular Content
- Contraception Coverage under the ACA’s Preventive Services Coverage Requirements, and Employer Implementation: An Update posted on April 20, 2012
- Update: Essential Health Benefits FAQs posted on May 9, 2012
- Update: Exchanges Establishment and Eligibility Final Rule posted on April 10, 2012
- State Health Insurance Exchange Navigators posted on February 28, 2011
- Update on the Final Rule: Standards Related to Reinsurance, Risk Corridors and Risk Adjustment posted on April 4, 2012
Categories
- Congressional Action
- Disparities
- Expert Commentary
- Fraud and Abuse
- Health Care Quality and Delivery System Reform
- Health Information
- Health Insurance
- Implementation Briefs
- Judiciary
- Key Developments
- Agency Profile
- Department of Education
- Department of Health and Human Services
- Administration for Children & Families
- Administration on Aging
- Agency for Healthcare Research & Quality
- and Public Health Council
- Centers for Disease Control & Prevention
- Centers for Medicare & Medicaid Services
- Health Promotion
- Health Resources & Services Administration
- National Institutes of Health
- National Prevention
- Office of Consumer Information and Insurance Oversight
- Office of Inspector General
- Office of Minority Health
- Office of Public Health and Science
- Office of the Secretary
- Department of Justice
- Department of Labor
- Department of the Treasury
- Grants
- Legislation
- Rulemaking, Rules, and Guidance
- Legal Challenges
- Long Term Care
- Medicaid and CHIP
- Medicare
- Public Health
- Tax Policy
- Workforce and Access
Archives by Date
- May 2012
- April 2012
- March 2012
- February 2012
- January 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- January 2011
- December 2010
- November 2010
- October 2010
- September 2010
- August 2010
- July 2010
- June 2010
- May 2010
- April 2010
- March 2010
Recent Posts
- CCIIO announces potential plans for risk adjustment
- HHS publishes Exchange guidance and draft blueprint
- HHS releases web-based search tool to track health care system performance
- Heritage Foundation Recommends Eliminating Premium Subsidy for High Income Beneficiaries to Shore-Up Medicare
- Update: Medical Loss Ratio Requirements
- CMS releases final rule on MLR requirements
- Report estimates impact of small business tax credit
- Health Affairs article explores power of providers to win payment increases
- Department of Labor releases FAQs on mental health parity compliance
- HHS announces funding for school-based health centers
