SCOTUS Grants Cert on ACA Tax Subsidy Case

On Friday, November 7, 2014, the U.S. Supreme Court agreed to hear King v. Burwell, one of the cases about who is eligible for the tax subsidies in the Affordable Care Act (ACA).  These subsidies are a critical part of the legislation as they are designed to help make health insurance affordable.  As we discussed in a prior post, at least two U.S. Circuit Courts of Appeal have issued different interpretations on this language.

In King v. Burwell, the 4th Circuit …

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Higher Deductible Plans Are the New Black and Speaking of Enrollment . . .

With 2014 wrapping up, attention is quickly turning to the benefits enrollment period for 2015 including enrollment for health insurance.  A new survey out by Towers Watson, the National Business Group on Health, and PriceWaterhouseCoopers provides a glimpse into how employers are thinking about these benefits.  One conclusion is that, for health insurance, higher deductible plans are the new black.

Since the passage of the Affordable Care Act (ACA), one of the big questions is what, if any, impact its passage would have on employer-provided …

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Obama Administration Files Proposed Rules on ACA Preventative Services Coverage–Seeks Input on Logistics

The Obama Administration has filed an Interim Final Rule seeking input on the logistics of obtaining an accommodation and in defining eligible organizations with respect to coverage for preventative services under the ACA.

The new interim final regulations establish another option for an eligible organization to avail itself of the accommodation. Under the IFR, an eligible organization may notify the Department of HHS in writing of its religious objection to contraception coverage. HHS will then notify the insurer for an insured health plan, or the …

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Obama Administration Seeking Full D.C. Circuit Rehearing to Address Obamacare Circuit Split; Plaintiffs in Fourth Circuit Seek Cert from Supreme Court

On Friday, August 1, the Obama Administration filed its much anticipatedpetition for rehearing en banc with the D.C. Circuit in Halbig v. Burwell.  The petition asks for the full D.C. Circuit bench to reconsider and overturn the original ruling by the three judge panel based on a what the Administration has characterized as a misconstruction of the statutory language at issue.

The D.C. Circuit’s three judge panel determined that the Affordable Care Act provision permitting subsidies unambiguously restricts its applicability only to state-based …

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Courts Split on ACA Health Insurance Subsidies: Highlights Differences in Statutory Interpretation

On July 22, 2014, two U.S. Courts of Appeals highlighted both the science and the art of statutory construction and interpretation — and came to very different conclusions. These courts were asked to consider an IRS rule (26 C.F.R. § 1.36B-2(a)(1)) associated with a section of the Affordable Care Act that provides tax credits (subsidies) for those who purchase health insurance under the exchanges. The central issue was whether the relevant provision of the ACA (26 U.S.C. 36B(c)(2)(A)(i)) (the provision), which provides that subsidies would …

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Hobby Lobby Precedent Already Undermined, Says Justice Sotomayor

Thursday, July 3, the United States Supreme Court granted an application for injunction pending appeal by Wheaton College, overriding its requirements for exemption from the contraceptive mandate under the Affordable Care Act, while calling into question the extent of the court’s holding in Burwell v. Hobby Lobby, Inc.  In her dissent, Justice Sotomayor writes that this order “evinces disregard for even the newest of this Court’s precedents and undermines confidence in this institution.” Wheaton v. Burwell, 573 U.S. ____ (2014). 

Wheaton College …

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Oregon to Join the Federal Healthcare Exchange

The first Affordable Care Act (ACA) health exchange open enrollment period ended March 31, 2014.  States and others are now doing their own evaluations and “after action reports” in an effort to find out what went well and what did not.

As of April 1, 2014, approximately 8 million people enrolled via the exchanges.  There are still some remaining questions such as how many have paid their premiums and what impact the young invincibles will have on premiums for the 2015 enrollment period.  Just under …

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N.Y. Attorney General, EmblemHealth Reach Settlement Over Continuation Coverage

In a press release, Attorney General Eric Schneiderman announced that his office had conducted an investigation into widespread violations of New York’s Age 29 Law, which requires health insurers to offer young adults continuation health coverage on their parents’ policies until they turn 30. Following the investigation, a settlement was reached with the health insurer requiring it to reinstatement health coverage to more than 8,000 young adults whose coverage was wrongly terminated, and to pay approximately $90,000 in denied claims.

The federal Affordable Care Act …

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The ACA and the Fountain of Youth

 

First it was Ponce de Leon and now it’s the ACA searching for the Fountain of Youth.   With 2014 here, implementation of the Affordable Care Act healthcare exchanges is underway.  Insurers cannot deny coverage based on health status. Insurers can charge higher rates based on age, but cannot charge any more than 3 times the rate of a young individuals.  These ratios may not adequately cover the risk. But, one of the premises under which the healthcare exchanges operate is that a sufficient number …

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President Obama’s ACA Extension – NAIC Response

With the January 2014 effective date under the Affordable Care Act’s (ACA) essential benefits and guaranteed coverage provisions quickly approaching, several million people have received a cancellation notice. Facing wild criticism, President Obama responded with a regulatory fix that will allow Americans to keep ACA non-compliant insurance policies, albeit temporarily.

The extension gives American consumers the option to renew their current non-conforming plans for one year. This extension mostly affects those plans not grandfathered in under the ACA, including those newer policies that were purchased …

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