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Health plans - policy

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[Opinion] With the Federal Individual Mandate Gone, States Might Step Up: Lessons from Massachusetts
"State-administered mandates or alternative policies to encourage broad coverage across a state's population can be a tool to foster premium stability and healthy issuer participation, but [Massachusetts has] found that mandates can also introduce extra advantages such as the promotion of consistent benefit floors and enabling effective outreach to the uninsured." (Health Affairs)
[Opinion] ECFC Comment Letter to IRS on about Qualified Small Employer Health Reimbursement Arrangements (PDF)
"We believe that Congress did not intend that coverage of excepted benefits would be considered group health coverage causing an employer to be unable to offer a QSEHRA to its employees.... [IRS Notice 2017-67 provides] that an employer would not be eligible to offer a QSEHRA if it provides current employees with continued access to amounts which accumulated in an HRA in previous year or carryover amounts in an FSA ... This is counterproductive to the policy behind consumer-directed health accounts[.]" (Employers Council on Flexible Compensation [ECFC])
[Guidance Overview] DOL Proposed Regs Would Allow Association Health Plans
"The proposed rule ... would require that the group or association have a formal organizational structure with a governing body ... and that the functions and activities of the group or association, including the establishment and maintenance of the group health plan, are controlled by its employer members. These requirements are intended to ensure that the organizations are bona fide organizations with the organizational structure necessary to act 'in the interests' of participating employers with respect to employee benefit plans as ERISA requires." (Wolters Kluwer Law & Business)
Centene Sued Over Provider Networks in ACA Exchange Plans
"Centene, an insurer that has thrived on the [ACA] exchanges, is facing a federal lawsuit alleging its plans fail to provide adequate access to in-network providers.... The lawsuit accuses Centene of 'selling junk plans on state exchanges and misleading enrollees about the plan benefits,' which violates the ACA's requirements that plans provide adequate coverage[.]" (FierceHealthcare)
[Opinion] The Individual Insurance Market in 2018: Business as Usual?
"Claims that the exchange market is unstable are greatly exaggerated.... A stable market does not necessarily yield optimal social or fiscal outcomes. Instead of achieving the ACA's goal of (near-) universal coverage, middle-class families who do not have access to employer coverage will continue to be squeezed out of the market. Those who have coverage will continue to see their costs rise as a result of an inefficient delivery system." (Health Affairs)
Whither Private Health Insurance Now?
"Congress has been busy enacting and proposing changes to the [ACA's] regulation of private health insurance, from repealing the tax on individuals without minimum essential coverage to the Alexander-Murray bill intended to shore up the private market. These changes do not play well together. Three reasons are explored here: the great wall, which divides advocates with different goals; whipsawed insurance markets, in which insurers are simultaneously pulled in different directions; and, of course, the cost of care, which each reform shifts onto different entities." (Health Affairs)
[Guidance Overview] What the Proposed Rule on Association Health Plans Means for Employers
"The lack of ERISA preemption could be a significant impediment to cost-effective implementation of self-funded AHPs. Currently, many states highly regulate (or prohibit altogether) self-funded MEWAs. On the other hand, implementation of insured AHPs could be a viable structure for some employer groups.... If the issue of preemption of state laws is not resolved by final rule, then it is difficult to see how permitting self-funded AHPs on the federal level would accomplish much, given that many states would continue to require such AHPs to be regulated as insurers." (Drinker Biddle)
Transforming the Federal Individual Mandate Into State Health Insurance Down Payments
"[Under the proposal, when] uninsured Marylanders ... file state income tax returns, they will receive notice that, unless they would rather pay a penalty and get nothing back, their money will instead be used as a down payment to help them buy insurance.... [T]he Maryland health insurance exchange will see whether the consumer is offered a plan that costs no more than the down payment plus any federal premium tax credit (PTC) for which the consumer qualifies. If such a plan is available, the consumer is enrolled, at zero additional cost.... If no zero-cost plan is available, the down payment is saved in an interest-bearing account that the consumer can use to buy insurance during the next open enrollment period." (Families USA)
The Proposed Association Health Plan Rules: Implications for Professional Employer Organizations
"The Proposed AHP Rule does not reference PEOs or PEO-sponsored coverage, and accordingly, does not directly implicate or call into question a PEO's ability to sponsor health coverage. However, it does have the potential to significantly impact the coverage options available to small employers, and therefore could have a profound effect on PEOs as drafted.... Notably, ... the Proposed AHP Rule imposes fairly rigorous nondiscrimination requirements that may make it difficult for AHPs and their carriers (if the AHP is fully insured) to secure relatively preferential risk from the community-rated insurance markets or even manage the ongoing risk profile of the AHP long-term." (NAPEO)
[Guidance Overview] DOL to Expand Association Health Plans
"Under the proposal, AHPs would not be required to comply with all provisions of the ACA. For example, their group health plans would not have to cover all of the 10 essential health benefits' (which include hospitalization, prescription drugs and emergency care). They would also be exempt from an ACA rule requiring insurers to spend at least 80 percent of premium revenue on medical care." (The Wagner Law Group)
HHS Nominee Sees PBMs as Tool to Lower Drug Costs
"Alex Azar, President Donald Trump's nominee to be the next secretary of HHS, suggested during his testimony before the Senate Finance Committee that pharmacy benefit managers (PBMs) would be the most effective tool to negotiate for lower drug costs, and said that PBMs should negotiate physician-administered drugs covered under Medicare Part B." (American Journal of Managed Care)
[Guidance Overview] Proposed AHP Regs Include Welcome Changes for Employers But Would Present State Regulatory Challenges
"MEWAs have historically attracted fraudulent schemes and operators. It has been the states, and not the Federal government, that have typically taken the lead in policing MEWAs. The proposal would change this. State regulators will also be worried about the impact of the proposal on their small group markets, which could be fragmented by the expanded adoption of AHPs." (Alden Bianchi, Mintz Levin)
National Taxpayer Advocate Releases Annual Report to Congress, Discusses Tax Reform Implementation, Unveils 'Purple Book'
"In Volume 1 of this year's report, we have identified 21 Most Serious Problems, made 11 Legislative Recommendations, and discussed the 10 Most Litigated Issues, along with significant stand-alone decisions. Volume 2 includes seven research studies and two Literature Reviews.... The Purple Book is a compendium of 50 legislative recommendations for strengthening taxpayer rights and improving tax administration that we and others have made over the years." (Taxpayer Advocate Service, Internal Revenue Service [IRS])
Estimating the Costs of Proposals Affecting Health Insurance Coverage
"This [slide presentation] explains the process followed by CBO and the staff of the Joint Committee on Taxation (JCT) when estimating the costs of legislative proposals affecting health insurance coverage. An example is the agencies' estimate of how repealing the individual mandate to have health insurance would affect federal deficits." (Congressional Budget Office [CBO])
Overview of CBO Estimates of Federal Subsidies for Health Insurance for People Under Age 65, 2017-2027
"The federal government subsidizes health insurance for most Americans through a variety of programs and tax provisions. In 2017, net subsidies for people under age 65 will total $705 billion, CBO and the staff of the Joint Committee on Taxation (JCT) estimate. This presentation provides an overview of CBO and JCT's current baseline projections of health insurance coverage and how those projections have changed since March 2016, highlighting changes in Medicaid and CHIP enrollment and nongroup coverage." (Congressional Budget Office [CBO])
Proposed Guidelines for Association Health Plans
"This does open a new potential market for health care coverage -- which means that it may damage individual insurance markets and the current public exchanges by attracting good risk out of those programs. While the proposed regulations are a catalyst for this market, creation of an AHP is not simple; there are regulatory requirements, funding issues, state regulations (including Multiple Employer Welfare Association guidance and qualifying group parameters) and insurance carrier partnerships to navigate." (Mercer)
New Rules Would Expand Access to Association Health Plans for Small Businesses
"Under the proposed rules, the employer association would need to have a formal organizational structure, with a governing body and by-laws. The association's activities, including adopting and maintaining the AHP, would need to be controlled by the members of the association, either directly or through elected representatives. The proposed rules would prohibit an association from setting different premium rates under the AHP for an employer based on the health status or claims history of its employees. Premium rates and eligibility criteria could vary, however, based on nondiscriminatory job classifications, such as part-time or full-time, or by industry." (Hanson Bridgett LLP)
Maine CO-OP Sues Federal Government Seeking Cost-Sharing Reduction Payments
"[Maine Community Health Options (MCHO), a nonprofit insurer in Maine,] seeks an estimated $5.6 million in CSR payments for the 2017 plan year. The lawsuit ... reflects some of the same claims made by insurers (with mixed success) in ongoing litigation over risk corridor payments." (Health Affairs)
Don't Overlook Fact That Association Health Plans Are MEWAs
"The regulation of AHPs is colored by the fact that they constitute Multiple Employer Welfare Arrangements (MEWAs). Under [ERISA], states have broad authority to apply their insurance laws to self-insured MEWAs. Many states regulate self-insured MEWAs like a commercial insurance company. State authority to regulate fully insured MEWAs, however, is much more limited." (Morris, Manning, & Martin, LLP)
Idaho Governor Signs Order Seeking to Roll Back Obamacare Rules
"Idaho Gov. Butch Otter (R) on Friday signed an executive order ... directing the state's insurance department to allow insurers to sell health plans that do not meet ObamaCare requirements.... [I]nsurers might not have to cover all of ObamaCare's essential health benefits, which include areas like maternity care and mental health coverage." (The Hill)
[Guidance Overview] DOL Issues Proposal on Association Health Plans
"[E]xamples of a 'metropolitan area' include the 'Greater New York City Area/Tri-State Region covering portions of New York, New Jersey and Connecticut; the Washington Metropolitan Area of the District of Columbia and portions of Maryland and Virginia; and the Kansas City Metropolitan Area covering portions of Missouri and Kansas.' Smaller geographic regions, such as a single city or county, would also suffice. The DOL is seeking public comment on whether additional clarification is needed to better define what constitutes a metropolitan area.... [Comments] are due by March 6, 2018." (Littler)
[Guidance Overview] DOL Proposes Expansion of Association Health Plans
"AHPs may be formed by employers that are engaged in the same trade, industry, line of business, or profession, or that are located in the same state or metropolitan area (even if the metropolitan area crosses state lines).... [An] AHP may be created solely for the purpose of providing health coverage to the employees of its members. AHPs may also be established by employers who meet 'commonality of interest' criteria under existing guidance that would allow their association to sponsor a single health plan for its members.... [No] size limit applies to employers seeking to form or join an AHP." (Ballard Spahr LLP)
Association Health Plan Proposal: Experts Wary of Consumer Protections, Oversight Issues
"Association health plans can't charge higher premiums or deny coverage based on health status ... But because AHPs would be subject to large-employer market rules, they wouldn't have to cover the list of essential health benefits that the [ACA] mandates. The upshot ... is that insurers could legally weed out those with costly conditions while still complying with regulations that bar them from denying those individuals coverage or hiking their premiums." (FierceHealthcare)
HHS Says New York May Have Misallocated Obamacare Exchange Funds
"The New York State Department of Health may have misallocated nearly $19.6 million in federal establishment grants to create its [ACA] exchange, the [HHS] Office of Inspector General said in a report Dec. 29. In addition, the state claimed unallowable fees of nearly $3.8 million paid to the state's exchange contractor, Maximus Inc., [the OIG report] said." (Bloomberg BNA)
[Opinion] DOL Rule on Association Health Plans Could Devastate Small-Group Markets
"Because the rule would subject AHPs to substantially weaker standards than ACA-compliant plans in the small-group and individual markets, they could -- and likely would -- be structured and marketed to attract younger and healthier people, thus pulling them out of the ACA-compliant small-group market and leaving older, sicker, and costlier risk pools behind." (Center on Budget and Policy Priorities)
Congress Eyes Several Health Care Reform Priorities, Including Delay of Cadillac Tax
"[S]everal health care legislative priorities ... are expected to be voted on before Memorial Day. These include bills aimed at reducing premiums and out-of-pocket costs in the ACA's individual market [and] a bipartisan package of HR Policy-supported bills that would delay a number of ACA taxes ... Meanwhile, Democrats will press for legislation to reduce drug costs, continue to build support for a single-payer system, and possibly enact state level individual mandates." (HR Policy Association)
Leading ACA Columnist Passes Baton to New Author
"[Timothy Jost, in the Health Affairs Blog, chronicled] the development and eventual passage of the ACA. Then, he began doing [hundreds of] posts on the seemingly endless stream of rules, guidances, and other documents necessary to put the new law into action.... Tim will continue to write the monthly 'Eye on Health Reform' [column in] Health Affairs.... Katie Keith will [take over for Jost on the ACA column]." (Health Affairs)
[Guidance Overview] The Proposed Rule for Association Health Plans: What It Says and What It Would Do
"One repeated consideration that characterizes the rule is the Department's effort to ensure that a group or association has a 'sufficiently close economic or representational nexus to the employers and employees that participate in the plan.' Where an employment relationship to the association does not exist, the only connection between a member employer and the association is the health coverage itself. When that is the case, courts have held that the relationship is more similar to a relationship between an employer and a state-regulated private insurer, which would be subject to many more consumer protections. The Department asserts throughout the rule that it has adequately addressed concerns about these types of arrangements masquerading as AHPs." (Katie Keith, in Health Affairs)
DOL Proposed Rule Paves Way for Association Health Plans
"State authority over such plans would vary depending on whether the plans were self-insured, which exempts them from some state coverage and benefit rules, or fully insured, which means they must meet state mandates. No matter how plans are funded, states would retain oversight of their solvency ... But the proposal asks for additional comments on state regulatory authority." (Kaiser Health News)
DOL Proposes New Health Plan Options for Small Businesses
"The proposal would allow small business owners, their employees, sole proprietors and other self-employed people to join together as a single group to buy insurance in the large-group market. The new health plans could be exempt from some requirements of the [ACA]. They would, for example, not have to provide certain 'essential health benefits' like mental health care, emergency services, maternity and newborn care and prescription drugs.... Marc I. Machiz, who investigated insurance fraud as a Labor Department lawyer for more than 20 years, said the proposed rules were an invitation to more scams." (The New York Times; subscription may be required)
DOL Proposes Expansion of Association Health Plans
"The proposed rule applies only to employer-sponsored health insurance. This would allow employers to join together as a single group to purchase insurance in the large group market. The [DOL] said this move would open health insurance coverage for millions of Americans and their families by making it more affordable for thousands of small businesses and sole proprietors." (
[Guidance Overview] DOL Announces Proposal to Expand Access to Healthcare Through Small Business Health Plans
"As proposed, the rule would: [1] Allow employers to form a Small Business Health Plan on the basis of geography or industry. A plan could serve employers in a state, city, county, or a multi-state metro area, or it could serve all the businesses in a particular industry nationwide; [2] Allow sole proprietors to join Small Business Health Plans, clearing a path to access health insurance for the millions of uninsured Americans who are sole proprietors or the family of sole proprietors." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])
[Official Guidance] Text of DOL Proposed Regs: Definition of Employer under Section 3(5) of ERISA
83 pages. "This document ... would broaden the criteria under ERISA section 3(5) for determining when employers may join together in an employer group or association that is treated as the 'employer' sponsor of a single multiple-employer 'employee welfare benefit plan' and 'group health plan' ... The regulation would modify the definition of 'employer,' in part, by creating a more flexible 'commonality of interest' test for the employer members than the [DOL] had adopted in sub-regulatory interpretive rulings under ERISA section 3(5). At the same time, the regulation would continue to distinguish employment-based plans ... from mere commercial insurance programs and administrative service arrangements marketed to employers. For purposes of Title I of ERISA, the proposal would also permit working owners of an incorporated or unincorporated trade or business, including partners in a partnership, to elect to act as employers for purposes of participating in an employer group or association sponsoring a health plan and also to be treated as employees with respect to a trade, business or partnership for purposes of being covered by the employer group's or association's health plan." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])
[Opinion] From Premiums to Politics: Predictions for the Health Insurance Industry in 2018
"[1] The CVS-Aetna deal will have a domino effect in the healthcare industry ... [2] Republicans and Democrats will be forced to work together on ACA fixes ... [3] There will be more premium hikes and insurer exits in the individual market ... [4] Federal agencies will start to carry out Trump's executive order -- and states will push back ... [5] Payers' move to value-based payment models will continue, with or without the feds leading the way." (FierceHealthcare)
[Opinion] The Frustration of Fraudulent Claims
"Despite all its quirky billing and procedure codes that add huge administrative burden ... the carrier payment system based upon thousands of CPT codes and 'modifiers' continues to be too provider-friendly. The complexity of the system has enabled unfair gamesmanship and misbehavior to the detriment of the payers (carriers and clients alike). We need a simpler and more responsive payment system." (Frenkel Benefits)
[Opinion] A Carrier's Economist's Take on the ACA
"Between 2010 and the actual ACA launch, [one Blue Cross plan] spent over $100,000,000 in new spending just on compliance work and building the systems to allow us to participate. This is money that could have bought actual health care. Pre-ACA we served an individual market with the following characteristics: 125,000 people, Average age 36 years, 51% female ... Fast forward to 2017: 165,000 people, Average age 46 years old [... 30% increase; older,sicker], 58% female [... more expensive claims] ... Only 40% of policyholders keep their plan for 12 premium payments in a row." (InsureBlog)
Outlook 2018: EBSA Awaits New Direction from Rutledge
"At the top of the list for [EBSA], as it has been for nearly a decade, is the fiduciary rule.... Years of DOL guidance could be reversed by [a] new regulation which will likely make it easier for individuals and small businesses to join association health plans.... When [Preston Rutledge] takes the helm at EBSA, it's a guessing game as to what retirement and benefits issues he may want tackled other than the fiduciary rule and association health plans." (Bloomberg BNA)
[Opinion] Years of Attack Leave Obamacare a More Government-Focused Health Law
"By ending the tax penalty for people who do not have coverage, beginning in 2019, Republicans may hasten the flight of customers who now pay the full cost of their insurance. Among those left behind under the umbrella of the [ACA] would be people of modest means who qualify for Medicaid or receive sizable subsidies for private insurance." (Robert Pear, in The New York Times; subscription may be required)
Individual Obamacare Plans Could Cover Less Under HHS Proposal
"[The proposed 2019 Notice of Benefit and Payment Parameters] would give states more leeway in designating benchmark health plans on which the ACA's comprehensive essential health benefits (EHB) requirements are based. That could help reduce costs and premiums, which rose sharply in 2017 and will rise again in 2018, but it could diminish the ACA aim of making the individual health insurance market more like employer group market coverage." (Bloomberg BNA)
Is Disaster Brewing in New York's Small Group Market?
"From 2007 to 2016 enrollment shrank by 600,000 members, to 1.1 million. Rates were 35% higher than the national average. This, despite New York being one of the very few states to increase the size of their small group risk pool from 50 employees to 100 in 2016." (Frenkel Benefits)
HHS Informal Request for Information: Promoting Healthcare Choice and Competition Across the United States
"HHS is interested in public comments about State and Federal laws, regulations, guidance, requirements, and policies that discourage or prevent the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people, the promotion of competition in healthcare markets, and the limitation of excessive consolidation throughout the healthcare system.... This request for information specifically requests information about barriers to choice and competition ... and proposed solutions that could facilitate the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people. Comments will be received until January 25, 2018." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])
What Individual Mandate Repeal Means for Employers
"If fewer individuals seek coverage through the [ACA] exchange ... it is likely that some employers will escape the employer mandate penalties[.]" (Society for Human Resource Management [SHRM])
Senate Confirms EBSA Head, Two SEC Commissioners
"The Senate on Thursday confirmed Hester Peirce and Robert Jackson as new commissioners for the [SEC] and Preston Rutledge as assistant secretary of labor for the Employee Benefits Security Administration. The approvals came in voice votes during an executive session before the chamber left for the year." (Pensions & Investments)
[Opinion] What the New Tax Law Likely Will and Won't Do to the Nation's Health Care
"As many of us have speculated about what insurers will do regarding future exchange participation, Jeff Young from the Huffington Post actually called a bunch of them. None have said they were running straight for the exits, but many sound very cautious about the 'big mess' ahead sans mandate." (Association of Health Care Journalists)
Creating Stability in Unstable Times: A Look at Risk Adjustment and Market Stabilization
"From 2014 to 2016, issuers experienced large losses as premiums were often too low or the health market did not meet issuer expectations ... Through 2017 the markets have evolved. Issuers have increased premiums to be more in line with the actual claim costs ... and risk adjustment methodological improvements have been well received as a step in the right direction. However, there are still high levels of market uncertainty and instability." (The Actuary Magazine)
Tax Bill: How Four Healthcare Measures Weathered Reconciliation
"[1] Individual mandate repeal included ... [2] Medical expense deduction expansion ... [3] Orphan drug tax credit reduction ... [4] Private activity bonds preserved." (HealthLeaders Media)
[Opinion] How Lawmakers Should Deal with ACA Cost-Sharing-Reduction Payments
"[P]remiums for Obamacare's exchange-based coverage in 2018 have once again risen at double-digit rates, even in plans that were entirely unaffected by the elimination of CSR payments. Providing CSR payments in 2018 will not dampen these premium increases. Nor do they address their underlying cause. Trying to rush CSR and reinsurance payments out the door in 2018 will result in wasteful and unnecessary spending, and is more likely to create confusion than to produce the predictability lawmakers seek." (The Heritage Foundation)
The Effect of the Risk Corridors Program on Marketplace Premiums and Participation
"[T]heoretically ... [the risk corridors (RC)] program creates strong incentives to lower premiums for some insurers. Empirically, ... insurers who claimed RC payments in 2015, before defunding, had greater premium increases in 2017, after the program ended. Insurance markets in which more insurers made RC claims experienced larger premium increases after the program ended ... Overall ... the end of the RC program significantly contributed to premium growth." (National Bureau of Economic Research [NBER])
[Opinion] The Eight C's That Will Define Healthcare in 2018 and Beyond
"Costs ... Capital ... Consolidation ... Consumerism ... Competition ... Compliance ... Culture ... Certainty ... Next year is pivotal to the future of our system of health.... Every board and management team in healthcare will be tested." (Paul Keckley)
[Official Guidance] Text of Treasury Department Regulatory Agenda, Fall 2017
Over 30 IRS proposed and final regulation items related to employee benefit plans and executive comp, including Determination of governmental plan status; collectively bargained welfare benefit funds; use of lump sum payments to replace lifetime income being received by retirees under defined benefit pension plans and lump sum payments after a restriction period; excise tax on high cost employer-sponsored health coverage; expatriate health plans, expatriate health plan issuers and qualified expatriates; definition of church plan; enrollment as an EA and EA and ERPA user fees; update to minimum present value requirements for defined benefit plan distributions; application of section 409A to nonqualified deferred compensation plans; application of normal retirement age regulations to governmental plans; nondiscrimination relief for closed defined benefit plans. [Also online: Fall 2017 Long-term Actions.] (U.S. Department of the Treasury)
[Official Guidance] Text of DOL Regulatory Agenda, Fall 2017
EBSA Items in Proposed or Final Rule stage: [1] Request for Information on Fiduciary Rule and Prohibited Transaction Exemptions; [2] Revision of Form 5500 Series and Implementing Related Regulations Under ERISA; [3] Definition of 'Employer' Under Section 3(5) of ERISA -- Association Health Plans; [4] Delay or Amend Final Rule Amending Claims Procedure Regulation; [5] Amendment of Abandoned Plan Program; [6] Electronic Filing of Apprenticeship & Training Notices, and Top Hat Plan Statements; [7] Adoption of Amended and Restated Voluntary Fiduciary Correction Program; [8] Interim Final Regulations; Religious Exemptions and Accommodations for Coverage of Certain Preventive Services Under the ACA; [9] Interim Final Regulations; Moral Exemptions and Accommodations for Coverage of Certain Preventive Services Under the ACA. Also online: Fall 2017 Long-term Actions, which includes 5 items from EBSA.] (U.S. Department of Labor [DOL])
Judge Blocks Administration's 'Moral Exemption Rule' on Birth Control Mandate
"The federal defendants argued the rules are intended to permit a small number of religious objectors to opt out of covering birth control because the requirement would impose a substantial burden on their religious practices. But Pennsylvania argued the exemptions would allow almost any employer to withhold insurance coverage for contraceptives, impacting millions of Americans." [Pennsylvania v. HHS, No. 17-4540 (E.D. Penn. Dec. 15, 2017)] (The Legal Intelligencer)
House GOP Unveils Package to Delay Obamacare Taxes
"House Ways and Means Chairman Kevin Brady (R-Texas) led the announcement for the bills to delay ObamaCare's tax on medical devices for five years, on health insurance for two years, and the 'Cadillac tax' on high-cost health plans for one year. The package would also eliminate penalties for employers who do not offer health insurance to their workers, under the employer mandate, through 2018." (The Hill)
Insurers Urge States to Counteract Trump Executive Order
"The executive order ... directs federal agencies to expand and extend short-term health plans, increase enrollment in association health plans, and relax rules for employer-based health reimbursement arrangements.... In practice, however, such policies could destabilize insurance markets that serve millions of individuals and employers, according to a letter from organizations including the Blue Cross Blue Shield Association, America's Health Insurance Plans, the American Heart Association, March of Dimes and six others." (FierceHealthcare)
GOP Tax Compromise Would Repeal Obamacare's Individual Mandate
"Senate Majority Leader Mitch McConnell said the compromise tax bill from House and Senate negotiators will end the health law's requirement that all individuals buy insurance or pay a fine. Doing so could jeopardize Obamacare's already-shaky marketplaces, by reducing the number of healthier people who sign up for insurance." (Bloomberg)
Health Insurance Exchanges: Changes in Benchmark Plans and Premiums and Effects of Automatic Re-Enrollment on Consumers' Costs (PDF)
"GAO analyzed changes in benchmark plans and premiums from 2015 through 2017 and found ... [1] Premium tax credits would limit the costs of increasing premiums for most consumers ... [2] Median net monthly premiums -- what consumers paid after premium tax credits -- increased less from 2015 to 2016 for those who actively enrolled ($5) than for those who were automatically re-enrolled ($22), although there was variation." [GAO-18-68] (U.S. Government Accountability Office [GAO])
Insurers Facing Impossible Scenario: Cover Everyone, But No Individual Mandate
"No one knows for sure how many young, healthy individuals will drop their health insurance coverage if the mandate is repealed ... For employer-sponsored plans, especially self-funded plans that tend to be less expensive than their fully-insured counterparts, it may be that healthy workers keep their coverage as part of their overall benefit packages." (HealthLeaders Media)
Senate HELP Committee Advances EBSA Nominee Rutledge
"[Preston Rutledge] currently serves as senior tax and benefits counsel on the Majority Tax Staff of the Senate Finance Committee, and as top aide to Senator Orrin Hatch, R-Utah. These ties to the government, and particularly to a legislator known for being active on retirement and labor issues, suggest a change in strategy from the president's first effort to name the top official at the [DOL]." (planadviser)
Employee Benefits: Past, Present and Future [Video]
American Benefits Council President James Klein interviews Dave Walker on the future of private sector benefit plans, the viability of government health and retirement entitlement programs, and the evolving role of states in regulating employee benefits. Walker is the former Assistant Secretary of Labor, the Public Trustee for Social Security and Medicare, and the Comptroller General of the United States. The interview was part of the American Benefits Council's "50th Anniversary Symposium: The Future of Employee Benefits." (American Benefits Council)
[Opinion] American Academy of Actuaries Letter to Congress: Potential Adverse Consequences of Eliminating the ACA's Individual Mandate (PDF)
"Eliminating the individual mandate would lead to premium increases.... Changes made to eliminate the mandate after premiums are finalized could weaken insurer solvency.... Increasing risks could cause an increase in insurer withdrawals from the market.... Strong alternative mechanisms to encourage enrollment and/or significant market stabilization provisions would be needed to counteract an elimination of the mandate." (Health Practice Council, American Academy of Actuaries)

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