Subscribe Now!
Free Daily News, Jobs, Webcasts, Discussions
Display and Distribute
Your Job Openings
COVID-19 News
COVID-19 Webcasts

Featured Jobs

Distribution Specialist

Carpenter Morse Group
(Telecommute / Longwood FL)

Carpenter Morse Group logo

Retirement Plan Consultant

Definiti
(Telecommute / Dallas TX / University Place WA / Spring TX)

Definiti logo

Free Daily News and Jobs

“BenefitsLink continues to be the most valuable resource we have at the firm.”

-- An attorney subscriber

Mobile App image LinkedIn icon
Twitter icon
Facebook icon

View Coronavirus (COVID-19) News and Resources

<< Older News  |  September 25, 2020

News

All News > Health Plan Policy

Get this news and more in our free daily email newsletters.
U.S. Supreme Court Will Hear Challenge to ACA on November 10, With or Without a New Justice
Benefit Revolution Link to more items from this source
[Opinion]
Sept. 24, 2020

"In a purely legal sense, the law's opponents have the better argument.... The better practical argument lies with PPACA's proponents.... [In] a practical sense, why do you need a mandate to make this program fiscally feasible if the federal government is ultimately going to make insurers whole and pay any form of required bloated premiums to keep the system afloat?"

Tags: Health Plan Policy

Editor's Pick Potential Impact of California v. Texas Decision on Key Provisions of the ACA
Henry J. Kaiser Family Foundation Link to more items from this source
Sept. 23, 2020

"[A] table summarizes the major provisions of the ACA, illustrating the breadth of its changes to the health care system, and public attitudes towards those changes. If all or most of the ACA is struck down, many of these provisions could be eliminated. Due to differences in populations and policies across states, the potential repeal of the ACA would play out differently from state to state."

Tags: Health Plan Design  •  Health Plan Policy

Text of EBSA Request for Nominations to Advisory Council on Employee Welfare and Pension Benefit Plans
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL] Link to more items from this source
[Official Guidance]
Sept. 21, 2020

"The terms of five Council members expire at the end of this year. The groups or fields they represent are as follows: [1] employee organizations; [2] employers; [3] the general public; [4] corporate trust; and [5] investment management.... [S]ubmit nominations to Christine Donahue, Council Executive Secretary ... Nominations must be received on or before [45 days after publication in the Federal Register, currently scheduled for Sep. 22, 2020]."

Tags: Health Plan Policy  •  Retirement Plan Policy

Editor's Pick What It Means to Cover Preexisting Conditions
Katie Keith, in Health Affairs Blog Link to more items from this source
[Opinion]
Sept. 11, 2020

"This post discusses what it means to cover preexisting medical conditions, offers a tool to assess candidate claims, and reviews a set of congressional proposals that purport to offer [ACA] alternatives that protect people with preexisting conditions but that ultimately fall short."

Tags: Health Plan Design  •  Health Plan Policy

Another Court Vacates LGBTQ-Specific Rollbacks from New 1557 Rule
Katie Keith, via Health Affairs Blog Link to more items from this source
Sept. 8, 2020

"We now have decisions in three of the five pending lawsuits over the Trump administration's rule on Section 1557.... In the meantime, briefing is ongoing in two other lawsuits (one in Massachusetts and one in New York) over the new rule.... [And] a longstanding challenge from 2016 to the Obama administration's rule on Section 1557 continues before the Fifth Circuit Court of Appeals."

Tags: Health Plan Design  •  Health Plan Policy

Temporary Premium Credits: New Rule Clarifies Risk Adjustment and Medical Loss Ratio Standards
Katie Keith, in Health Affairs Blog Link to more items from this source
[Guidance Overview]
Aug. 27, 2020

"[C]urrent CMS regulations would require insurers to report premium credits as part of their full earned premium for purposes of the 2020 medical loss ratio (MLR) and the risk adjustment program.... As expected, the new interim final rule addresses those areas with the goal of ensuring accurate reporting of premiums, including premium reductions, for 2020."

Tags: Health Plan Costs  •  Health Plan Policy

The Tradeoff Between Employer Premium Contributions and Wages
UC Berkeley Labor Center Link to more items from this source
[Opinion]
Aug. 27, 2020

"[T]he bulk of the research literature indicates that, one way or another, most of the burden of ever-increasing health care costs falls on the shoulders of workers. That burden may come in the form of lower wages, higher premium contributions, or higher out-of-pocket costs. All these impacts are likely to have more severe consequences for low- and moderate-income workers, but rising health care costs affect the economic well-being of all workers with job-based coverage."

Tags: Health Plan Costs  •  Health Plan Policy

Health Insurance and the COVID-19 Shock: What We Know So Far About Health Insurance Losses and What It Means for Policy
Economic Policy Institute Link to more items from this source
Aug. 26, 2020

"In March and April, ... new hiring led to 2.4 million workers gaining ESI coverage each month, but historically large layoffs led to 5.6 million workers losing coverage each month. This rate of lost coverage -- over 3 million workers -- dwarfs a similar calculation for the number of workers losing coverage each month during the biggest job-losing period of the Great Recession ... Since the onset of the COVID-19 shock to the economy, roughly 6.2 million workers have lost access to health insurance that they previously got through their employer, according to the best measure of net employment change."

Tags: Coronavirus (COVID-19)  •  Health Plan Design  •  Health Plan Policy

Supreme Court Adds Extra Time for Arguments in ACA Challenge
SCOTUSblog Link to more items from this source
Aug. 25, 2020

"The court allocated 40 minutes to each side, up from the usual 30 minutes per side. The justices also granted requests from the House and the Trump administration to participate in the argument. On the side defending the health law, a group of blue states -- led by California -- will have 30 minutes of argument time, and the House will have 10 minutes. On the side challenging the law, a group of red states -- led by Texas -- will have 20 minutes, and the U.S. solicitor general will have an additional 20 minutes." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)]

Tags: Health Plan Design  •  Health Plan Policy

Federal Circuit Holds U.S. Must Pay Health Insurers for 2017 ACA Cost-Sharing Reductions
Faegre Drinker Link to more items from this source
Aug. 24, 2020

"[T]he Federal Circuit's decision hands insurers a major victory on two fronts: first, that the government is liable for non-payment of CSRs under Section 1402; and second, that insurers are entitled to the full amount of unpaid CSRs for 2017. For those insurers asserting CSR claims for 2018 or later, additional litigation will be required via further appeals and/or trial in the CFC to determine the extent of damages." [Sanford Health Plan v. U.S., Nos. 2019-1290 and 19-1302 (Fed. Cir. Aug. 14, 2020); Community Health Choice, Inc. v. U.S., No. 2019-1633 (Fed. Cir. Aug. 14, 2020)]

Tags: Health Plan Costs  •  Health Plan Policy

DOL Issues 'Promoting Regulatory Openness Through Good Guidance' Rule
U.S. Department of Labor [DOL] Link to more items from this source
[Guidance Overview]
Aug. 21, 2020

"The PRO Good Guidance Rule ... requires that the Department use guidance appropriately, transparently, and in a manner that is accessible to the public. The rule accomplishes this in four key ways: [1] By providing that, for significant guidance involving impacts greater than $100 million, the Department will provide for notice-and-comment review of the guidance; [2] By requiring all Department guidance to be made available to the public in a searchable database [on the DOL website]; [3] By allowing the public to petition the Department on issues related to its guidance; and [4] By limiting the Department's use of guidance to avoid potentially unfair conduct." [Also available: Fact Sheet]

Tags: Health Plan Policy  •  Retirement Plan Policy

CMS Finalizes Basic Health Plan Methodology for 2021
Katie Keith, in Health Affairs Blog Link to more items from this source
[Guidance Overview]
Aug. 20, 2020

"Because the only two states that have adopted the [basic health plan (BHP)] have also expanded their Medicaid program, CMS proposes to incorporate an income reconciliation factor that solely reflects states that expanded their Medicaid program. For 2021, this factor is 99.23 percent. CMS will calculate the value of the income reconciliation factor based on the latest available year of marketplace data."

Tags: Health Plan Design  •  Health Plan Policy

SCOTUS Schedules ACA Oral Arguments for November 10
HealthLeaders Media Link to more items from this source
Aug. 20, 2020

"The consolidated [cases] will be heard one week after the presidential election, but a ruling is not expected until June.... The plaintiffs in both cases are asking the justices to rule on the constitutionality of the individual mandate without a tax mandate, and whether the mandate is severable from the rest of the law." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)]

Tags: Health Plan Design  •  Health Plan Policy

Health Coverage Affordability Crisis: 2020 Biennial Survey
The Commonwealth Fund Link to more items from this source
Aug. 19, 2020

"In the first half of 2020, 43.4 percent of U.S. adults ages 19 to 64 were inadequately insured. This is statistically unchanged from the last time we fielded the survey in 2018.... There was no statistically significant change in coverage inadequacy between the months leading up to the pandemic and the months that followed, but this may change as the pandemic continues. Half of adults who spent any time uninsured or who were underinsured reported problems paying medical bills or said they were paying off medical debt over time."

Tags: Coronavirus (COVID-19)  •  Health Plan Design  •  Health Plan Policy

Choice, Competition, and Flexibility, Part I: Post-ACA Consumer Challenges
Brian J. Miller and Robert E. Moffit, in Health Affairs Blog Link to more items from this source
Aug. 19, 2020

"Current consumer challenges ... The legacy of the ACA: coverage expansion without cost control ... Health plan market dynamics: impact of the ACA ... Progressive responses to rising health care costs: public option to single payer."

Tags: Health Plan Design  •  Health Plan Policy

Court Says Marketplace Insurers Are Entitled to Payments for Reducing Cost-Sharing, But Must Offset Premium Tax Credit Increases
Timothy S. Jost, for The Commonwealth Fund Link to more items from this source
Aug. 19, 2020

"[T]he Federal Circuit Court of Appeals released [decisions in two cases] brought by insurers claiming damages because the Trump administration stopped making so-called cost-sharing reduction (CSR) payments in the fall of 2017.... In one case, the court decided that the insurers were entitled to reimbursement for the payments and should receive them for 2017. But, because after 2017 states allowed insurers to increase premiums to compensate for the loss of CSR payments, the court held in the other case that for 2018 and later, the court of claims must decide whether the additional premium tax credits (PTC) insurers gained from these increases offset the missing CSR payments." [Sanford Health Plan v. U.S., Nos. 2019-1290 and 19-1302 (Fed. Cir. Aug. 14, 2020); Community Health Choice, Inc. v. U.S., No. 2019-1633 (Fed. Cir. Aug. 14, 2020)]

Tags: Health Plan Costs  •  Health Plan Policy

Federal Circuit: Insurers Are Owed Unpaid Cost-Sharing Reductions, Reduced by Higher Premium Tax Credits from Silver Loading
Health Affairs Blog Link to more items from this source
Aug. 18, 2020

"The Federal Circuit agreed with the lower courts that Section 1402 imposes an 'unambiguous obligation' on the government to make CSR payments to insurers and that this obligation is enforceable for damages in court. However, the panel differed with the lower courts on damages and limited the amount of unpaid CSRs that insurers can recover based on premium loading." [Sanford Health Plan v. U.S., Nos. 2019-1290 and 19-1302 (Fed. Cir. Aug. 14, 2020); Community Health Choice v. U.S., No. 19-1633 (Fed. Cir. Aug. 14, 2020)]

Tags: Health Plan Costs  •  Health Plan Policy

How to Boost Health Insurance Enrollment: Three Practical Steps That Merit Bipartisan Support
American Enterprise Institute Link to more items from this source
[Opinion]
Aug. 18, 2020

"In this post, [the authors] explain how gaps in eligibility for federal assistance programs, perceptions of affordability, and administrative complexity create barriers that prevent millions of Americans from obtaining affordable coverage. To address these issues, we propose three interventions that merit bipartisan support."

Tags: Coronavirus (COVID-19)  •  Health Plan Design  •  Health Plan Policy

The Value of Short-Term Health Plans: Rebutting the Energy and Commerce Democratic Staff Report
Brian Blase and Doug Badger, in Health Affairs Blog Link to more items from this source
[Opinion]
Aug. 17, 2020

"Short-term plans represent an important option for millions of Americans harmed by federal policy over the past decade that has resulted in reduced choice of health insurance plans and skyrocketing premiums and deductibles. Eliminating this option would force those enrolled in short-term plans to choose between paying much higher premiums for ACA-compliant coverage and becoming uninsured."

Tags: Health Plan Policy

The Negative Economic Effects of Medicare for All and Medicare Buy-In Proposals
U.S. Chamber of Commerce Link to more items from this source
[Opinion]
Aug. 14, 2020

"Democratic lawmakers and candidates for political office recently have expressed a renewed interest in enlarging government healthcare programs. The specifics of each plan differ, but all proposals would significantly alter the existing healthcare landscape by expanding the share of the population covered by public payors and increasing the government's fiscal responsibility, influence, and control over the healthcare sector.... This paper discusses recent proposals to expand Medicare or offer a public option and lays out the likely impact such a move would have on various stakeholders."

Tags: Health Plan Design  •  Health Plan Policy

Seattle's Mandate for Healthcare Expenditures for Hotel Employees Survives ERISA Challenge
Mercer Link to more items from this source
Aug. 6, 2020

"The court noted that employers can satisfy the ordinance with a health plan or cash compensation, so no ERISA plan is required. While the ERISA Industry Committee (ERIC) intends to appeal the ruling, covered employers should review their health plan designs and strategy for compliance. Seattle has issued final rules for the Improving Access to Medical Care for Hotel Employees Ordinance and set up a website that includes waiver forms and Q&As clarifying certain provisions in the law." (ERISA Indus. Comm. v. Seattle, No. 18-1188 (W.D. Wash. May 8, 2020))

Tags: ERISA Preemption  •  Health Plan Policy

COVID-19 Proves Need for Universal Medical Coverage
Erica Heiman, Jack Bernard and Henry Kahn, via Atlanta Journal-Constitution Link to more items from this source
[Opinion]
Aug. 5, 2020

"Our U.S. healthcare financing is a clumsy mixture of public, private, and employer-based insurance. As the COVID-19 calamity has shown, our current 'hodgepodge' financing denies high-quality care to people who are economically and socially underprivileged. We also allow increasing numbers of Americans to fall into these deprived categories as massive job losses lead to terminations of health insurance."

Tags: Health Plan Design  •  Health Plan Policy

California, House File Reply Briefs in ACA Challenge
Katie Keith, in Health Affairs Blog Link to more items from this source
Aug. 4, 2020

"The briefs from California and the House reiterate the same arguments made in earlier briefs and the lower courts. They argue that [1] the individual plaintiffs and the Texas-led states do not have standing to sue; [2] the individual mandate, with a $0 penalty, remains constitutional; and [3] the mandate, even if unconstitutional, is severable from the rest of the ACA." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)]

Tags: Health Plan Design  •  Health Plan Policy

American Benefits Council Letter to IRS on Application of Section 4976 to Repurposing of Surplus Welfare Plan Assets
American Benefits Council Link to more items from this source
[Opinion]
July 27, 2020

"[The Council recommends] that Treasury and the IRS publish official guidance affirming that the 100% excise tax under Internal Revenue Code Section 4976 does not apply to an employer's reallocation or repurposing of surplus welfare benefit fund assets to provide other health and welfare benefits to employees.... [T]he IRS' position has a particularly adverse impact on employers and employees during the pandemic when many employers and employees are struggling financially or exploring ways to use assets most efficiently."

Tags: Health Plan Costs  •  Health Plan Policy

ACA Litigation Round-Up, Part 2
Katie Keith, in Health Affairs Blog Link to more items from this source
July 22, 2020

"This post covers a decision from ... the Second Circuit holding that New York is preempted from making changes to ACA-governed risk adjustment transfers and a decision from ... the Ninth Circuit holding that the ACA prohibits discrimination in plan benefit design under Section 1557 of the ACA. Additional decisions could be issued any day on a Trump-era rule on association health plans, whether insurers are entitled to unpaid cost-sharing reductions, and how the health insurance tax applies to Medicaid managed care organizations." [UnitedHealthcare of New York v. Lacewell, No. 18-2583 (2d Cir. Jul. 20, 2020); Schmitt v. Kaiser Foundation Health Plan of Washington, No. 18-35846 (9th Cir. Jul. 14, 2020)]

Tags: Health Plan Costs  •  Health Plan Design  •  Health Plan Policy


<< Older News  |  September 25, 2020

© 2020 BenefitsLink.com, Inc.