Health & Welfare Plans Newsletter

December 7, 2016

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[Guidance Overview]

Rescinding Coverage from a Full-Time Employee During a Stability Period: Legal, But Fraught with Danger
"If the strategy is not applied correctly or one of the three conditions is not met, it is easy to envision an employer incorrectly rescinding coverage from a full-time employee which could lead to a section 4980H penalty.... [T]he strategy is worth exploring for a select number of employers [because] it could reduce the cost of health coverage for an employer ... The cost of implementing this strategy, in terms of attention to detail as well as the human resource/employee morale cost of kicking people off coverage, is high."
Accord Systems, LLC

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The High Cost of Living Longer: Women and Retirement Health Care (PDF)
"[W]omen, on average, will pay more for health care in retirement than men, but the reason is primarily because of longevity, not the use of medical services.... [A] healthy 55-year-old woman will pay $522,827 ($253,594 in today's dollars) in retirement health care expenses -- almost $79,000 more than a male -- because she will live two years longer. Looking ahead, because of rising health care inflation and an additional year of life expectancy, a 45-year-old single female will pay 27.5% more in health care costs than a male of the same age."
HealthView

Taking Stock of Health Reform: Where We've Been, Where We're Going
"This [article] will describe and assess the ACA in its sixth year, its successes and failures. It will next consider how the new administration might proceed with repealing and replacing it. Finally, it will examine the provisions that the new Congress and administration may adopt to try to replace the ACA and assess how they might improve on or undermine the ACA's accomplishments. This assessment will focus on the effects of the ACA and its likely replacements on accessibility and affordability."
Timothy Jost, in Health Affairs

Implications of a Partial Obamacare Repeal, Part 2
"Even in the midst of such uncertainty, however, the move towards population health management initiatives and the assumption of financial risk by providers is likely to continue. Although such developments were perhaps hastened -- or at least shone brighter -- in the post-ACA healthcare landscape, there is some consensus (to the extent there is consensus on anything healthcare related) around the idea that they make fundamental economic sense for all participants."
Sheppard Mullin

A Framework for Handicapping Proposals to Replace the ACA
"As they endeavor to regulate the U.S. health care financing system, lawmakers confront three high-level policy questions: Is health care a right or a commodity? ... Is there a role for Government in financing and regulating health care? ... What are the proper roles of the Federal government vs. the States?"
Mintz Levin

Cost-Sharing Subsidies Ruling Adds More Uncertainty to ACA
"This is a significant development throwing more uncertainty into the future of the ACA and undoubtedly causing concerns among health insurers. Once President-Elect Trump takes office, he can instruct the U.S. Department of Justice to abandon the appeal. If that happens, the district court's decision would stand and the government arguably would not make further cost-sharing reduction payments to insurers." [House v. Burwell, No. 16-5202 (D.C. Cir. Dec. 5, 2016)]
Holland & Knight

McConnell Insists on Extending Coal Miners' Health Benefits in Funding Bill
"Senate Majority Leader Mitch McConnell ... is pushing to include an extension of health benefits for retired coal miners in a must-pass government funding measure. More than 16,000 retired coal miners stand to lose their health benefits at the end of the year."
Morning Consult

[Opinion]

Repealing and Replacing the ACA: Five Developments Likely to Occur in the Years Ahead
"[1] Reductions in federal subsidies, changes to Medicaid funding and contraction of insurance coverage ... [2] Increased state autonomy in managing Medicaid program design ... [3] Increased emphasis on marketplace solutions and consumer choice ... [4] Potential changes in the shape of the Medicare program ... [5] New rules for the pharma and medical device sector."
Proskauer Rose LLP

Benefits in General

Are HSAs Set to Follow Growth of 401(k)s?
"[A]lthough introduced as part of [ERISA] in 1974, it took more than 10 years for 401(k)s to gain the same percentage of market share that HSAs have now. In addition, 401(k)s were met with reluctance at first. Similarly, the retirement industry first saw HSAs as competition for savings dollars ... but as health care became a bigger part of the conversation about expenses in retirement, HSAs are now being thought of as a complementary savings vehicle."
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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