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Report to Congress on the Impact on Premiums for Individuals and Families with Employer-Sponsored Health Insurance from the Guaranteed Issue, Guaranteed Renewal, and Fair Health Insurance Premiums Provisions of the ACA (PDF)

"There is considerable uncertainty as to whether small employers will decide to terminate their existing offer of health insurance coverage and send their employees to individual market Exchanges. Many factors may be relevant to their decisions.... Once the new premium rating requirements go into effect, it is anticipated that the small employers that offer health insurance coverage to their employees and their families would have average premium rates. Therefore, we are estimating that 65 percent of the small firms are expected to experience increases in their premium rates while the remaining 35 percent are anticipated to have rate reductions.... This results in roughly 11 million individuals whose premiums are estimated to be higher as a result of the ACA and about 6 million individuals who are estimated to have lower premiums."

HHS Overview: Final Regs for Health Insurance Market Reforms (Guaranteed Availability; Fair Premiums; Single Risk Pool; Guaranteed Renewability; Catastrophic Plans)

"Today, as many as 129 million -- or 1 in 2-non-elderly Americans -- have some type of pre-existing health condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease. In most states, these consumers can be denied individual health insurance coverage, charged significantly higher rates, or have benefits for medical conditions excluded by insurance companies. In addition, individuals and small employers often find that they have few protections against premiums increases. To address these problems starting in 2014, CMS [has] issued a final rule that contains: Guaranteed Availability of Coverage; Fair Health Insurance Premiums; Single Risk Pool; Guaranteed Renewability of Coverage; Catastrophic Plans; [and] Updating Rate Review[.]"

Fair Market Value in Health Care Transactions

Excerpt: This paper will address the varying requirements for fair market value in transactions involving physicians and hospitals and other health care providers. The paper will first examine the Stark law and how and when transactions may satisfy Stark's requirements for fair market value. Second, the use of fair market value for compliance with the federal Anti-Kickback statute will be addressed. The paper will then address the implications of fair market value for[.]

House Passes Small Business Health Fairness Act

"The House of Representatives [on March 22] passed the Small Business Health Fairness Act (H.R. 1101) ... [T]he legislation empowers small businesses to band together though association health plans (AHPs) and negotiate for lower health insurance costs on behalf of their employees. The bill passed by a vote of 236 to 175."

Small Business Health Fairness Act Fact Sheet

"Introduced by Rep. Sam Johnson (R-TX), chairman of the Subcommittee on Social Security, and Rep. Tim Walberg (R-MI), chairman of the Subcommittee on Health, Employment, Labor, and Pensions, the Small Business Health Fairness Act (H.R. 1101) would empower small businesses to band together and offer coverage through AHPs to purchase quality health care coverage at a lower cost for their employees."

ERISA Implications for State Health Care Access Initiatives: Maryland Fair Share Act Court Decision (PDF)

14 pages. Excerpt: [ERISA] complicates state efforts to include employer financing in initiatives to expand access to health care. This issue brief discusses implications of the recent court decision holding that ERISA preempts one such law, the Maryland Fair Share Health Care Fund Act.

Maryland's Fair Share Health Care Law (PDF)

4 pages. Excerpt: On January, 12th, 2006, Maryland's much-anticipated Fair Share Health Care (FSHC) bill became law. That was the day that the Maryland legislature voted overwhelmingly to override the governor's May 2005 veto of the legislation. Maryland thus became the only state -- with the exception of Hawaii and Massachusetts -- to require large employers to either pay a share of their payroll toward their employees' health insurance or pay into a state fund to expand coverage.

Massachusetts Law Makes Changes to 'Fair Share Contribution' Rules Regulating Employer-Sponsored Group Health Plans

"While the Act's principal purpose is to address issues of health care cost, quality, and transparency, it makes a minor though important change to the way that employers determine their liability under the "fair share contribution testing" rules, which form the core of the employer responsibility provisions of the Massachusetts health care reform law."

Employer Health Fair Saves Employee's Life

"By participating in a health fair through his employer, [an employee] learned he had prostate cancer. He now works to encourage others to participate in these types of screenings."

Federal Courts Appear to Disagree on Whether ERISA Preempts State and Local 'Fair Share' / 'Play-or-Pay' Health Reform Laws

Excerpt: In the past year, federal courts have addressed challenges to three different state and local 'fair share' (or 'pay-or-play') laws. The laws, passed in San Francisco, Suffolk County (New York), and Maryland, require employers to contribute certain minimum amounts toward the health care coverage of their employees. The district courts in all three cases held that the Employee Retirement Income Security Act of 1974 ('ERISA') preempted each law. But, a split appears to be emerging among some federal appellate courts.