Patient Protection and Affordable Care Act (PPACA) Health Insurance Exchanges

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
News & Analysis as of

House Republicans and Trump Administration File Joint Motion to Delay Suit Challenging Obamacare Subsidies

An interesting development transpired Tuesday, February 21, 2017 in a case pending in Federal District Court in the District of Columbia that challenges subsidy payments from the Federal Treasury to support Obamacare. The...more

CMS Proposes Affordable Care Act Exchange, Individual, and Small Group Insurance Market Changes

Not relying on Congress to take action on the Affordable Care Act, the Centers for Medicare and Medicaid Services (“CMS”) has proposed new regulations intended to attract health insurance issuers back into ACA health...more

Reducing the Regulatory Stranglehold on Federally Facilitated Exchanges: Will It Work?

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule aimed at improving the individual and small group markets that have been plagued with instability as issuers continue exiting the Exchanges....more

CMS Proposes Changes to Stabilize ACA Health Insurance Markets

At the same time Republican Congressional leaders are attempting to develop legislation to repeal and replace the Affordable Care Act (ACA), CMS has published a proposed rule that is intended to help stabilize the Affordable...more

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

CMS, IRS Address Affordable Care Act Issues in Transition

The Centers for Medicare and Medicaid Services (CMS) and the IRS have each published guidance on matters arising under the Affordable Care Act (ACA). It is too early to tell whether these measures—some of the first guidance...more

Marketplace Shockwaves: Insurer Exits Leave Marketplaces Vulnerable

Early this month, Aetna announced that in 2018, it will not expand its Health Insurance Marketplace ("Marketplace" or "Exchange") coverage, and is evaluating whether it will completely pull out of the Marketplaces created by...more

The Affordable Care Act: On the Fast Track to Repeal

On January 20, hours after his inauguration, President Donald Trump issued an executive order directing the heads of all executive departments and agencies to “waive, defer, grant exemptions from, or delay the implementation...more

President Trump Signs Executive Order on Affordable Care Act

On Friday January 20, 2017, President Trump signed an executive order titled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.” The Order directs the Secretary of Health and...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part I: the Insurance Industry

In the uncertain atmosphere surrounding the process of ‘repealing’ and replacing the Affordable Care Act (ACA), there are some clues as to what we can expect to come next, at least with regard with the health insurance...more

Recent Legislation Offers Small Employers a New HRA Option

A health reimbursement arrangement (HRA) is a funding arrangement under which employers fund health care expenses for their employees on a pre-tax basis. Prior to the Affordable Care Act (ACA), HRAs were popular among small...more

Part 3: Exploring “Repeal and Replace”

In Part II of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we considered potential healthcare market consequences of a partial repeal of the Affordable Care Act (ACA). In...more

The ERISA Litigation Newsletter - December 2016

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

Back from the Dead – Cures Act Resurrects Premium Reimbursement Arrangements for Small Employers

Last week, President Obama signed the 21st Century Cures Act (the “Cures Act”), which contains numerous provisions touching on a wide range of public health matters. Among the provisions is the creation of a new health...more

Basics of New Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), part of the 21st Century Cures Act signed into law by President Barack Obama on December 13, 2016, makes available to small employers a new option to...more

2017 Labor & Employment Laws: New Year, New Government, New Challenges

On January 1, 2017, employers across the nation will face a host of new or amended federal, state, and/or local labor and employment requirements. At the same time, there is uncertainty as to how the Trump Administration and...more

Aetna and Humana Go to Battle With Regulators Over Multi-Billion Dollar Merger

The trial over Aetna and Humana's $37 billion proposed merger kicked off today in a Washington, D.C. federal court. At issue is whether the companies' merger would substantially lessen competition in the market for...more

Health Care Reform 2017: Substance, Process, and Timeline

President-elect Donald J. Trump campaigned on a promise to “repeal and replace” the Affordable Care Act (“ACA”). For several years, the newly reelected Republican majority in Congress has likewise identified ACA repeal as a...more

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

Risk Adjustment Update: CMS and the states react to insurer exits

The close of 2016 will mark the end of the third full year that the Affordable Care Act (ACA) has been fully implemented. Data is available for the first two "reporting years," 2014 and 2015, for which health insurers and...more

What Should You Do With a Marketplace Notice?

Employers of all sizes are receiving notices from Health Insurance Marketplaces (“Notice” or “Marketplace Notice”) alerting them that an employee or employees have obtained Exchange coverage and are eligible for and receiving...more

Seattle Ballot Initiative Targets Hotel Industry

According to Ballotpedia, 140 state ballot initiatives in 35 states have already been certified for the November 8, 2016 election. This number does not include the many city-wide measures that will be before voters on...more

We Received an Exchange Subsidy Notice…Now What?

The Affordable Care Act exchanges/marketplaces are required to notify employers of any employees who have been determined eligible for advance payments of the premium tax credit or cost-sharing reductions (i.e., subsidy) and...more

Responding to Marketplace Notices

Employers have begun to receive notices from the Health Insurance Marketplace Exchanges (Marketplace) notifying them that one or more of their employees is eligible for governmental subsidies under the Marketplace. Employers...more

Manatt on Health Reform: Weekly Highlights - July 2016 #4

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

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