Patient Protection and Affordable Care Act (PPACA) Healthcare Internal Revenue Service

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

IRS Seeks to Curb Popularity of ‘Skinny’ Health Plans

The Internal Revenue Service, in Notice 2014-69, has concluded that certain unconventional group health plan designs that offer limited or no coverage for in-patient hospitalization services and/or physician services will not...more

New IRS Guidance May Require Amendments to Section 125 (“Cafeteria”) Plans

Many employers permit employees to pay for employer-sponsored health coverage, on a pre-tax basis, under Internal Revenue Code section 125 (“cafeteria”) plans. These plans generally require employees to make an irrevocable...more

Recent Employee Benefit Developments - October 2014

IRS Expands Cafeteria Plan Status Change Events - On September 18, 2014, the Internal Revenue Service issued Notice 2014-55, which establishes two new change in status events for cafeteria plans. The new change in...more

Affordable Care Act in Mergers and Acquisitions: New Guidance from Internal Revenue Service

In Notice 2014-49, the Internal Revenue Service (“Service”) issued guidance on how to avoid potential penalties under the Affordable Care Act (“ACA”) in connection with mergers and acquisitions (“M&A”). The notice provides a...more

New ACA Rules Allow Employees a Second Trip Through the Cafeteria Plan Election Line

Under Notice 2014-55, the Internal Revenue Service (IRS) will now permit a cafeteria plan to allow an employee to revoke his election for coverage under the employer's group health plan in order to purchase a qualified health...more

Monthly Benefits Update - September 2014

IRS Issues Guidance on How to Deal With a Change to an Employee’s Measurement Period Under ACA Employer Mandate - The Internal Revenue Service (IRS) issued Notice 2014-49, which proposes an approach for dealing with...more

Fatal Blow to Healthcare Reform? Courts split on federal tax credit

On July 22, 2014, two federal courts came down on opposite sides of an issue that may have far-reaching consequences about the future of the Patient Protection and Affordance Care Act ("PPACA"). At stake is whether the PPACA...more

Circuit Courts’ Split over Major ACA Issue Will Impact Employers

Two U.S. Courts of Appeals recently issued conflicting rulings on a major provision of the Affordable Care Act (ACA), and the U.S. Supreme Court is being asked to weigh in. The concern is over the Internal Revenue Service’s...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 16: So What, Exactly, is an “Offer of Coverage”?

Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more

Advocacy Organizations’ Complaint Puts a Spotlight on Potential Noncompliance by Nonprofit Hospitals

On August 25, two advocacy organizations filed a complaint with the Internal Revenue Service (IRS) alleging noncompliance by a hospital system with respect to certain community benefit requirements imposed by the Patient...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 17: Cherry Bomb in the Gold Fish Pond, or Third-Party Staffing...

With two seemingly simple and straightforward definitions in the final regulations implementing the Affordable Care Act’s pay-or-play rules—i.e., definitions of “employer” and “employee”— the Treasury Department and IRS have...more

IRS Guidance on the Application of the Affordable Care Act’s Market Reform Provisions to HRAs and FSAs

The Internal Revenue Service (IRS) recently published guidance in Notice 2013-54 (the “Notice”) on the application of certain market reform provisions of the Affordable Care Act to Health Reimbursement Accounts (“HRAs”),...more

IRS Issues Draft Forms for Coverage Reporting Requirements under the Affordable Care Act

The Internal Revenue Service (IRS) has released draft versions of forms that will be used by employers to report health coverage information required under the ACA’s employer shared responsibility rules. As we have written in...more

Splits Are Not the Best for Business: Uncertainty after Conflicting Decisions on the Scope of Obamacare Subsidies

The recent decisions by the Fourth Circuit and the D.C. Circuit address a controversy that could have far-reaching consequences for the Patient Protection and Affordable Care Act (the “ACA”). Under the ACA, states and the...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 20: 9.5% ? 9.56% (And Why It Matters to Applicable Large...

While employers sometimes view the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules in isolation, they don’t operate that way. Instead, they exist side-by-side with other provisions of the Act. In...more

Individual Responsibility under the ACA

Effective 2014, if a taxpayer is not covered under minimum essential coverage for one or more months, then, unless an exemption applies, the taxpayer is liable for the individual shared responsibility payment on his return. ...more

IRS Increases 9.5% Affordability Threshold—Or Did It?

On July 24, 2014, the Internal Revenue Service (IRS) released three Revenue Procedures (2014-46, 2014-37, and 2014-41), which provide guidance to individuals on their obligation to maintain minimum essential coverage (MEC)...more

Monthly Benefits Update - July 2014

Two federal appeals courts issued contradictory rulings on the validity of subsidies for the purchase of health insurance under the federal marketplace established pursuant to the Affordable Care Act (ACA). On July 22, a...more

Employee Benefits Developments - July 2014

In May 2014, the Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued Frequently Asked Questions (FAQs) Part XIX, addressing, among other subjects, the following: The newly revised DOL model...more

Capital Thinking: Health Care

LEGISLATIVE ACTIVITY - On Monday, July 28, the House Committee on Energy and Commerce, Subcommittee on Health will hold a markup to consider two bills: H.R. ____, a bill to require the Secretary of Health and Human...more

Circuit Courts Split on ACA Subsidies

On July 22, 2014, United States Circuit Courts of Appeals from two different circuits issued opposing rulings on the legality of the Federal government providing subsidies to eligible buyers of health insurance products from...more

Of Mice and Elephants: Halbig and King and The Struggle of Two Federal Appeals Courts to Find Meaning in Words That May or May Not...

At issue in Halbig v. Burwell and King v. Burwell is whether or not subsidies to buy insurance on an exchange are available in both state and federal exchanges. On its face the Affordable Care Act (“ACA”) provides for...more

Federal Courts Make Conflicting Rulings on Premium Assistance for Federal Exchange Plan Participants

Does the Affordable Care Act (ACA) authorize the payment of premium and copayment subsidies, or “premium assistance subsidies,” to individuals enrolled in a federally established Exchange? On July 22, 2014, two federal courts...more

Clash of the Circuits: Federal Exchange Subsidies at Risk?

These four words “established by the state,” at first blush do not appear obtuse or particularly vague. But these four words form the basis for the latest challenges to the Affordable Care Act (ACA) and have resulted in two...more

U.S. Appeals Courts Issue Conflicting Decisions on Whether ACA Permits Tax Subsidies of Health Care Coverage Purchased Through...

On July 22, 2014, three-judge panels of the U.S. Courts of Appeals for the District of Columbia and Fourth Circuits issued conflicting decisions regarding whether the Affordable Care Act (ACA) permits federal tax credits for...more

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