Health Insurance

News & Analysis as of

Obamacare Reform Watch: Reimbursement Strategies in an Environment of Growing Out-of-Pocket Costs and an Expanding Self-Pay...

The increase in patient financial responsibility for health care costs in the past ten years has outpaced consumer growth in wages. This escalation of out-of-pocket costs represents a major revenue cycle challenge for health...more

DOJ Successfully Blocks Insurance Mergers: What Are the Takeaways?

In July 2016, following a lengthy review, the Antitrust Division of the Department of Justice (DOJ), together with several states, sued to block two proposed health insurer mergers: Aetna/Humana and Anthem/Cigna. On January...more

Manatt on Health Reform: Weekly Highlights - February 2017 #3

Congress moves forward on key healthcare appointments; the Administration takes steps to shore up the Marketplaces; and Governors prepare to gather in Washington as new reports document the ACA's impacts on states....more

Should You Invest In Long-Term Care Insurance?

It is very difficult to predict whether you or a loved one will one day need long-term care insurance. A diagnosis like Alzheimer’s disease or another dementia can drastically change your life and your financial plans. With...more

What Can Employers Expect from the Trump Administration in the Upcoming Year?

It has been a little less than a month since President Donald Trump took office, and employers are anxious to see what changes the new administration will make that will affect both businesses and employees. President Trump...more

Health Update - February 2017

Securing the Safety Net for America's Vulnerable Populations - Editor's Note: America's population is aging rapidly. By 2029, 75 million baby boomers will have reached age 65 and older, and older adults will represent...more

Federal Court Blocks Anthem - Cigna Merger; King & Spalding Looks Deeper into Aetna-Humana Challenge

On February 8, 2017, the United States District Court for the District of Columbia granted a request filed by the U.S. Department of Justice’s Antitrust Division for an injunction blocking Anthem, Inc.’s (Anthem) proposed $54...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

Executive Order Results in IRS' Reconsideration of Plan to Reject Certain Returns Missing Health Insurance Information

The IRS recently announced that it will not automatically reject individual income tax returns on which a taxpayer has failed to indicate whether they maintained qualifying health insurance coverage during the year for the...more

A tale of two mergers: Following their losses in DOJ merger challenges, Anthem fights on and Aetna gives up

In the past month, the DOJ and several state governments scored two trial wins in their challenges to mergers among some of the country’s largest health insurers. First, Judge Bates of the District of Columbia blocked the...more

New SBC Template Goes Into Effect April 1

The U.S. Department of Labor (DOL) released a new template for the Summary of Benefits and Coverage (SBC) last year. As background, the Affordable Care Act requires health plans and health insurers to annually distribute SBCs...more

Fast Take on House Republicans’ “Obamacare Repeal and Replace” Plan

On February 16, 2017, House Republicans issued an “Obamacare repeal and replace” policy brief for members to use in speaking with constituents during the Presidents’ Day break. This repeal-and-replace plan is not yet a...more

2017 Health Care Policy Debates Ramp Up in Massachusetts

With the unveiling of Governor Charlie Baker’s FY2018 budget, the commencement of the 2017-2018 legislative session on Beacon Hill, and a new presidential administration underway in Washington D.C., the Massachusetts health...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

Will lawmakers on break get an earful over GOP’s outline for Trumpcare?

Members of Congress are home in their districts for a week-long break, and many lawmakers are expected to get an earful from voters upset over many issues at the start of the Trump Administration, especially this: What the...more

“Patient Protection and Affordable Care Act; Market Stabilization” Proposed Rule

On February 15, 2017 the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, “Patient Protection and Affordable Care Act; Market Stabilization.” Excerpt - In general, the proposed rule...more

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #2

Governor’s $35 Million Housing Bond Discussed in Ways and Means Committee - Executive Director Gus Selig of the Vermont Housing and Conservation Board revealed some of the details this week behind the $35 million bond...more

Health Care E-Note - Februaury 2017

Ransomware: A Reportable Breach? In the past several years, a huge increase has occurred in the number of electronic attacks in the United States using ransomware, a form of malware that targets and encrypts critical...more

The Future of the Affordable Care Act Week 6: Focus on the Individual Health Insurance Market

A recent report from the nation’s top actuaries takes a sobering look at the challenges policy makers face in creating a viable individual (i.e., non-group) health insurance market—a critical component of any plan to replace...more

HHS Expresses Interest in Pre-Existing Condition Exclusions

In proposed regulations published on February 17, 2017, the U.S. Department of Health and Human Services (HHS) has suggested several adjustments designed to help stabilize the individual health insurance market – particularly...more

HHS Makes Its First Move to Stabilize the Individual Health Insurance Market

Wednesday, the Trump Administration released its first proposed regulation seeking to stabilize the individual insurance market – in particular, the Affordable Care Act (ACA) insurance exchange market (or marketplace). Amidst...more

HHS Proposed Rule Signals Future of Obamacare May be Repair not Repeal

On Wednesday, February 15, 2017, the Health and Human Services Department (HHS) announced a proposed rule designed to help stabilize the Affordable Insurance Exchanges for the 2018 benefit year. The rule proposes several...more

Update #4: Proposed ACA Rules to Stabilize Exchange Markets

Insurers have been pressuring the Trump Administration to relieve some of the uncertainty from the pending ACA “repeal/replace” debate in time for them to decide whether to participate in the individual health insurance...more

Trump Administration Proposes Insurer-Friendly Rule Modifying Exchanges under the ACA

Less than three weeks after our last article involving healthcare under the Trump Administration, the Centers for Medicare and Medicaid Services Department of Health and Human Services (“HHS”) has released its first proposed...more

Medicaid Outlook: Policy and Regulatory Change in 2017

Perspectives on Health Care and Life Sciences - Medicaid has been a vital part of the American health care safety net for more than 50 years. Today, Medicaid, along with the State Children’s Health Insurance Program...more

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