News & Analysis as of

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

Health Care Alert: ACA Health Insurance Subsidies Called into Question by DC Circuit

Yesterday, a divided three judge panel of the United States Court of Appeals for the DC Circuit struck down the IRS regulation allowing federal premium subsidies for individuals buying health insurance at...more

Hobby Lobby: Just a Start

As a trial lawyer, I rarely pay much attention to dissenting opinions. They do not serve as meaningful precedent, and they tend only to express the loser’s frustrated perspective. But Justice Ginsburg’s dissent in the Supreme...more

A Tale of Two Circuits: D.C. Circuit, Fourth Circuit Split on ACA Subsidies

It was the best of times for ACA subsidies, it was the worst of times for ACA subsidies. On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth...more

Health Law Blog: Court Strikes Down Tax Credit Provision for Low Income Americans Participating Through Federal and Federal/State...

Yesterday, the United States Court of Appeals for the District of Columbia ruled the IRS’ interpretation of a key ACA provision is invalid. Specifically, the court found that the IRS did not have the authority to interpret...more

Rethinking COBRA After Health Care Reform

The Health Care Reform Act made many changes to health plans, but one thing it did not do was expressly eliminate or change the COBRA rules. Although health care reform does not expressly change COBRA, it does, in many ways,...more

News from the Health Law Gurus™: July 2014

Survey of ACA Navigators Finds 10.6 Million People Sought Enrollment Help — In a survey released this week, the Kaiser Family Foundation (“Kaiser”) estimates that approximately 10.6 million people received assistance...more

Burwell v. Hobby Lobby: What Else the Hobby Lobby Decision means

Whether you are a friend or foe of the Hobby Lobby decision handed down by the United States Supreme Court this past Monday, citizens must know the very real and far-reaching consequences of the decision. This...more

The ACA’s Bumpy Ride

From the monumental failure of the initial government website for the federal health insurance marketplace (healthcare.gov) to the looming employer mandate, the Affordable Care Act has garnered its fair share of criticism....more

Telemedicine and Mobile Health Innovations Amid Increasing Regulatory Oversight

The growing mobile health market is rapidly transforming health care delivery. More than 80 percent of physicians use mobile technology to provide patient care, and more than 25 percent of commercially insured patients use...more

High Rates of Unhealthy Enrollees in ACA Exchanges

Perhaps putting added pressure on insurers as they prepare to set rates for 2015, new evidence suggests that people enrolled in health plans under the Affordable Care Act have higher rates of serious health conditions than...more

The IRS Says (Again) That Certain Employer Payment Plans Won’t Fly

The IRS recently issued two new Q&As to underscore that arrangements allowing employers to reimburse employees on a pre-tax basis for premiums used to purchase individual health coverage, either inside or outside of a public...more

Medicaid Enrollment Continues to Grow

The U.S. Department of Health and Human Services (HHS) has reported that at the close of April, an additional 6 million Americans have enrolled in Medicaid and related health programs for the poor since the launch of coverage...more

IRS Issues Guidance Effectively Prohibiting Employers From Reimbursing Employees For Individual Health Insurance Premiums

The IRS’ reasoning is that such reimbursement arrangements, often referred to as “employer payment plans” are “group health plans.” All group health plans must meet the Affordable Care Act’s “market reform” requirements, such...more

Labor Pains: The $2 Million Part-Time Employee

One of your employees (we’ll call him “Don”) cannot enroll in your health insurance plan because you classify him as “part-time” (one who works less than 30 hours a week). This forces Don to get health insurance through a...more

Changes & Opportunities in 2014 for Small Employers under ACA

The Affordable Care Act (ACA) brings about significant healthcare reform changes, as well as opportunities for small employers in 2014. Many of the reforms affect all employers who sponsor group health plans; however, the...more

HEAL Advisory: New COBRA Model Notices and Coordination with Marketplace Enrollment

On May 2, 2014, the U.S. Departments of Labor and Health and Human Services published a series of guidance and model notices clarifying the provision of health insurance to recently terminated employees. The Department of...more

New Model COBRA Notices

To coordinate information about the new marketplace/exchange coverage that may be available under the Affordable Care Act, today the U.S. Department of Labor, in conjunction with the IRS and U.S. Department of Health and...more

COBRA Coverage Too Expensive? Consider ACA Coverage Instead, Obama Administration Says

On Friday, the Obama administration announced a proposed rule (the “Proposed Rule”) that will require that notices sent to workers regarding Consolidated Omnibus Budget Reconciliation Act (“COBRA”) health insurance coverage...more

New Data Shows Higher Healthcare Costs in Second Half of 2013 – Is this A Result of the Affordable Care Act?

Will insurance expansion and industry consolidation result in higher healthcare costs, at least in the short term, and further stress the economy and the healthcare industry? That highly political question is being asked now...more

Federal Agencies Issue Final Rule for Implementation of Mental Health Parity Act

On October 3, 2008, Congress enacted the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act of 2008 (MHPAEA). This law requires health insurance plans, which cover mental health or substance use...more

Health Care Reform Update -- December 16, 2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; and Hearings and Mark-Ups Scheduled. Excerpt from...more

Affordable Care Act Transitional Policy For Individual And Small Group Plans

On November 14, 2013, the Obama Administration announced a transitional policy, whereby insurers may, but are not required to, renew existing health plans in the individual and small-group markets in 2014, even if those plans...more

CMS Letter to State Insurance Commissioners Offers Transitional Policy to Prevent Health Insurance Issuers from Cancelling Plans...

On November 14, 2013, the CMS Center for Consumer Information and Insurance Oversight issued a letter to State Insurance Commissioners announcing a “transitional policy” to permit health insurance issuers to continue plan...more

Section 125 Cafeteria Plan Requirement for Massachusetts Employers Ends

Massachusetts recently announced that, due to federal rules under the Affordable Care Act, it will cease enforcement of its Section 125 cafeteria plan requirement for Massachusetts employers. Under that requirement, employers...more

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