News & Analysis as of

Premiums Patient Protection and Affordable Care Act (PPACA)

House Amends the American Health Care Act: Where Will It Lead?

by Perkins Coie on

On the last day before the U.S. Congress began its spring recess, the U.S. House of Representatives amended the now consolidated bill H.R. 1628, known as the American Health Care Act (the AHCA). We previously discussed the...more

ACA Repeal and Replace Update: House Vote Expected This Week; CBO Estimates Impact of Repeal and Replace Legislation; CMS...

by King & Spalding on

After narrowly passing the Budget Committee, the Republican-sponsored health reform repeal and replace bill, the American Health Care Act (AHCA), is scheduled for a floor vote for Thursday, March 23, 2017, seven years to the...more

Health Update - March 2017

The Future of Essential Health Benefits - Editor's Note: The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and...more

Employee Benefits Developments - January 2017

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of January, 2017. Click through the links below for more information on each specific development or case. IRS...more

2016 Health Care Year in Review

by Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

What Trump’s HHS Secretary Appointment Could Mean for Healthcare Providers

by Nilan Johnson Lewis PA on

President-elect Donald Trump announced on November 28, 2016, that current House Budget Chair Representative Tom Price is his choice for Health and Human Services (HHS) Secretary. Many providers are wondering what health care...more

Manatt on Health Reform: Weekly Highlights - November 2016

Minnesota’s Governor and legislators propose financial assistance options for on- and off-Marketplace individual coverage; Vermont receives final federal approval for the country’s first all-payer ACO model; and a report...more

The 2016 Election and Your Healthcare System: What’s at Stake?

Regardless of the 2016 general election outcome, a new administration will have to respond to pressing policy issues that will shape continued transformation of the U.S. healthcare system. What are the issues and where do...more

Manatt on Health Reform: Weekly Highlights - October 2016 #3

HealthCare.gov consumers begin previewing 2017 coverage options as HHS projects a 9% enrollment increase over last year and an average 22% benchmark premium increase; Oregon study finds increased primary care spending in...more

Manatt on Health Reform: Weekly Highlights - October 2016 #2

Kentucky receives final approval from CMS to transition its Marketplace to the HealthCare.gov platform; Ohio puts a prescription drug price ceiling on its November 2017 ballot; and a new study links Medicaid expansion to...more

Manatt on Health Reform: Weekly Highlights - August 2016 #5

A federal report finds that Marketplace premiums are lower in expansion states; Massachusetts and Pennsylvania launch prescription drug monitoring systems; and Kentucky submits a slightly modified Medicaid expansion waiver to...more

Recent Congressional Hearings

by Reed Smith on

Congressional committees held hearings on a wide variety of on health policy issues this month before going on summer recess. Notable hearings include the following...more

Manatt on Health Reform: Weekly Highlights - June 2016#2

Arkansas’ Governor requests to transition to a “State-based Marketplace on the Federal Platform;” Louisiana launches Medicaid expansion with SNAP fast-track enrollment; and study shows 2016 premium increases are lower for...more

Are You Still Reimbursing Premiums For Your Employee's Individual Healthcare Insurance? Then You'd Better Read This!!

by Tucker Arensberg, P.C. on

In the past, many employers (especially smaller companies) have offered to pay their employees’ premiums for individual healthcare insurance instead of sponsoring their own group health plans. With the advent of the...more

CMS Finalizes 2017 Requirements for ACA Marketplace Plans

by Reed Smith on

CMS has published its annual Notice of Benefit and Payment Parameters, which governs participation in the Affordable Care Act (ACA) Health Insurance Marketplaces for 2017. The sweeping rule addresses protection of consumers...more

Drug Costs, Risk Adjustment Drive Q2 Health Insurance Rate Increases

The Massachusetts Division of Insurance (DOI) recently held a two-day hearing on rate changes proposed by Massachusetts health insurance plans to be effective for the second quarter of 2016 (Q2). Presentations by carriers, in...more

Manatt on Health Reform: Weekly Highlights - December 2015

CMS concludes no QHPs can be certified as comparable to CHIP coverage; California's Marketplace plans to connect consumers to vision coverage issuers; and states react to CMS's proposed HealthCare.gov user fee....more

Automatic Enrollment for Health Plans Has Been Repealed

by McDermott Will & Emery on

Budget legislation signed into law by President Barack Obama on November 2, 2015, the Bipartisan Budget Act of 2015, repeals the controversial automatic enrollment provision under the Affordable Care Act (ACA). Section 18A of...more

Manatt on Health Reform: Weekly Highlights - October 2015 #4

HHS announces average premium price increases of 7.5% across HealthCare.gov; Michigan and Illinois launch the country’s first joint cloud-based, real-time Medicaid information management system; and the Marketplace carrier...more

Manatt on Medicaid: Arizona Releases Draft Waiver Request for Approval to Implement Reforms to ACA Medicaid Expansion

Overview - On August 18, 2015, Arizona released the Modernizing Arizona Medicaid proposal for a new 1115 waiver to implement coverage and delivery system reforms in its Medicaid program, the Arizona Health Care Cost...more

Manatt on Health Reform: Weekly Highlights - September 2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 4 of 24): Highlights from the Draft 2015...

The IRS recently issued draft 2015 Instructions for Forms 1094-C and 1095-C (“2015 Instructions”). These are the forms that employers with 50 or more full-time employees (including full-time equivalent employees) in the...more

Will § 4980H Require Judicial Amendment Too?

by Balch & Bingham LLP on

Absent applicable transitional relief, most of which vanishes after 2015, an ACA Applicable Large Employer that fails to offer Minimum Essential Coverage to at least 70% of its 2015 full-time employees and their dependents...more

Health Care Update - July 2015

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Congressional Health Policy Hearings - June 2015 #2

by Reed Smith on

A House Ways and Means Subcommittee on Oversight hearing recently reviewed the effects of the Affordable Care Act (ACA) on health insurance premiums. In addition, a House Energy and Commerce Health Subcommittee hearing...more

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