Public Health Insurance Marketplace

News & Analysis as of

OIG Early Alert on State-Based ACA Marketplace Funding Use

The OIG has issued an “Early Alert” warning regarding the use of federal funding by state-based marketplaces under the Affordable Care Act (ACA). The OIG notes that the ACA clearly prohibits marketplaces from using grant...more

Manatt on Health Reform: Weekly Highlights - May 2015 #3

Washington and Iowa report surges in insurer participation in Marketplaces for 2016; Maine considers legislation to maintain premium subsidies regardless of King v. Burwell. KING V. BURWELL ACTIVITY: Maine:...more

IRS Provides Penalty Relief for Incorrect or Delayed Forms 1095-A

The IRS issued Notice 2015-30, which provides penalty relief for taxpayers who received an incorrect or delayed Form 1095-A. Form 1095-A is provided to all individuals who enrolled in health insurance coverage through the...more

Manatt on Health Reform: Weekly Highlights - May 2015

This week Montana became the 30th state to expand Medicaid, and the battle over Medicaid expansion and uncompensated care reached a breaking point in Florida. Meanwhile, as the King v Burwell decision looms, Congress and...more

Marketplace Premium Assistance: Creating Alignment Between Medicaid and Qualified Health Plans

Arkansas broke new ground with its Marketplace Premium Assistance Medicaid expansion (widely referred to as the “Private Option”) last year, spurring additional states to consider the model. Under Marketplace Premium...more

Manatt on Health Reform: Weekly Highlights - April 2015 #3

This week, CMS proposes continued 90% funding for Medicaid eligibility and enrollment system development. Montana is on the verge of becoming the 29th state (plus D.C.) to expand Medicaid eligibility, and Florida Governor...more

CMS Announces Key 2015 Compliance Priorities for Federally Facilitated Exchange Plans

The Centers for Medicare & Medicaid Services (“CMS”) recently announced its 2015 key priorities for compliance reviews of qualified health plans (“QHPs”) offered in the federally facilitated marketplaces (“FFMs”). Through a...more

My Day at the U.S. Supreme Court: King v. Burwell

Describing her recent Supreme Court experience as “my Super Bowl,” Susan Feigin Harris offers her personal account and analysis of the oral arguments in King v. Burwell. I was ready to go: hat, gloves, boots and parka. A...more

Stripping the ACA of Both the Carrot and the Stick: Sticking it to Consumers On and Off the Federal Exchange

Even as we write and you read, the Supreme Court in King v. Burwell is considering whether qualifying (often low income) individuals and families who have an opportunity to purchase healthcare coverage through the Affordable...more

Supreme Court Hears Oral Arguments in Challenge to ACA Premium Subsidies

On March 4, 2015, the United States Supreme Court heard oral arguments in King v. Burwell, in which the plaintiffs are challenging the Internal Revenue Service’s (IRS) interpretation of certain statutory language in the...more

IRS Issues More Guidance On Employers That Pay For Individual Health Insurance Policies for Employees – Gives Limited Relief to...

I have blogged more on the topic of how the Health Care Reform Act applies to employers that reimburse employers for individual health insurance policies than any other topic in the last year....more

Health Care Update - March 2015

In This Issue: - King v. Burwell before the Supreme Court and the Potential Congressional Response - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

MNsure Audit Released

The Office of the Legislative Auditor (OLA) released its much-anticipated review of MNsure’s first year of operations. MNsure is Minnesota’s online health insurance marketplace that was established in accordance with the...more

Manatt on Health Reform: Weekly Highlights - February 2015 #3

Although the official February 15th enrollment deadline has now passed, the 2015 open enrollment period isn’t over for the Federally-facilitated Marketplace (FFM) and many State-based Marketplaces (SBMs).While the FFM...more

Weekly Update Newsletter - January 2015 #2

GOVERNMENT CONTRACTS - HHS IG Issues Report Regarding Federal Marketplace: Inadequacies in Contract Planning and Procurement - The Department of Health and Human Services (HHS) inspector...more

CMS Releases Key Proposals for the 2016 Qualified Health Plan Application Process

Stakeholders received insight on the Obama administration’s expected approach to the certification and oversight of qualified health plans (“QHPs”) on December 19, 2014, with the release by the Centers for Medicare & Medicaid...more

Detailing Provisions of “Obamacare” Affecting Individuals

In Fact Sheet 2014-09, November, 2014, the IRS provides details on “Obamacare”, technically known as the Affordable Care Act (the “ACA”). However, the Fact Sheet does not discuss a case currently before the U.S. Supreme...more

Manatt on Health Reform: Weekly Highlights

Welcome to the first publication of the “Manatt on Health Reform: Weekly Highlights” newsletter. Many of you are familiar with the healthcare reform tracking efforts and weekly newsletters we produced for the KidsWell...more

Health Care Update - September 2014 #4

In This Issue: - Policymakers Continue Bi-partisan Push to Accelerate ACO Evolution - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and...more

When Did You Last Amend Your Section 125 Cafeteria or Flexible Benefit Plan? Now May Be A Good Time to Dust It Off and Update It

Section 125 Plans, which are commonly referred to as either cafeteria plans or flexible benefit plans, are much loved, and needed, if you want to allow employees to pay health insurance and other premiums on a pre-tax basis....more

IRS to Amend Cafeteria Plan Regulations to Facilitate Enrollment in Marketplace Coverage

On Thursday, September 18, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-55, which expands the cafeteria plan “change in status” rules to allow plans to offer employees an option to revoke their elections...more

Quick! Do Employers Need To Update Their COBRA Notices?

On May 2, 2014, the Department of Labor ("DOL") issued new model COBRA notices in conjunction with a proposed rule that would shift the role of the DOL's model COBRA notices from a helpful example to an indicator of required...more

HHS Report Highlights “Surge” In Enrollment in Health Insurance Marketplaces

Last week, HHS’s Office of the Assistant Secretary for Planning and Evaluation published a Report offering health plan enrollment data for the state-based insurance marketplaces authorized by the Affordable Care Act...more

U.S. Government Issues Helpful Hints Regarding Marketplace Health Insurance Coverage and Immigration Status

In mid-March, the U.S. Citizenship and Immigration Services issued a notice including helpful hints for individuals who may have questions regarding their immigration status and how this may or may not affect eligibility for...more

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