News & Analysis as of

Public Health Insurance Marketplace

Back in the Spotlight: The Affordable Care Act Again Takes Center Stage

by Ballard Spahr LLP on

After a brief lull in activity, recent developments are likely to involve all three branches of government in addressing issues under the Affordable Care Act....more

The Health Care Executive Order and Its Effect on Employee Benefit Options

by Hodgson Russ LLP on

In a development with potentially far-reaching ramifications, on October 12, 2017, the President signed Executive Order No. 13813 expressing an executive policy of facilitating, “to the extent consistent with law”, the...more

Health Insurance for U.S. Employees - A New Option for an Old Problem

by Hodgson Russ LLP on

There is good news in the world of U.S. health insurance laws, at least for Canadian companies with fewer than 50 full-time U.S. employees. Effective this year, it is now possible to directly reimburse employees for the cost...more

Trump Administration Takes Aim at ACA With AHP Executive Order

Thursday, October 12th, on the heels of the recent and repeated failures to repeal and replace the Affordable Care Act (“ACA”), President Donald Trump signed an executive order nominally aimed at increasing competition in the...more

Vermont AG Settles with SAManage for $264,000 for Delayed Breach Notification

The Vermont Attorney General (AG) recently announced that it has settled with SAManage USA, a business support services company, for failing to timely notify 660 Vermont residents that their names and Social Security numbers...more

Trump Administration Pulls the Plug on CSR Payments

After months of veiled threats, President Trump formally announced that his Administration will cease funding Cost-Sharing Reduction (“CSR”) payments, a key component of the Affordable Care Act (“ACA”) intended to help...more

“Ceasing the CSR’s: Once a Threat, Now A Promise”

by LeClairRyan on

Late in the evening of October 12, 2017, word leaked that the Trump Administration planned to finally carry out its threat to stop the Cost-Sharing Reduction Payments (“CSRs”) under the Affordable Care Act (“ACA”). The...more

President Orders FTC to Report on Competition in Healthcare Markets

by Perkins Coie on

On October 12, 2017, President Donald J. Trump signed an executive order designed to promote choice and competition in healthcare markets. The order was reported as a first step in the administration’s effort to undermine the...more

OIG Work Plan – September 2017 Update

by Baker Ober Health Law on

Beginning in June 2017, the OIG began making monthly Work Plan updates. These monthly updates create some practical challenges for health care providers and compliance professionals trying to make operational and compliance...more

Fractal Geometry, Actuarial Risk, and §1332 Waivers—The Role of the States in Reforming Health Care

At this writing, the prospects for success of the latest Republican effort to replace the Affordable Care Act appear bleak — but the Graham-Cassidy bill on which the GOP has pinned its last-ditch hopes highlights a major...more

Updated Health Care Reform Legislation Comparison Chart

The chart below compares key provisions of the Affordable Care Act (ACA), the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA). This chart is current as of July 13, 2017, and as of that date,...more

Senate Republicans Release Bill to "Repeal and Replace" the Affordable Care Act

by Littler on

On June 22, 2017, Senate Republicans released a draft of their legislation to repeal and replace the Affordable Care Act (“ACA”). After the House narrowly passed its version of ACA overhaul legislation, the American Health...more

Senate Healthcare Bill Released for Public Review

Just over four weeks after the Congressional Budget Office (CBO) released its score of the American Healthcare Act (AHCA), the bill passed by a narrow margin in the U.S. House of Representatives, the U.S. Senate released ‘The...more

Healthcare Weekly Preview from ML Strategies – June 2017

Welcome back everybody. With Congress returning from recess, we should expect an update on the progress of the Senate-version of the American Health Care Act. Despite the noise from GOP members about a timeline, one thing...more

Congress Returns for June Session to Face AHCA, User Fees and More

Congress returns from its Memorial Day recess to four full weeks of legislative activity. The drama of the American Health Care Act (AHCA) now hangs over the Senate. The House will return to its regular work once they advance...more

Health Care Reform Weekly Roundup – Issue 2

Below are key health care reform developments from the week of May 15th: ACA Repeal Efforts. Efforts to repeal and replace the Affordable Care Act (ACA) continue despite slowing down as the House of Representatives’...more

A Spring Cheat Sheet to Congressional Health Care Policy

Welcome back, friends. While the next stretch likely won’t have the drama of the American Health Care Act (AHCA), there will be plenty happening. There are deadlines that require decisive action on behalf of stakeholders and...more

The Fate of the ACA’s Cost-Sharing Reduction Subsidies

by Perkins Coie on

As deliberations over a replacement of the Affordable Care Act (ACA) continue in the U.S. House of Representatives, the fate of the ACA’s Cost-Sharing Reduction subsidies (CSRs) may be at stake. Under the ACA, Marketplace...more

Changes to Stabilize HealthCare.gov Have Implications for Employer Sponsored Health Plans

by Winstead PC on

We learn early on that for any action there is a reaction. On Friday, the Department of Health and Human Services released “Market Stabilization” final regulations that will impact group health plans as they plan for 2018....more

HHS Finalizes Rule Aimed at Stabilizing ACA Individual Marketplace

by Baker Ober Health Law on

On Thursday, April 13, the Department of Health and Human Services finalized a long-awaited regulation intended to stabilize the Affordable Care Act (ACA) individual health insurance marketplace. The final rule tracks closely...more

CMS Issues Final Rule to Stabilize ACA Insurance Markets, While Emphasizing Marketplace Woes

by Reed Smith on

The Centers for Medicare & Medicaid Services has published a final rule intended to help improve the risk pool and stabilize the Affordable Care Act (ACA) Insurance Exchanges for 2018 – even as CMS contends that consumers...more

ACA repeal without replacement negatively impacts Mississippians

During my career as a health lawyer, I have presented both sides of an issue to clients. When the Affordable Care Act was enacted in March 2010, I spoke to various audiences explaining the provisions and impact on their...more

CMS, IRS Address Affordable Care Act Issues in Transition

by Ballard Spahr LLP on

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

Marketplace Shockwaves: Insurer Exits Leave Marketplaces Vulnerable

by Kiesewetter Law Firm on

Early this month, Aetna announced that in 2018, it will not expand its Health Insurance Marketplace ("Marketplace" or "Exchange") coverage, and is evaluating whether it will completely pull out of the Marketplaces created by...more

CMS Issues Proposed Rule to Increase Patients’ Health Insurance Choices for 2018

by Ruder Ware on

On February 17, 2017, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule aimed at reforming and stabilizing the individual and small group health insurance markets. When (or if) finalized, the...more

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