Health Care Reform Implementation Update - August 26, 2013

by Cozen O'Connor

In response to security concerns about personal information in the health insurance exchanges, the Centers for Medicare and Medicaid Services (CMS) released a new security agreement for the data hubs where this information will be stored. Opposition to the Affordable Care Act (ACA) continues to be voiced from many directions. Some lawmakers who oppose the ACA are pushing for answers on the employer mandate delay or encouraging the law’s defunding. The National Retail Federation, America’s Health Insurance Plans, the National Association of Health Underwriters, the National Association for Manufacturers and the U.S. Chamber of Commerce have launched a campaign highlighting the problems that will be caused by the ACA’s penalties. Notwithstanding the opposition, major provisions of the law continue to go into effect, and the countdown to open enrollment is less than 40 days.


In an effort to raise awareness and enthusiasm among young consumers without health insurance for the ACA, HHS and Young Invincibles launched The Healthy Young America Video Contest on August 19 for videos urging young people to enroll in new insurance policies. Participants may submit by September 23, 2013 videos in three categories: song, short film or video infographic.

On August 20, CMS released a new agreement with state exchanges on the federal data service hub. The agreement requires state exchanges to alert the Center for Consumer Information and Insurance Oversight (CCIIO) within an hour of detecting a possible breach of personally identifiable information on the data hub. Once CCIIO is alerted, it will contact the relevant agencies about the breached data.

On August 23, the IRS released a proposed rule, Tax Credit for Employee Health Insurance Expenses of Small Employers. The proposed regulations provide guidance on the tax credit available to certain small employers that offer health insurance coverage to their employees under section 45R of the Internal Revenue Code, enacted by the ACA.


On August 21, Rep. Mark Meadows (R-N.C.) and 79 colleagues sent a letter to Speaker John Boehner (R-Ohio) and Majority Leader Eric Cantor (R-Va.) pressing them to defund the ACA as part of a government funding bill.

On August 21, five Republican members of the House Energy and Commerce Committee sent a letter to Treasury Secretary Jack Lew pushing for more details on the administration’s decision to delay the ACA’s employer mandate. The signing members are Energy and Commerce Chairman Rep. Fred Upton (R-Mich.), and Reps. Tim Murphy (R-Pa.), Joe Pitts (R-Pa.), Marsha Blackburn (R-Tenn.) and Michael Burgess (R-Texas). The members had previously written a letter to the Treasury but have not heard back.

The Government Accountability Office released a report requested by Sen. Tom Coburn (R-Okla.) examining the efficiency and effectiveness of contractors CMS uses to conduct post-payment claims reviews to identify improper payments. GAO recommends that CMS examine ways to make the review processes more consistent among different types of contractors.

A Government Accountability Office report finds that the U.S. Postal Service’s proposal to run its own health care plan in lieu of a federal plan could add slight financial strain to Medicare.

On August 21, Congressman Bill Cassidy, M.D. (R-La.), sent a letter to HHS Secretary Sebelius protesting the Obama administration’s granting of ACA navigator funds to Planned Parenthood. In a statement, Rep. Cassidy said “Every federal dollar that goes to Planned Parenthood, regardless of its stated purpose, offsets their costs to provide abortions.”


Notwithstanding Medicaid expansion, many who are currently eligible for Medicaid may lose Medicaid coverage. Maine, Rhode Island, Wisconsin and Vermont are planning to scale back some of their eligibility in January, meaning more than 150,000 will lose access to the program.

Last week the New York Department of Health announced the name of its health benefit exchange. It will be called the “NY State of Health.”

On August 23, Iowa Gov. Terry Branstad and Lt. Gov. Kim Reynolds formally requested a federal waiver to expand its Medicaid program in a way that would allow those between 100 and 138 percent of the federal poverty level to use federal dollars to buy coverage on the health exchange Iowa is running in partnership with the federal government.

On August 20, Rhode Island released rate information for insurance policies sold through the ACA’s exchanges. Rhode Island residents will be able to choose among 12 insurance plans offered through two insurance companies, Blue Cross & Blue Shield of Rhode Island and Neighborhood Health Plan of Rhode Island. The cost of insurance varies by type of plan and the individual’s age. A plan with a $5,800 annual deductible and a 30 percent co-pay would cost a 21-year-old consumer $169 per month and a 45-year old $244 per month. Rhode Island residents are now able to compare premiums and details of plans by plan and age through

On August 19, Montana state officials released prices for insurance under its exchange. According to the released rates, a mid-level plan would cost a 30-year-old somewhere between around $200 a month to $300 a month. The released rates do not include the up-front federal tax credits that will be available to many.

Though Louisiana had pursued funds under the ACA for long-term care reform, it withdrew its application this week citing complicated federal stipulations associated with the program.


The National Retail Federation, America’s Health Insurance Plans, the National Association of Health Underwriters, the National Association of Manufacturers, and the U.S. Chamber of Commerce have launched a campaign called the Affordable Coverage Project, whose slogan is The Health Insurance Tax Will Hurt. The campaign focuses on three main populations it argues will be harmed: families, seniors and small business.

On August 20, the Kaiser Family Foundation released its annual Employer Health Benefit Survey. The results showed that health insurance premiums have grown slowly in 2013, by 4 percent for an employer-sponsored family health plan. For some, this finding should stifle criticism that the ACA will increase health premium costs. Others are quick to highlight, however, that many of the ACA’s largest changes, especially for employers, have not yet gone into effect.

Heritage Action for America began a nine-city tour this week to urge lawmakers to defund the ACA. Heritage Action also announced a $550,000 defunding advertisement campaign that will fund advertisements in 100 congressional districts under Republican control.

According to a new study from the RAND Corporation, an estimated 300,000 fewer people or merely .2 percent of the population will have employer-sponsored health insurance in 2014 as a result of the employer mandate delay. Additionally, the study finds that the government will collect about $11 billion less in penalties.

According to a Kaiser Family Foundation report released on August 14, nearly half of those who currently buy their own health insurance would be eligible for tax credits next year under the ACA.

On August 15, Organizing for Action released a television advertisement touting the ACA. The ad is the group’s third this summer in support of the law.

A new study from the Commonwealth Fund found that the majority of young adults between the ages of 19 and 29 are unaware of the health insurance exchanges (marketplaces).


An Oklahoma judge granted a temporary injunction from a state law that put restrictions on the emergency contraceptive drug Plan B One-Step. The Oklahoma Coalition for Reproductive Justice and Jo Ann Mangili, the mother of a 15-year old girl, sued the state arguing that the bill violates the Oklahoma Constitution’s ban on including more than one subject in a bill.

To view our compilation of recent health care reform implementation news, click here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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