What the Supreme Court’s Ruling on the Affordable Care Act Means for Employers

Jackson Walker
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Jackson Walker

During the last administration, Texas joined by a number of other states filed suit seeking to overturn the Patient Protection and Affordable Care Act (ACA) because the individual mandate penalty in such law had its penalty reduced to zero. In a 7-2 vote, the Supreme Court of the United States today decided that the states challenging ACA did not have standing to challenge the ACA as they lacked an injury in fact. While the analysis of standing is an important issue for lawyers to debate, the importance of this decision for employers to take away is that the ACA is still the law.

Complying With ACA Mandates

Employers who meet the threshold of having 50 or more full-time equivalent employees in the preceding calendar year still must file Forms 1095-C and 1094-C each year.

Employers must also still have health plans designed to provide the claims procedures and benefit mandates required under the ACA. As employers work toward their 2022 health benefit plan offerings, they should continue to comply with the ACA’s benefit mandates, prior mandates such as the Mental Health Parity and Addiction Equity Act and the new mandated disclosure requirements following the enactment of the Consolidated Appropriations Act, 2021 (CAA21), and the additional new mandated procedures and coverage requirements under the act. Employers should also document which relief provisions they enacted with respect to health care flexible spending accounts and dependent care flexible spending accounts so that they can document such relief in the required amendments by the extended deadlines. With all of the relief provided to date, employers are responsible for amending their plans to conform to the relief adopted in operation.

Conclusion

Group health plans will have significant changes to comply with in 2022. The initial regulations implementing one aspect of the CAA21 changes regarding prescription drug cost reporting, including rebates have crossed another hurdle in the regulatory process and are closer to issuance. The CAA21 mandated that group health plans submit the first such report by December 27, 2021. Employers should watch closely for regulatory developments related to their group health plans.

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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