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The California Legislature voted Monday to tax people who refuse to buy health insurance, bringing back a key part of former President Barack Obama’s health care law in the country’s most populous state after it was eliminated by Republicans in Congress.
The tax now heads to Democratic Gov. Gavin Newsom, who proposed a similar plan in January — an indication he will likely approve it.
POSTED 3:59 PM, JUNE 24, 2019, BY ASSOCIATED PRESS, UPDATED AT 06:04PM, JUNE 24, 2019
The announcement late last week by the Justice Department that they would no longer defend the ACA’s individual mandate or consumer protection provisions sent shockwaves throughout the healthcare industry and may have major implications for the law’s future. While Democratic-led states have stepped up to defend the law in the Trump Administration’s absence, the future of the ACA is once again uncertain. A ruling by the courts to strike down the mandate, on the basis that with the penalties zeroed-out that it no longer functions as a tax, could threaten the very foundation that the law is built upon. NAHU’s Vice President of Government Affairs Marcy M. Buckner and Vice President of Congressional Affairs John Greene join the podcast this week to break down the details of this announcement and what the legalese means for you and your clients.Trump Administration to No Longer Defend the ACA’s Individual Mandate
This afternoon the Trump Administration released a final rule regarding Association Health Plans as well as a fact sheet on the new rule. The rule was in response to an executive order issued by President Trump on October 12 directing federal agencies to expand the availability of AHPs, short-term limited duration insurance policies and Health Reimbursement Arrangements. The proposal calls for a revision to ERISA in order to redefine “employer” to allow more groups to qualify as associations and treating health coverage sponsored by an employer association as a single group health plan that would not be subject to the ACA’s essential health benefits.
The final rule does not differ much from the proposed rule that came out in January, and the Congressional Budget Office now estimates that 4 million Americans, including 400,000 who otherwise would lack insurance, will join an AHP by 2023.
The goal of the rule is to provide small-business owners, employees of small businesses and family members of working owners/employees more coverage options, more affordable pricing, enhanced ability to self-insure, less regulatory burden and complexity, and reduced administrative costs.
The rule does this by eliminating the requirement that an association exist for a bona fide purpose other than offering health coverage. To qualify under the rule, employers would need to be either in the same trade, industry, line of business or profession, or have a principal place of business within a region that does not exceed the boundaries of the same state or the same metropolitan area. Therefore, AHPs could cross state lines if the metropolitan area includes more than one state. These plans would be subject to state regulation of insurance and plans across multiple states could be subject to varying rules. The Department of Labor has committed to continuing to partner with states to protect consumers and enforce state regulations.
Under the final rule, self-employed individuals, sole proprietors and common-law employees would be permitted to join an AHP. These individuals would be treated as an employee of the trade or business for purposes of being covered by the AHP. The proposal includes non-discrimination protections to avoid potential of adverse selection. It would require that the association not restrict membership based on any health factor, as defined in the HIPAA/ACA health nondiscrimination rules. These include health status, medical condition (including both physical and mental illnesses), claims experience, receipt of healthcare, medical history, genetic information, evidence of insurability, and disability.
The final rule has staggered dates for implementation:
Be Well Insurance Solutions will continue to provide our members with guidance on the implementation of this new rule, and will work with both state and federal policymakers as they oversee the offerings of these new AHPs.
NAHU’s Washington Update is on hiatus this week. In lieu of our usual collection of articles and podcast, we are summarizing the most recent regulatory action affecting our industry.
On Wednesday, February 15, the Trump Administration released its first significant health policy action, a proposed rule intended to stabilize the individual and small group private health insurance markets for 2018. The 71-page proposal released by the Centers for Medicare and Medicaid Services (CMS) includes the following significant components:
Comments are due on this proposed rule by March 7, 2017. NAHU is currently evaluating the provisions of the proposal and how they may impact our members, their clients and the stability of the individual and small group markets. CMS has also asked for additional market stabilization ideas to be submitted, so NAHU will provide them with a detailed letter on behalf of the membership about both the potential of the proposed rule and our additional ideas to improve the private individual and group marketplaces.
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Views 9 questions for the Trumpcare architects
By Perry Braun
As a new plan is presented for debate and discussion by the Trump administration — with the goal of building an affordable plan — here are my questions:
With the new administration committing to repeal and replace Obamacare, we are all left to wait and see the details of the plan — and adjust accordingly.”
Read Full Article Here: http://bit.ly/2knbT69
One of Trump’s top campaign promises was to repeal and replace the Affordable Care Act, commonly called Obamacare.
His first official act in office was declaring his intention to do so. Congressional Republicans have been working to do just that since their term started January 3, though there’s dissent among Republicans over whether or not to complete the repeal process before a replacement plan is finalized and strident Democratic resistance to any repeal of the ACA.
On Wednesday, the Trump Administration submitted a proposed rule to the Office of Management and Budget designed to help stabilize the ACA marketplaces. Details on the rule are not currently available as it has not yet been published, but it is expected to address a number of immediate fixes to stabilize the marketplaces in the coming year. The administration is also in the process of releasing an executive order directing the Department of Labor to review the fiduciary rule, which currently imposes significant requirements on health savings accounts. NAHU will continue to monitor these regulatory items and will update members as details become available. The proposed rule on stabilizing the marketplace is the first regulation directed at the department of Health and Human Services since President Trump took office two weeks ago.
NAHU has called on the Trump Administration, and previously the Obama Administration, to implement several changes that would improve stability in the individual marketplaces. We have suggested that the administration could restrict the use of special enrollment periods (SEPs) to reduce their abuse and also implement more stringent documentation requirements. Similarly, we have called on reducing the current 90-day grace period for individuals with premium tax credits down to 30 days for non-payment. We also suggest allowing “grandmothered” policies to continue beyond their 2017 expiration date and removing limitations on “grandfathered” policies. And we have called on the administration to simplify the employer reporting requirements. NAHU CEO Janet Trautwein’s testimony before the Senate Health, Education, Labor and Pensions Committee included many of these suggestions.
The proposed rule follows an executive order (EO) issued by President Trump on Monday, which requires that for every new regulation that is issued, two previous regulations must be eliminated. Based on interim guidance released today and a previous executive order from 1993 that is still in effect, the rule will apply to any “significant” regulation that imposes an annual economic cost of $100 million or more. Agencies issuing regulations starting on September 30 will need to identify two existing regulations to eliminate prior to the new regulation being issued, as well as fully offset total incremental cost of the new regulation. Regulations addressing health, safety or financial emergencies may request a waiver from this requirement. This EO order fulfills a campaign pledge that was part of President Trump’s 100-day plan, and follows a listening session last Monday with a dozen business executives from several large companies where he promised to cut regulations by 75%. President Trump has issued seven executive orders and 11 presidential memorandums since taking office on January 20.
NAHU is continuing to work with the Trump Administration and congressional leadership to determine the best approach and timing for change in our healthcare system. We will continue to update you as any other regulatory changes, EOs or legislation are released. In the meantime, all statutes and regulations enacted by the ACA continue to be in place and NAHU members should continue to work with their clients to be in compliance with the law. Additionally, if you have suggestions regarding our work with the Trump Administration and members of Congress on the future plans to reform the ACA that you would like to share with NAHU, you can send your thoughts and ideas to ACAreform@nahu.org.
Health insurance companies are bailing and co-ops are failing as Obamacare barrels down the road to collapse.
Health policy experts predict the Affordable Care Act will continue to muddle along for the next few years at least. But when the breaking point comes, experts warn the debate will center on whether to move toward a free market system or double down on government takeover of healthcare. Read More Here: Get Ready for Hillarycare, Part II