health care reform
You may recall the circuit panel ruling in Halbig v. Burwell this past Summer. This is a little case with huge potential implications for the ACA. I say potential because the panel holding was quickly vacated by the DC Circuit Court of Appeals.
Last week, the IRS released Notice 2014-69. The notice states that plans that do not provide in-patient hospitalization or physician services do not provide "minimum value" as that term is defined by the ACA.
As we noted here, the DC Circuit has vacated its panel decision deciding the ACA shoud be enforced as it reads to NOT allow subsidies sold outside of state health exchanges (i.e., through the federal exchange). This was a huge holding, but the odds were stacked against its survival within the more liberal DC Circuit.
The Affordable Care Act (ACA) requires health insurance issuers and sponsors of self-insured health plans to pay Patient-Centered Outcomes Research Institute fees (PCORI fees). The fees are reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return). If you have a fully-insured group health plan, you carrier will handle the PCORI fee payment.
The crisis that was (is) the uninsured was a primary justification for the passage of the ACA. "We have 40 million people without health insurance! We have to do something." And something they did. A massive expansion of the public into the private sector. The cancellation of more than 4 million existing health insurance policies. Double-digit increases in premiums costs, etc.
On April 1st (yes, April Fool's Day even), the Obama Administration declared that they had reached their "goal" (scare quotes used because they had refused to say it was their goal just a few weeks ago) of 7,000,000 million "sign ups" for ACA compliant policies through healthcare.gov, the state exchanges, and other enrollment methods. This was heralded as a victory by media outlets and administration officials and a "in your face" moment for opponents and critics of the ACA. So, everything is awesome now! We are all good. Everybody is loving it right? This is now a huge success. So, at any moment, congressional Democrats will be picking up the Obamacare banner and waving it proudly whereas only days before they were in full retreat. Right?
Hobby Lobby will stand before the Supreme Court today to plead its case on why it should not be forced to offer abortion pills in the health insurance plan it provides for its employees. You may recall that the Obama Administration has tried to "accommodate" religious institutions, but its "accommodation" is illusory at best. That is another lawsuit. In Hobby Lobby's case, no accommodation or reprieve has been offered.
As we near the end of the first open enrollment period for the state and federal exchanges, we are getting some data about just who is signing up and/or enrolling for health insurance coverage. First, there is a difference between "sign ups" and "enrollments." Sign ups have not yet paid. Enrollments have paid.