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WASHINGTON—The Supreme Court has set aside three days at the end of March to hear oral arguments in lawsuits challenging the legality of the health care reform law.
The court announced Monday that it will hear five and a half hours of arguments over three days.
On March 26, the justices will hear arguments on whether a challenge to the law's individual mandate that requires individuals to enroll in a qualified plan or pay a financial penalty can be imposed before the provision's January 2014 effective date.
On March 27, the court will hear arguments on whether the individual mandate is constitutional.
On March 28, the court will hear arguments on whether the entire law can stand if the individual mandate were to be found unconstitutional.
A ruling is expected by the end of the court's term in June.
The high court in November agreed to review the legality of the Patient Protection and Affordable Care Act.
To view the entire article click here.
Monday, December 19, 2011
Monday, November 14, 2011
Supreme Court takes up challenge to health care reform law
The U.S. Supreme Court will hear a challenge to President Barack Obama's sweeping health care reform law, the court announced Monday.
Oral arguments will likely be held in late February or March, with a ruling by June.
A key issue to be considered by the high court's nine justices is whether the "individual mandate" section of the law -- requiring nearly all Americans to buy health insurance by 2014 or face financial penalties -- is an improper exercise of federal authority.
Various states have argued that if that linchpin provision is found unconstitutional, the entire law will have to be scrapped.
To view the entire article click here
Oral arguments will likely be held in late February or March, with a ruling by June.
A key issue to be considered by the high court's nine justices is whether the "individual mandate" section of the law -- requiring nearly all Americans to buy health insurance by 2014 or face financial penalties -- is an improper exercise of federal authority.
Various states have argued that if that linchpin provision is found unconstitutional, the entire law will have to be scrapped.
To view the entire article click here
Friday, October 14, 2011
CLASS Program Axed by Obama Administration
The Obama administration announced today it will not move forward with a new long-term care insurance plan -- a major part of its health care law -- because of problems with paying for it.
"Despite our best analytical efforts, I do not see a viable path forward," wrote Health and Human Services Secretary Kathleen Sebelius in a letter to Congress.
Congressional Republicans had vowed to kill the program, calling the Community Living Assistance Services and Supports program (CLASS) too expensive.
Some Republicans have vowed to try and repeal the entire Obama health care law, calling it too much of a government intrusion into the health care system.
A key part of the law -- the requirement that nearly all Americans buy some form of health insurance -- is also being challenged in court; the Supreme Court is expected to rule on the case next summer.
For the entire article click here
"Despite our best analytical efforts, I do not see a viable path forward," wrote Health and Human Services Secretary Kathleen Sebelius in a letter to Congress.
Congressional Republicans had vowed to kill the program, calling the Community Living Assistance Services and Supports program (CLASS) too expensive.
Some Republicans have vowed to try and repeal the entire Obama health care law, calling it too much of a government intrusion into the health care system.
A key part of the law -- the requirement that nearly all Americans buy some form of health insurance -- is also being challenged in court; the Supreme Court is expected to rule on the case next summer.
For the entire article click here
Thursday, September 29, 2011
U.S. health benefits recommendations coming October 7
WASHINGTON (Reuters) - A key recommendation for medical coverage standards under President Barack Obama's healthcare overhaul will be released on October 7, according to the organization preparing the report.
The Department of Health and Human Services has asked the influential Institute of Medicine, an independent agency in Washington, to recommend how HHS should determine the basic health benefits for millions of Americans who will qualify for coverage sold through insurance exchanges beginning in 2014.
IOM spokeswoman Christine Stencel on Thursday said the agency will release the report on October 7, just a week later than the self-imposed deadline of the end of September.
Stencel has previously told Reuters that IOM will not produce specific benefits standards for the exchanges. Instead, the group is working toward recommendations on criteria and methods that would allow HHS to determine and update the essential health benefits package.
The findings will inform the final HHS decision expected by the end of the year. HHS has been subject to intense lobbying over which health services should be mandated by the government.
To view the entire article click here.
The Department of Health and Human Services has asked the influential Institute of Medicine, an independent agency in Washington, to recommend how HHS should determine the basic health benefits for millions of Americans who will qualify for coverage sold through insurance exchanges beginning in 2014.
IOM spokeswoman Christine Stencel on Thursday said the agency will release the report on October 7, just a week later than the self-imposed deadline of the end of September.
Stencel has previously told Reuters that IOM will not produce specific benefits standards for the exchanges. Instead, the group is working toward recommendations on criteria and methods that would allow HHS to determine and update the essential health benefits package.
The findings will inform the final HHS decision expected by the end of the year. HHS has been subject to intense lobbying over which health services should be mandated by the government.
To view the entire article click here.
White House, health reform opponents ask Supreme Court to review law
WASHINGTON (Reuters)—Twenty-six states and a small business group appealed Wednesday to the Supreme Court seeking to strike down all of President Obama's signature health care law, while the administration defended it.
The states and National Federation of Independent Business argued the entire law should be invalidated because Congress exceeded its powers requiring that Americans buy health insurance or face a penalty.
They urged the high court to quickly decide the issue in its upcoming term, which begins next week and lasts through June 2012.
The Obama administration filed its own appeal in which the Justice Department argued the so-called individual mandate was constitutional and said the issue was appropriate for Supreme Court review.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed,” the Justice Department said.
“We believe the challenges to Affordable Care Act…will also ultimately fail and that the Supreme Court will uphold the law,” the department said in a statement.
White House adviser Stephanie Cutter said the administration asked the Supreme Court to hear the case “so that we can put these challenges to rest and continue moving forward implementing the law to lower the cost of health care and make it more secure for all Americans.”
At issue was a ruling by a U.S. appeals court in Atlanta in August that declared unconstitutional the individual insurance requirement but refused to strike down the entire law.
The ruling by the appeals court in Atlanta conflicted with rulings by other appeals courts that have upheld the law or have rejected legal challenges, including a lawsuit by the state of Virginia that was dismissed earlier this month on procedural grounds.
The law, passed by Congress and signed by President Obama in 2010 after a bruising political battle, is expected to be a major issue in the 2012 elections as Obama seeks another four-year term. Republican presidential candidates oppose it.
The Supreme Court long has been expected to have the final word on the law's constitutionality. The dispute has important legal, political and financial implications for companies in the health care field.
Florida Attorney General Pam Bondi said the states sought Supreme Court review of their lawsuit.
“This health care law is an affront on Americans' individual liberty, and we will not allow the federal government to violate our constitutional rights,” she said.
Legal experts have said the nine member Supreme Court, with a conservative majority and four liberals, most likely will be closely divided on whether the individual mandate requiring insurance purchases exceeded the power of Congress.
The Obama administration earlier this week said it decided against asking the full U.S. Appeals Court for the 11th Circuit to review the August ruling by a three-judge panel of the court that found the insurance requirement unconstitutional.
That decision cleared the way for the administration to go to the Supreme Court.
The states in their appeal also argued the law's expansion of Medicaid, a federal-state partnership that provides health care to low-income Americans, was unconstitutionally coercive, forced upon the states.
The states and National Federation of Independent Business argued the entire law should be invalidated because Congress exceeded its powers requiring that Americans buy health insurance or face a penalty.
They urged the high court to quickly decide the issue in its upcoming term, which begins next week and lasts through June 2012.
The Obama administration filed its own appeal in which the Justice Department argued the so-called individual mandate was constitutional and said the issue was appropriate for Supreme Court review.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed,” the Justice Department said.
“We believe the challenges to Affordable Care Act…will also ultimately fail and that the Supreme Court will uphold the law,” the department said in a statement.
White House adviser Stephanie Cutter said the administration asked the Supreme Court to hear the case “so that we can put these challenges to rest and continue moving forward implementing the law to lower the cost of health care and make it more secure for all Americans.”
At issue was a ruling by a U.S. appeals court in Atlanta in August that declared unconstitutional the individual insurance requirement but refused to strike down the entire law.
The ruling by the appeals court in Atlanta conflicted with rulings by other appeals courts that have upheld the law or have rejected legal challenges, including a lawsuit by the state of Virginia that was dismissed earlier this month on procedural grounds.
The law, passed by Congress and signed by President Obama in 2010 after a bruising political battle, is expected to be a major issue in the 2012 elections as Obama seeks another four-year term. Republican presidential candidates oppose it.
The Supreme Court long has been expected to have the final word on the law's constitutionality. The dispute has important legal, political and financial implications for companies in the health care field.
Florida Attorney General Pam Bondi said the states sought Supreme Court review of their lawsuit.
“This health care law is an affront on Americans' individual liberty, and we will not allow the federal government to violate our constitutional rights,” she said.
Legal experts have said the nine member Supreme Court, with a conservative majority and four liberals, most likely will be closely divided on whether the individual mandate requiring insurance purchases exceeded the power of Congress.
The Obama administration earlier this week said it decided against asking the full U.S. Appeals Court for the 11th Circuit to review the August ruling by a three-judge panel of the court that found the insurance requirement unconstitutional.
That decision cleared the way for the administration to go to the Supreme Court.
The states in their appeal also argued the law's expansion of Medicaid, a federal-state partnership that provides health care to low-income Americans, was unconstitutionally coercive, forced upon the states.
Thursday, September 22, 2011
Obama Administration Downsizes CLASS Act Office
WASHINGTON BUREAU -- The Obama administration is reassigning the workers in the office that was developing the Community Living Assistance Services and Supports (CLASS) Act long term care benefits plan – a program that is part of the Patient Protection and Affordable Care Act (PPACA).
Erin Shields, director of communications for health issues at the U.S. Department of Health and Human Services (HHS), would say only that the office was being “reduced.”
Shields made the comment after Bob Yee, the actuary for the CLASS Act office, told friends in an e-mail he had lost his job effective Friday.
Yee said in an interview that the 9 members of the CLASS Act unit were told last Thursday that they were being reassigned effective Friday. Yee said he is leaving because he is an actuary and there is no comparable position for him to go to.
Shields said that the office is not closing and that HHS is continuing its analysis of the CLASS Act program.
“As we have said in the past, it is an open question whether the program will be implemented,” Shields said. “A CLASS program will only be implemented if it is fiscally solvent, self-sustaining, and consistent with the statute.”
The CLASS Act provision in PPACA -- a provision strongly supported by the late Sen. Edward Kennedy, D-Mass. -- is supposed to create a national, voluntary insurance program that workers would use to buy LTC protection at the worksite.
The office responsible for implementing the CLASS Act provision was created in January and has been headed by Kathy Greenlee, assistant HHS secretary for aging.
PPACA calls for HHS Secretary Kathleen Sebelius to define the CLASS benefit by October 2012.
To view the article in its entirety click here.
Erin Shields, director of communications for health issues at the U.S. Department of Health and Human Services (HHS), would say only that the office was being “reduced.”
Shields made the comment after Bob Yee, the actuary for the CLASS Act office, told friends in an e-mail he had lost his job effective Friday.
Yee said in an interview that the 9 members of the CLASS Act unit were told last Thursday that they were being reassigned effective Friday. Yee said he is leaving because he is an actuary and there is no comparable position for him to go to.
Shields said that the office is not closing and that HHS is continuing its analysis of the CLASS Act program.
“As we have said in the past, it is an open question whether the program will be implemented,” Shields said. “A CLASS program will only be implemented if it is fiscally solvent, self-sustaining, and consistent with the statute.”
The CLASS Act provision in PPACA -- a provision strongly supported by the late Sen. Edward Kennedy, D-Mass. -- is supposed to create a national, voluntary insurance program that workers would use to buy LTC protection at the worksite.
The office responsible for implementing the CLASS Act provision was created in January and has been headed by Kathy Greenlee, assistant HHS secretary for aging.
PPACA calls for HHS Secretary Kathleen Sebelius to define the CLASS benefit by October 2012.
To view the article in its entirety click here.
Wednesday, September 14, 2011
Judge Invalidates Health-Care Act’s Insurance-Buying Mandate
Sept. 13 (Bloomberg) -- The requirement in the 2010 health- care law that most Americans buy insurance or pay a fine is unconstitutional, a federal judge in Pennsylvania ruled.
U.S. District Judge Christopher C. Conner in Harrisburg today said Congress exceeded its powers under the federal Constitution when it included in the act President Barack Obama signed last year the provision requiring almost all Americans to have medical insurance starting in 2014.
“The federal government,” Conner said, “is one of limited enumerated powers, and Congress’s efforts to remedy the ailing health-care and health-insurance markets must fit squarely within the boundaries of those powers.”
Three federal appeals courts have weighed in on the issue since June 29. A Cincinnati three-judge panel backed the provision 2-1, while one in Atlanta rejected it by the same vote. The U.S. appeals court in Richmond on Sept. 8 declined to rule on two separate challenges, citing jurisdictional grounds.
The Harrisburg ruling, if appealed, would be heard by the U.S. Court of Appeals in Philadelphia, which hasn’t yet ruled on the merits of the Patient Protection and Affordable Care Act.
To view the entire article click here.
U.S. District Judge Christopher C. Conner in Harrisburg today said Congress exceeded its powers under the federal Constitution when it included in the act President Barack Obama signed last year the provision requiring almost all Americans to have medical insurance starting in 2014.
“The federal government,” Conner said, “is one of limited enumerated powers, and Congress’s efforts to remedy the ailing health-care and health-insurance markets must fit squarely within the boundaries of those powers.”
Three federal appeals courts have weighed in on the issue since June 29. A Cincinnati three-judge panel backed the provision 2-1, while one in Atlanta rejected it by the same vote. The U.S. appeals court in Richmond on Sept. 8 declined to rule on two separate challenges, citing jurisdictional grounds.
The Harrisburg ruling, if appealed, would be heard by the U.S. Court of Appeals in Philadelphia, which hasn’t yet ruled on the merits of the Patient Protection and Affordable Care Act.
To view the entire article click here.
IRS proposes safe harbor for health care plan affordability test
WASHINGTON—A new Internal Revenue Service proposal would make it easier for employers to determine if their health care plans are “affordable” and exempt from a stiff financial penalty mandated by the health care reform law.
Under the law, starting in 2014, employers are liable for an annual $3,000-per-employee penalty for employees whose required health insurance premium contribution for single coverage exceeds 9.5% of family income and the employees are eligible for federal premium subsidies to buy coverage through state insurance exchanges.
Following up on a promise made in August, the IRS on Tuesday asked for public comment on a proposed safe harbor in which coverage would be considered affordable as long as the premium contribution for single coverage did not exceed 9.5% of an employee's W-2 wages.
‘More workable, practical'
“By allowing employers to base their affordability calculations on each employee's W-2 wages (which employers know) instead of each employee's household income (which employers generally would not know), the safe harbor could provide a more workable and practical method for measuring the affordability of an employer's coverage,” the IRS said in Notice 2011-73.
“This will work very well for employers. It is a real positive for employers,” said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.
To qualify for the safe harbor, an employer would have to meet certain requirements, including offering full-time employees the opportunity to enroll in a qualified employer-sponsored plan and that the required employee premium contribution for individual coverage in an employer's lowest-cost plan available to the employee not exceed 9.5% of the employee's W-2 wages.
Determined by employer
Application of the safe harbor would be determined at the end of a calendar year and on an employee-by-employee basis.
“The employer would determine whether it met the proposed affordability safe harbor for 2014 for an employee by looking at that employee’s W-2 wages for 2014 and comparing 9.5% of that amount to the employee’s 2014 premium contribution,” the IRS said.
To view the entire artcile click here.
Under the law, starting in 2014, employers are liable for an annual $3,000-per-employee penalty for employees whose required health insurance premium contribution for single coverage exceeds 9.5% of family income and the employees are eligible for federal premium subsidies to buy coverage through state insurance exchanges.
Following up on a promise made in August, the IRS on Tuesday asked for public comment on a proposed safe harbor in which coverage would be considered affordable as long as the premium contribution for single coverage did not exceed 9.5% of an employee's W-2 wages.
‘More workable, practical'
“By allowing employers to base their affordability calculations on each employee's W-2 wages (which employers know) instead of each employee's household income (which employers generally would not know), the safe harbor could provide a more workable and practical method for measuring the affordability of an employer's coverage,” the IRS said in Notice 2011-73.
“This will work very well for employers. It is a real positive for employers,” said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.
To qualify for the safe harbor, an employer would have to meet certain requirements, including offering full-time employees the opportunity to enroll in a qualified employer-sponsored plan and that the required employee premium contribution for individual coverage in an employer's lowest-cost plan available to the employee not exceed 9.5% of the employee's W-2 wages.
Determined by employer
Application of the safe harbor would be determined at the end of a calendar year and on an employee-by-employee basis.
“The employer would determine whether it met the proposed affordability safe harbor for 2014 for an employee by looking at that employee’s W-2 wages for 2014 and comparing 9.5% of that amount to the employee’s 2014 premium contribution,” the IRS said.
To view the entire artcile click here.
Thursday, September 8, 2011
Court tosses Virginia challenge to health care law
RICHMOND, Va. (Reuters)—A U.S. appeals court handed President Barack Obama a victory Thursday, ruling against challenges by the state of Virginia and others seeking to invalidate the health care reform law as unconstitutional.
The 4th U.S. Court of Appeals in Richmond, Va., overturned a lower court judge who had ruled the federal government could not compel people to buy health insurance or face paying a penalty. This is known as the individual mandate and takes effect in 2014.
Virginia had contended this provision conflicted with a state statute, giving it standing to challenge the federal law. But the appeals court found that Virginia did not have the right to challenge it and overturned the decision.
One day after Congress passed the federal health care overhaul in March 2010, Virginia signed into law a measure aimed at protecting its residents from the federal law. But the appeals court said that was merely a declaration and did not trump the federal government's authority.
The appeals court did not address Virginia's challenge to whether the mandate, due to take effect in 2014, was constitutional.
In a separate ruling, the appeals court ordered another lawsuit against the health care law, which targeted the penalty imposed for those who do not purchase insurance, be dismissed because the penalty has yet to be imposed.
It was the second major victory at the appellate level for the White House in a case that will likely be heard by the U.S. Supreme Court during the 2011-12 term that begins next month.
President Obama, a Democrat, pressed for the legislation to be passed to help stem the soaring costs of health care services, but rival Republicans have pushed to undo it in the courts, in state legislatures and in the U.S. Congress.
The issue is expected to dominate the November 2012 elections for president and Congress.
The decision follows a similar one in late June by the U.S. Court of Appeals for the 6th Circuit in Cincinnati that upheld the so-called individual mandate by ruling that Congress had the power to require Americans to buy health insurance.
But it contrasts with one by the 11th Circuit in August that ruled against the individual mandate requirement in a challenge brought by 26 states.
Those conflicting decisions likely ensure that the Supreme Court, the country's highest court, will have to step in to resolve the differences
The 4th U.S. Court of Appeals in Richmond, Va., overturned a lower court judge who had ruled the federal government could not compel people to buy health insurance or face paying a penalty. This is known as the individual mandate and takes effect in 2014.
Virginia had contended this provision conflicted with a state statute, giving it standing to challenge the federal law. But the appeals court found that Virginia did not have the right to challenge it and overturned the decision.
One day after Congress passed the federal health care overhaul in March 2010, Virginia signed into law a measure aimed at protecting its residents from the federal law. But the appeals court said that was merely a declaration and did not trump the federal government's authority.
The appeals court did not address Virginia's challenge to whether the mandate, due to take effect in 2014, was constitutional.
In a separate ruling, the appeals court ordered another lawsuit against the health care law, which targeted the penalty imposed for those who do not purchase insurance, be dismissed because the penalty has yet to be imposed.
It was the second major victory at the appellate level for the White House in a case that will likely be heard by the U.S. Supreme Court during the 2011-12 term that begins next month.
President Obama, a Democrat, pressed for the legislation to be passed to help stem the soaring costs of health care services, but rival Republicans have pushed to undo it in the courts, in state legislatures and in the U.S. Congress.
The issue is expected to dominate the November 2012 elections for president and Congress.
The decision follows a similar one in late June by the U.S. Court of Appeals for the 6th Circuit in Cincinnati that upheld the so-called individual mandate by ruling that Congress had the power to require Americans to buy health insurance.
But it contrasts with one by the 11th Circuit in August that ruled against the individual mandate requirement in a challenge brought by 26 states.
Those conflicting decisions likely ensure that the Supreme Court, the country's highest court, will have to step in to resolve the differences
Tuesday, August 30, 2011
House panels to consider repeal of 'grandfather' rules for health care plans
WASHINGTON—House Republican leaders on Monday said several House committees will develop legislation to repeal the health care reform law's grandfather plan rules.
Failure to follow those rules will result in health care plans losing an exemption from complying with several health care reform law requirements, such as providing full coverage for preventive services.
Under those rules, to win grandfathered status, a health care plan, among other things, can't ever increase coinsurance requirements or boost the percentage of the premium paid by enrollees by more than 5 percentage points.
Employers may see higher costs
House Majority Leader Eric Cantor, R-Wis., said in a memorandum sent to House Republicans that employers losing grandfathered status for their health care plans will face higher costs, “negatively affecting wages and job growth.”
Rep. Cantor said the House Education and Labor, Energy and Commerce and Ways and Means committees, will “soon” develop legislation “to repeal these ObamaCare restrictions.”
Last year, the Senate defeated a proposal by Rep. Mike Enzi, R-Nev., that would have effectively nullified the grandfather rules.
Failure to follow those rules will result in health care plans losing an exemption from complying with several health care reform law requirements, such as providing full coverage for preventive services.
Under those rules, to win grandfathered status, a health care plan, among other things, can't ever increase coinsurance requirements or boost the percentage of the premium paid by enrollees by more than 5 percentage points.
Employers may see higher costs
House Majority Leader Eric Cantor, R-Wis., said in a memorandum sent to House Republicans that employers losing grandfathered status for their health care plans will face higher costs, “negatively affecting wages and job growth.”
Rep. Cantor said the House Education and Labor, Energy and Commerce and Ways and Means committees, will “soon” develop legislation “to repeal these ObamaCare restrictions.”
Last year, the Senate defeated a proposal by Rep. Mike Enzi, R-Nev., that would have effectively nullified the grandfather rules.
Thursday, August 18, 2011
Federal rules would dictate how employers explain health plan coverage
WASHINGTON—Employers would have to revamp how they communicate and explain their health care plans next year under health care reform law rules proposed Wednesday.
The rules, which would be effective March 23, 2012, would require employers to provide employees with an “easy-to-understand” summary of benefits and coverage and, upon request, a glossary of commonly used health care coverage terms, such as deductible and copay.
The summary of benefits and coverage would have to include the portion of expenses a health care plan would cover in each of three situations: having a baby, treating breast cancer and managing diabetes.
Additional examples might be added in the future, according to the rules proposed jointly by the Health and Human Services, Labor and Treasury departments.
Benefit experts say they have never before heard of using such an approach.
In addition under the proposal, employers would have to notify plan participants at least 60 days before making any significant modification to plan coverage during the plan or policy year.
For employers, complying with the new rules “will be a major effort,” said Jennifer Henrikson, senior counsel at Aon Hewitt Inc. in Lincolnshire, Ill.
The proposed rules are to be published in the Aug. 22 issue of the Federal Register.
The proposed rules on communicating health care benefits followed by one week the three agencies’ proposed rules that would make it easier for employers to determine if their health care plans are affordable. Starting in 2014, employers whose plans fail that affordability test are liable for a $3,000 penalty for each employee that is eligible for federal premium subsidies to purchase coverage through state health insurance exchanges.
To view the artcile click here
The rules, which would be effective March 23, 2012, would require employers to provide employees with an “easy-to-understand” summary of benefits and coverage and, upon request, a glossary of commonly used health care coverage terms, such as deductible and copay.
The summary of benefits and coverage would have to include the portion of expenses a health care plan would cover in each of three situations: having a baby, treating breast cancer and managing diabetes.
Additional examples might be added in the future, according to the rules proposed jointly by the Health and Human Services, Labor and Treasury departments.
Benefit experts say they have never before heard of using such an approach.
In addition under the proposal, employers would have to notify plan participants at least 60 days before making any significant modification to plan coverage during the plan or policy year.
For employers, complying with the new rules “will be a major effort,” said Jennifer Henrikson, senior counsel at Aon Hewitt Inc. in Lincolnshire, Ill.
The proposed rules are to be published in the Aug. 22 issue of the Federal Register.
The proposed rules on communicating health care benefits followed by one week the three agencies’ proposed rules that would make it easier for employers to determine if their health care plans are affordable. Starting in 2014, employers whose plans fail that affordability test are liable for a $3,000 penalty for each employee that is eligible for federal premium subsidies to purchase coverage through state health insurance exchanges.
To view the artcile click here
Friday, August 12, 2011
Appeals court rules against Obama healthcare law
WASHINGTON (Reuters) - An appeals court ruled on Friday that President Barack Obama's healthcare law requiring Americans to buy healthcare insurance or face a penalty was unconstitutional, a blow to the White House.
The Appeals Court for the 11th Circuit, based in Atlanta, found that Congress exceeded its authority by requiring Americans to buy coverage, but also ruled that the rest of the wide-ranging law could remain in effect.
The legality of the so-called individual mandate, a cornerstone of the healthcare law, is widely expected to be decided by the U.S. Supreme Court. The Obama administration has defended the provision as constitutional.
It is expected that the U.S. Supreme Court will hear the case sometime in mid-2012.
To view the full artile click here.
The Appeals Court for the 11th Circuit, based in Atlanta, found that Congress exceeded its authority by requiring Americans to buy coverage, but also ruled that the rest of the wide-ranging law could remain in effect.
The legality of the so-called individual mandate, a cornerstone of the healthcare law, is widely expected to be decided by the U.S. Supreme Court. The Obama administration has defended the provision as constitutional.
It is expected that the U.S. Supreme Court will hear the case sometime in mid-2012.
To view the full artile click here.
Tuesday, August 2, 2011
Employers must provide preventive health care services to women: Rules
WASHINGTON—Group health care plans would have to provide full coverage—with neither copayments nor deductibles—for a wide range of women’s preventive services under rules issued Monday.
The rules stemming from the 2010 health care reform law and jointly issued by the departments of Health and Human Services, Labor and Treasury, require full coverage with no plan enrollee cost-sharing for services such as well-woman visits; screening for gestational diabetes; sexually transmitted infection counseling; breastfeeding support, supplies and counseling; domestic violence screening; and U.S. Food and Drug Administration-approved contraception methods and counseling.
2012 start date
The mandate would apply for plan years starting on or after Aug. 1, 2012. For calendar years, compliance would begin on Jan. 1, 2013. However, what are known as “grandfathered plans” would be exempt from having to meet the requirements.
In addition, religious organizations would not be required to cover contraceptives if it is inconsistent with their beliefs. A religious employer is one that, among other things, primarily employs individuals who share its religious beliefs and primarily serves those who share in its religious beliefs, according to the regulations, which are scheduled to be published in Wednesday’s Federal Register.
While the vast majority of plans will have to expand coverage to comply with the rules, employers should have sufficient time to make the needed changes, said Susan Margolis, a director with PricewaterhouseCoopers L.L.P. in New York.
Compared with the overall cost of coverage, the new requirement will result in “very modest” cost increases, said Rich Stover, a principal with Buck Consultants L.L.C. in New York.
The women’s preventive services come about a year after regulations mandating coverage—except for grandfathered plans—for a wide range of other preventive services, such as blood pressure, diabetes and cholesterol tests and annual physicals.
To view the interim final rule click here
The rules stemming from the 2010 health care reform law and jointly issued by the departments of Health and Human Services, Labor and Treasury, require full coverage with no plan enrollee cost-sharing for services such as well-woman visits; screening for gestational diabetes; sexually transmitted infection counseling; breastfeeding support, supplies and counseling; domestic violence screening; and U.S. Food and Drug Administration-approved contraception methods and counseling.
2012 start date
The mandate would apply for plan years starting on or after Aug. 1, 2012. For calendar years, compliance would begin on Jan. 1, 2013. However, what are known as “grandfathered plans” would be exempt from having to meet the requirements.
In addition, religious organizations would not be required to cover contraceptives if it is inconsistent with their beliefs. A religious employer is one that, among other things, primarily employs individuals who share its religious beliefs and primarily serves those who share in its religious beliefs, according to the regulations, which are scheduled to be published in Wednesday’s Federal Register.
While the vast majority of plans will have to expand coverage to comply with the rules, employers should have sufficient time to make the needed changes, said Susan Margolis, a director with PricewaterhouseCoopers L.L.P. in New York.
Compared with the overall cost of coverage, the new requirement will result in “very modest” cost increases, said Rich Stover, a principal with Buck Consultants L.L.C. in New York.
The women’s preventive services come about a year after regulations mandating coverage—except for grandfathered plans—for a wide range of other preventive services, such as blood pressure, diabetes and cholesterol tests and annual physicals.
To view the interim final rule click here
Tuesday, July 12, 2011
States can let large employers tap health insurance exchanges
WASHINGTON—States have the authority to decide whether large employers can purchase coverage through new state health insurance exchanges starting in 2017, according to health care reform regulations that were issued Monday.
The exchanges are a pivotal part of the Patient Protection and Affordable Care Act. Starting in 2014, they will be available to individuals, especially those eligible for federal health insurance premium subsidies, and employers with 100 or fewer employees. States, though, can until 2016 limit employer participation in the exchanges to organizations with up to 50 employees.
Defining ‘large’ employer
Starting in 2017, states can open the exchanges to employers with more than 100 employees, according to regulations issued Monday by the Department of Health and Human Services. However, the rules do give states the authority to define the conditions, such as number of employees, under which larger employers can buy coverage through the exchanges.
“The scope of the term qualified employer is expected to vary among states and over time,” according to the regulations.
“What is a large employer could well vary by state,” said Paul Dennett, senior vp-health care reform with the American Benefits Council in Washington.
The regulations do not address whether employers with early retiree health care plans could obtain coverage through the exchanges or the extent to which employers could pay a share of the retirees’ premiums.
That issue, benefit lobbyists say, is likely to be addressed in future regulations yet this year.
To view the original article click here.
To view the regultion click here.
The exchanges are a pivotal part of the Patient Protection and Affordable Care Act. Starting in 2014, they will be available to individuals, especially those eligible for federal health insurance premium subsidies, and employers with 100 or fewer employees. States, though, can until 2016 limit employer participation in the exchanges to organizations with up to 50 employees.
Defining ‘large’ employer
Starting in 2017, states can open the exchanges to employers with more than 100 employees, according to regulations issued Monday by the Department of Health and Human Services. However, the rules do give states the authority to define the conditions, such as number of employees, under which larger employers can buy coverage through the exchanges.
“The scope of the term qualified employer is expected to vary among states and over time,” according to the regulations.
“What is a large employer could well vary by state,” said Paul Dennett, senior vp-health care reform with the American Benefits Council in Washington.
The regulations do not address whether employers with early retiree health care plans could obtain coverage through the exchanges or the extent to which employers could pay a share of the retirees’ premiums.
That issue, benefit lobbyists say, is likely to be addressed in future regulations yet this year.
To view the original article click here.
To view the regultion click here.
Wednesday, June 29, 2011
Appeals court upholds healthcare law
The new healthcare law President Obama signed last year survived its first test before a federal appellate court Wednesday, as the Sixth U.S. Court of Appeals in Cincinnati concluded that the law’s insurance requirement is constitutional.
“We find that the minimum coverage provision is a valid exercise of legislative power by Congress under the Commerce Clause,” the judges said in rejecting a legal challenge to the law by the conservative Thomas More Law Center.
The Thomas More lawsuit has not attracted as much attention as two other legal challenges being pushed by Republican state officials in Virginia and other states. Those suits are being reviewed by federal appellate courts in Atlanta and Virginia.
And few legal experts expect that the constitutionality of the Patient Protection and Affordable Care Act will be settled until it is reviewed by the U.S. Supreme Court, likely next year.
But the ruling Wednesday nonetheless marked a legal victory for the Obama administration and its Democratic allies who have argued that Congress could require Americans to get health insurance starting in 2014.
To view the entire article, click here.
“We find that the minimum coverage provision is a valid exercise of legislative power by Congress under the Commerce Clause,” the judges said in rejecting a legal challenge to the law by the conservative Thomas More Law Center.
The Thomas More lawsuit has not attracted as much attention as two other legal challenges being pushed by Republican state officials in Virginia and other states. Those suits are being reviewed by federal appellate courts in Atlanta and Virginia.
And few legal experts expect that the constitutionality of the Patient Protection and Affordable Care Act will be settled until it is reviewed by the U.S. Supreme Court, likely next year.
But the ruling Wednesday nonetheless marked a legal victory for the Obama administration and its Democratic allies who have argued that Congress could require Americans to get health insurance starting in 2014.
To view the entire article, click here.
Monday, June 27, 2011
Previous Rules on External Reviews Eased in Regulations
WASHINGTON—Revamped health care reform regulations involving external reviews and coverage decisions ease rules proposed last year.
“Generally, this is good. This eases up—compared to the initial guidance—some requirements that would have been problematic for employers,” said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.
Urgent care decisions
One change involves the amount of time health care plan enrollees have to be notified of an urgent care coverage decision. Last year, regulators said enrollees would have to be notified of an urgent care decision within 24 hours of receipt of a claim.
But in a joint amendment to the 2010 regulations published in Friday's Federal Register, the Health and Human Services, Labor and Treasury Departments said they will allow plans to make notification of coverage decisions within 72 hours, closely following a Labor Department rule.
“This is a welcome change for employers. A 24-hour deadline would have been extremely challenging to meet,” said Sharon Cohen, an attorney with Towers Watson & Co. in Arlington, Va.
“A 24-hour standard—think, for example, of Thanksgiving weekend—would not have been practical,” said Andy Anderson, a partner with Morgan, Lewis & Bockius L.L.P. in Chicago.
Regulators, though, noted that the 72-hour limit is a maximum “and that in cases where a decision must be made more quickly based on the medical exigencies involved, the requirement remains that the decision should be made sooner than 72 hours after the receipt of the claim,” according to the rules published in Fridays' Federal register.
Notifications in languages besides English
The latest rules also amend a requirement that notices of available and external claims appeal processes and review be provided in a “culturally and linguistically appropriate manner.”
Under the previous rules, the requirement to provide notices in a language other than English was based on the percentage of plan enrollees who were literate in a common non-English language. For plans that cover more than 100 participants, the threshold was 10% of plan participants, or 500 participants, whichever was less.
Under the latest rules, the requirement applies if at least 10% of the population residing in a county where an employer’s health care plan enrollees reside are literate in the same non-English language. Currently, 255 U.S. counties meet this standard, including 78 of which are in Puerto Rico, according to the rules.
To view the entire article click here
To view the official release click here
“Generally, this is good. This eases up—compared to the initial guidance—some requirements that would have been problematic for employers,” said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.
Urgent care decisions
One change involves the amount of time health care plan enrollees have to be notified of an urgent care coverage decision. Last year, regulators said enrollees would have to be notified of an urgent care decision within 24 hours of receipt of a claim.
But in a joint amendment to the 2010 regulations published in Friday's Federal Register, the Health and Human Services, Labor and Treasury Departments said they will allow plans to make notification of coverage decisions within 72 hours, closely following a Labor Department rule.
“This is a welcome change for employers. A 24-hour deadline would have been extremely challenging to meet,” said Sharon Cohen, an attorney with Towers Watson & Co. in Arlington, Va.
“A 24-hour standard—think, for example, of Thanksgiving weekend—would not have been practical,” said Andy Anderson, a partner with Morgan, Lewis & Bockius L.L.P. in Chicago.
Regulators, though, noted that the 72-hour limit is a maximum “and that in cases where a decision must be made more quickly based on the medical exigencies involved, the requirement remains that the decision should be made sooner than 72 hours after the receipt of the claim,” according to the rules published in Fridays' Federal register.
Notifications in languages besides English
The latest rules also amend a requirement that notices of available and external claims appeal processes and review be provided in a “culturally and linguistically appropriate manner.”
Under the previous rules, the requirement to provide notices in a language other than English was based on the percentage of plan enrollees who were literate in a common non-English language. For plans that cover more than 100 participants, the threshold was 10% of plan participants, or 500 participants, whichever was less.
Under the latest rules, the requirement applies if at least 10% of the population residing in a county where an employer’s health care plan enrollees reside are literate in the same non-English language. Currently, 255 U.S. counties meet this standard, including 78 of which are in Puerto Rico, according to the rules.
To view the entire article click here
To view the official release click here
Wednesday, June 22, 2011
Waiver Application Period to End September 22, 2011
The Center for Consumer Information and Insurance Oversight2 (CCIIO) has previously published guidance, on September 3, 2010, November 5, 2010, and December 9, 2010, setting out the process that a group health plan or health insurance issuer that offers a limited benefit, or "mini-med" plan, should follow to apply for a waiver of the restrictions on annual limits on the dollar value of essential health benefits (as defined in section 1302(b) of the Affordable Care Act) for plan years beginning on or after September 23, 2010 but before September 23, 2011. CCIIO will conclude the annual limit waiver application process on September 22, 2011.
To see the entire release click here.
To see the entire release click here.
Wednesday, June 8, 2011
Order in the Courts! Healthcare Reform Update
ATLANTA (Reuters)—A U.S. appeals court in Atlanta will hear a lawsuit Wednesday challenging the constitutionality of the health care reforms signed into law by President Barack Obama a year ago.
The suit, filed by more than half the states, could reach the U.S. Supreme Court during its 2011-2012 term, which begins in October. Individuals, advocacy groups and hospitals have also sued.
Following are details of current lawsuits:
Lawsuit being heard in Georgia
• A lawsuit filed by 26 states and led by Florida Judge Roger Vinson said the requirement that individuals buy health insurance is unconstitutional. The 11th U.S. Circuit Court of Appeals will hear arguments Wednesday in Atlanta. While Judge Vinson said the entire health care law "must be declared void" because the requirement is inextricably linked to other parts of the law, he put his decision on hold pending appeal. Judge Vinson had ordered the Obama administration to seek a fast-track review of its appeal.
Challenges in Virginia
• A three-judge panel of the 4th U.S. Circuit Court of Appeals heard oral arguments in May challenging the recent ruling by U.S. District Judge Henry Hudson that the federal government cannot compel a person to buy health insurance. The judges, one of whom was appointed by President Obama, sharply questioned if Virginia had the right to bring the suit just because it passed a state law saying its citizens were not required to purchase insurance. In a twist, both the federal government and Virginia had appealed Judge Hudson's decision. Virginia says the judge erred by not throwing out the entire law.
• The court also heard an appeal in a lawsuit filed by Liberty University, the Virginia college founded by conservative evangelical leader Jerry Falwell. A federal judge had ruled the requirement to have health insurance and a requirement some employers buy coverage for employees was legal under the U.S. Constitution's Commerce Clause.
Other rulings
• Last week, the 6th U.S. Circuit Court of Appeals in Cincinnati heard an appeal in one of the first suits, filed by Michigan's Thomas More Law Center. One of the plaintiffs disclosed that she recently bought health insurance, and the panel of three judges is now trying to decide if there is still legal standing to sue. In October, a federal judge partly dismissed the suit, ruling Congress had the authority to enact the law under the Commerce Clause of the Constitution.
• In April, the U.S. District Court in New Jersey decided two individuals who said they represented "we the people" did not have any standing to sue, primarily because they could not establish they had been harmed by the law. The court had already dismissed on Dec. 9 a lawsuit filed by a cardiologist, a patient and a physicians' advocacy organization that had alleged the law violates the Constitution's Commerce Clause and the Fifth Amendment.
• A California federal court dismissed a lawsuit, now before the the 9th U.S. Circuit Court of Appeals, that said the health care law violates individual rights, increases taxes and violates physician-patient privileges, along with violating the Commerce Clause.
• In November, U.S. District Court Judge David Dowd partially denied and partially granted a motion to dismiss a lawsuit filed by the U.S. Citizen's Assn. in Ohio. While he dismissed arguments that the law violates freedom of association, due process and privacy protections, Judge Dowd is considering arguments that the law exceeds federal authority granted by the
Commerce Clause.
• At least 24 lawsuits have been filed in federal courts by states and private parties. One suit, Shreeve vs. Obama, was filed by a group of 25,000 individuals and entities.
What is at issue?
• States like Virginia have passed, or are considering, legislation declaring that the health care law cannot be enforced in their states. State legislators in Maine, Montana, Nebraska, Oregon, Texas and Wyoming have introduced bills that establish penalties, including fines and jail time, for any agent seeking to enforce the health care law within their states' borders. North Dakota's Legislature passed a "nullification" bill in April authorizing it to enact any measure necessary to prevent enforcement of the law.
• The states' main concern is that the law permits the federal government to force people to buy things, in this case requiring that all Americans purchase health insurance or pay a penalty under the "individual mandate." The federal government counters that everyone will inevitably pay for health care, whether through insurance or during an emergency, and that without the individual mandate premiums will rise.
• If the courts decide the individual mandate is unconstitutional, it is unclear if the mandate can be cut away from the law while leaving the other requirements intact. The states say that without the individual mandate, the law is rendered toothless.
• Parts of the U.S. Constitution that have come into play are the Commerce Clause, which regulates commerce among states; the Supremacy Clause, which makes federal power supreme to states' power; and the 10th Amendment, which leaves to states all powers not explicitly granted to the federal government.
• Some of the suits also focus on whether abortions are funded with taxpayer dollars under the law.
• When President Obama lobbied for the bill, he said there would not be a new tax associated with the individual mandate. The penalty for not having health insurance, though, is collected through tax filings and the federal government argues the fine is indeed a tax it is empowered to levy. States say the U.S. government does not have the authority to charge the fine and point to the discrepancy between President Obama's statements and the U.S. government's arguments.
Sources: Court documents, governors' offices, Pacific Legal Foundation
To view the original article please click here
The suit, filed by more than half the states, could reach the U.S. Supreme Court during its 2011-2012 term, which begins in October. Individuals, advocacy groups and hospitals have also sued.
Following are details of current lawsuits:
Lawsuit being heard in Georgia
• A lawsuit filed by 26 states and led by Florida Judge Roger Vinson said the requirement that individuals buy health insurance is unconstitutional. The 11th U.S. Circuit Court of Appeals will hear arguments Wednesday in Atlanta. While Judge Vinson said the entire health care law "must be declared void" because the requirement is inextricably linked to other parts of the law, he put his decision on hold pending appeal. Judge Vinson had ordered the Obama administration to seek a fast-track review of its appeal.
Challenges in Virginia
• A three-judge panel of the 4th U.S. Circuit Court of Appeals heard oral arguments in May challenging the recent ruling by U.S. District Judge Henry Hudson that the federal government cannot compel a person to buy health insurance. The judges, one of whom was appointed by President Obama, sharply questioned if Virginia had the right to bring the suit just because it passed a state law saying its citizens were not required to purchase insurance. In a twist, both the federal government and Virginia had appealed Judge Hudson's decision. Virginia says the judge erred by not throwing out the entire law.
• The court also heard an appeal in a lawsuit filed by Liberty University, the Virginia college founded by conservative evangelical leader Jerry Falwell. A federal judge had ruled the requirement to have health insurance and a requirement some employers buy coverage for employees was legal under the U.S. Constitution's Commerce Clause.
Other rulings
• Last week, the 6th U.S. Circuit Court of Appeals in Cincinnati heard an appeal in one of the first suits, filed by Michigan's Thomas More Law Center. One of the plaintiffs disclosed that she recently bought health insurance, and the panel of three judges is now trying to decide if there is still legal standing to sue. In October, a federal judge partly dismissed the suit, ruling Congress had the authority to enact the law under the Commerce Clause of the Constitution.
• In April, the U.S. District Court in New Jersey decided two individuals who said they represented "we the people" did not have any standing to sue, primarily because they could not establish they had been harmed by the law. The court had already dismissed on Dec. 9 a lawsuit filed by a cardiologist, a patient and a physicians' advocacy organization that had alleged the law violates the Constitution's Commerce Clause and the Fifth Amendment.
• A California federal court dismissed a lawsuit, now before the the 9th U.S. Circuit Court of Appeals, that said the health care law violates individual rights, increases taxes and violates physician-patient privileges, along with violating the Commerce Clause.
• In November, U.S. District Court Judge David Dowd partially denied and partially granted a motion to dismiss a lawsuit filed by the U.S. Citizen's Assn. in Ohio. While he dismissed arguments that the law violates freedom of association, due process and privacy protections, Judge Dowd is considering arguments that the law exceeds federal authority granted by the
Commerce Clause.
• At least 24 lawsuits have been filed in federal courts by states and private parties. One suit, Shreeve vs. Obama, was filed by a group of 25,000 individuals and entities.
What is at issue?
• States like Virginia have passed, or are considering, legislation declaring that the health care law cannot be enforced in their states. State legislators in Maine, Montana, Nebraska, Oregon, Texas and Wyoming have introduced bills that establish penalties, including fines and jail time, for any agent seeking to enforce the health care law within their states' borders. North Dakota's Legislature passed a "nullification" bill in April authorizing it to enact any measure necessary to prevent enforcement of the law.
• The states' main concern is that the law permits the federal government to force people to buy things, in this case requiring that all Americans purchase health insurance or pay a penalty under the "individual mandate." The federal government counters that everyone will inevitably pay for health care, whether through insurance or during an emergency, and that without the individual mandate premiums will rise.
• If the courts decide the individual mandate is unconstitutional, it is unclear if the mandate can be cut away from the law while leaving the other requirements intact. The states say that without the individual mandate, the law is rendered toothless.
• Parts of the U.S. Constitution that have come into play are the Commerce Clause, which regulates commerce among states; the Supremacy Clause, which makes federal power supreme to states' power; and the 10th Amendment, which leaves to states all powers not explicitly granted to the federal government.
• Some of the suits also focus on whether abortions are funded with taxpayer dollars under the law.
• When President Obama lobbied for the bill, he said there would not be a new tax associated with the individual mandate. The penalty for not having health insurance, though, is collected through tax filings and the federal government argues the fine is indeed a tax it is empowered to levy. States say the U.S. government does not have the authority to charge the fine and point to the discrepancy between President Obama's statements and the U.S. government's arguments.
Sources: Court documents, governors' offices, Pacific Legal Foundation
To view the original article please click here
Monday, May 9, 2011
House GOP Votes To Defund State Exchanges
(Reuters) - In a renewed attack against President Barack Obama's healthcare overhaul program, House Republicans voted on Tuesday to deny funding for a central element of the law that sets up marketplaces for people to shop for health insurance coverage.
The bill passed by the House of Representatives would rescind some $1.9 billion in grants that are being made available under the healthcare law to help states establish insurance exchanges where individuals and small businesses can shop for medical coverage plans.
The exchange idea is central to the law that has faced a number of challenges in Congress and the courts since it was enacted more than a year ago. Tuesday's bill, which passed on a largely party-line vote of 283-183, likely will be blocked by the Democratic-led Senate, just as an earlier effort by House Republicans to repeal the entire healthcare law was defeated.
To read the full artcile click here
The bill passed by the House of Representatives would rescind some $1.9 billion in grants that are being made available under the healthcare law to help states establish insurance exchanges where individuals and small businesses can shop for medical coverage plans.
The exchange idea is central to the law that has faced a number of challenges in Congress and the courts since it was enacted more than a year ago. Tuesday's bill, which passed on a largely party-line vote of 283-183, likely will be blocked by the Democratic-led Senate, just as an earlier effort by House Republicans to repeal the entire healthcare law was defeated.
To read the full artcile click here
Monday, April 25, 2011
Supreme Court rejects request to hear Va. health care case
WASHINGTON —The Supreme Court rejected a request Monday by Virginia officials to hear the constitutionality of the federal health-care overhaul, ensuring that the legal battle over the Obama-sponsored law will play out first in lower courts.
The high court's order in Virginia v. Sebelius was issued with no recorded vote or public dissent. It would have been highly unusual for the justices to taken up the dispute without at least one lower appeals court ruling first.
The high court's resolution of the law that continues to divide congressional Republicans and Democrats would now likely come in mid-2012, rather than the middle of this year.
The high court's order in Virginia v. Sebelius was issued with no recorded vote or public dissent. It would have been highly unusual for the justices to taken up the dispute without at least one lower appeals court ruling first. In the few instances when the justices have intervened early, it has been on a matter of imperative public importance and urgency, such as in the 1974 case involving President Nixon's Watergate tapes.
Virginia Attorney General Ken Cuccinelli had urged the justices to step in to resolve conflicting trial court opinions on the constitutionality of the provision that requires, beginning in 2014, that people buy insurance coverage or face a tax penalty.
Lower U.S. district courts have split on whether Congress had the authority to pass the individual-insurance mandate included in the legislation that became law in March 2010. Appeals of those rulings are pending in several U.S. circuit courts of appeals, which is the second step of the three-tier federal judiciary.
To view the entire article click here.
The high court's order in Virginia v. Sebelius was issued with no recorded vote or public dissent. It would have been highly unusual for the justices to taken up the dispute without at least one lower appeals court ruling first.
The high court's resolution of the law that continues to divide congressional Republicans and Democrats would now likely come in mid-2012, rather than the middle of this year.
The high court's order in Virginia v. Sebelius was issued with no recorded vote or public dissent. It would have been highly unusual for the justices to taken up the dispute without at least one lower appeals court ruling first. In the few instances when the justices have intervened early, it has been on a matter of imperative public importance and urgency, such as in the 1974 case involving President Nixon's Watergate tapes.
Virginia Attorney General Ken Cuccinelli had urged the justices to step in to resolve conflicting trial court opinions on the constitutionality of the provision that requires, beginning in 2014, that people buy insurance coverage or face a tax penalty.
Lower U.S. district courts have split on whether Congress had the authority to pass the individual-insurance mandate included in the legislation that became law in March 2010. Appeals of those rulings are pending in several U.S. circuit courts of appeals, which is the second step of the three-tier federal judiciary.
To view the entire article click here.
Friday, April 22, 2011
Obama signs bill repealing health care reform vouchers
WASHINGTON—President Barack Obama has signed into law a bill that repeals a health care reform law provision that would have required employers to offer low-wage employees company-paid vouchers to buy coverage in state health insurance exchanges.
The voucher repeal provision is part of an appropriations measure, H.R. 1473, that the president signed Friday after final congressional passage of the bill.
The voucher provision, which Sen. Ron Wyden, D-Ore., backed when the health care reform legislation was working its way through Congress, prompted strong opposition from business groups, which said it would boost employer costs and add administrative complexity.
Under the provision, employers starting in 2014 would have been required to offer vouchers to employees with household incomes up to 400% of the federal poverty level and whose premium contributions were between 8% and 9.8% of their household income.
The value of the voucher, though, would have been equal to what their employer would have paid if the employee enrolled in a plan with the largest employer premium contribution. Employees then could have used the voucher to buy coverage in an exchange and keep the difference in cash if the plan they purchased cost less.
The voucher repeal provision is part of an appropriations measure, H.R. 1473, that the president signed Friday after final congressional passage of the bill.
The voucher provision, which Sen. Ron Wyden, D-Ore., backed when the health care reform legislation was working its way through Congress, prompted strong opposition from business groups, which said it would boost employer costs and add administrative complexity.
Under the provision, employers starting in 2014 would have been required to offer vouchers to employees with household incomes up to 400% of the federal poverty level and whose premium contributions were between 8% and 9.8% of their household income.
The value of the voucher, though, would have been equal to what their employer would have paid if the employee enrolled in a plan with the largest employer premium contribution. Employees then could have used the voucher to buy coverage in an exchange and keep the difference in cash if the plan they purchased cost less.
Obama signs 1099 fix bill
President Obama has signed H.R. 4 – a bill that will repeal the Form 1099 reporting provision created by Patient Protection and Affordable Care Act (PPACA) Section 9006 – into law.
If PPACA 9006 Section 9006 had taken effect as written, it would have required a business entity to file a 1099 miscellaneous income reporting form with the Internal Revenue Service for a vendor whenever it had $600 or more in transactions with that vendor in a given tax year.
The provision would have taken effect in January 2012.
Small business groups had argued that the provision would create a paperwork nightmare, forcing independent contractors to file a Form 1099 whenever they bought a computer or a suite of office furniture from a large retailer.
The new law created by H.R. 4, the “Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011,” also repeals a separate Form 1099 information reporting requirement that would have been imposed on owners of rental real estate.
Analysts have estimated repeal of PPACA Section 9006 will cost $19 billion over 10 years. Drafters of the repeal law have paid for repeal by adjusting a PPACA health insurance subsidy program that is set to start up in 2014.
To view the full article click here
If PPACA 9006 Section 9006 had taken effect as written, it would have required a business entity to file a 1099 miscellaneous income reporting form with the Internal Revenue Service for a vendor whenever it had $600 or more in transactions with that vendor in a given tax year.
The provision would have taken effect in January 2012.
Small business groups had argued that the provision would create a paperwork nightmare, forcing independent contractors to file a Form 1099 whenever they bought a computer or a suite of office furniture from a large retailer.
The new law created by H.R. 4, the “Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011,” also repeals a separate Form 1099 information reporting requirement that would have been imposed on owners of rental real estate.
Analysts have estimated repeal of PPACA Section 9006 will cost $19 billion over 10 years. Drafters of the repeal law have paid for repeal by adjusting a PPACA health insurance subsidy program that is set to start up in 2014.
To view the full article click here
Friday, April 8, 2011
The IRS releases interim guidance on W2 reporting requirements
The Internal Revenue Service has issued interim guidance to employers on the informational reporting requirements on each employee's annual Form W-2 of the cost of the health insurance coverage they sponsor for employees. The IRS is also asking for comments on the interim guidance. The IRS emphasized that the new reporting to employees is for their information only, to inform them of the cost of their health coverage, and does not cause excludable employer-provided health coverage to become taxable; employer-provided health coverage continues to be excludable from an employee's income, and is not taxable. To view the guidance click here
Thursday, April 7, 2011
U.S. Senate votes to repeal 1099 reporting requirement
WASHINGTON (Reuters)—Bowing to pressure from business groups worried about an avalanche of paperwork, the U.S. Senate voted Tuesday to rescind the Form 1099 tax reporting requirement included in last year's health care overhaul law. With bipartisan support, the Senate voted 87-12 to pass legislation sponsored by Sen. Mike Johanns, R-Neb., that repeals a requirement for businesses and landlords to file a Form 1099 document with the Internal Revenue Service for purchases of goods and services exceeding $600 a year. The tax filing requirement did not directly relate to health care but was intended to help pay for the health care law that is considered one of President Barack Obama's top legislative achievements. The legislation earlier was passed by the House of Representatives and now goes to President Obama, who is expected to sign it into law. It was approved in Congress despite concerns by some Democrats to the way the $22 billion cost to the U.S. Treasury of repealing the tax reporting provision is covered. The bill adjusts the health insurance tax subsidies to be given to middle-income people under the health care law. It would require anyone who receives excessive tax subsidies for health insurance to pay back a greater share than currently required under the law. The Form 1099 reporting provision was meant to improve tax compliance and help pay for the health care law. But small firms and the self-employed complained it would bury them in paperwork. Lawmakers in both parties agreed that the tax reporting requirement should go. To view the full artcile click here.
House Committee Bill Would Restrict Funding for State-Based Exchanges
The ability of the Obama administration to provide unlimited funds to states to establish health exchanges would be ended under legislation reported out by a House committee late Tuesday. The House Energy & Commerce Committee legislation, H.R. 1213, would strike the unlimited direct appropriation of funds provided under the healthcare reform law for creation of state-based exchanges. The bill would also order that unspent money in the hands of the Department of Health and Human Services to provide funds to the states be returned to the Treasury. The bill is among five bills that would rescind authority to fund the law, the Patient Protection and Affordable Care Act. Rep. Fred Upton, R-Mich., chairman of the panel, says the committee passed the bills to “limit the Department of Health and Human Services’ unprecedented power, and restore Congress’ fiduciary duty as representatives of the people.” To view the full article click here.
Monday, March 21, 2011
Certain health care reform law requirements delayed
WASHINGTON—Employers will be given until Jan. 1, 2012, to comply with certain health care reform law requirements, the Labor Department has decided.
One delay involves a reform provision in which health plan enrollees have to be notified of an urgent care coverage decision within 24 hours of receipt by the employer or plan administrator That is a big change from a decade-old Labor Department rule that requires such notifications be made within 72 hours.
In rules issued last July, federal regulators said the 24-hour notification requirement would go into effect Jan. 1, 2011. Then in technical guidance issued in September, the Labor Department said it was establishing an “enforcement grace period” running until July 1, 2011, in which no action would be taken against employers that were working in good faith to comply with the new standard by July 1. The latest Labor Department guidance issued last week extends that grace period to Jan. 1, 2012.
The same Jan. 1, 2012, grace period extension also applies to another new mandate, which requires that notices of available internal and external claims appeals and review processes be provided in a “culturally and linguistically appropriate manner.”
The Labor Department said the delay will enable it to take into account comments it has received on the regulations. It said it will amend those regulations, but gave no indication of what those changes will be.
To read the full article click here.
One delay involves a reform provision in which health plan enrollees have to be notified of an urgent care coverage decision within 24 hours of receipt by the employer or plan administrator That is a big change from a decade-old Labor Department rule that requires such notifications be made within 72 hours.
In rules issued last July, federal regulators said the 24-hour notification requirement would go into effect Jan. 1, 2011. Then in technical guidance issued in September, the Labor Department said it was establishing an “enforcement grace period” running until July 1, 2011, in which no action would be taken against employers that were working in good faith to comply with the new standard by July 1. The latest Labor Department guidance issued last week extends that grace period to Jan. 1, 2012.
The same Jan. 1, 2012, grace period extension also applies to another new mandate, which requires that notices of available internal and external claims appeals and review processes be provided in a “culturally and linguistically appropriate manner.”
The Labor Department said the delay will enable it to take into account comments it has received on the regulations. It said it will amend those regulations, but gave no indication of what those changes will be.
To read the full article click here.
Monday, February 28, 2011
Obama Supports Easing Health Law Mandates for States
WASHINGTON — Seeking to appease disgruntled governors, President Obama announced Monday that he supported amending the 2010 health care law to allow states to opt out of its most burdensome requirements three years earlier than currently permitted.
In remarks to the National Governors Association, Mr. Obama said he backed legislation that would enable states to request federal permission to withdraw from the law’s mandates in 2014 rather than in 2017 as long as they could prove that they could find other ways to cover as many people as the original law would and at the same cost. The earlier date is when many of the act’s central provisions take effect, including requirements that most individuals obtain health insurance and that employers of a certain size offer coverage to workers or pay a penalty.
“I think that’s a reasonable proposal; I support it,” Mr. Obama told the governors, who were gathered in the State Dining Room of the White House.
To read the entire artile click here.
In remarks to the National Governors Association, Mr. Obama said he backed legislation that would enable states to request federal permission to withdraw from the law’s mandates in 2014 rather than in 2017 as long as they could prove that they could find other ways to cover as many people as the original law would and at the same cost. The earlier date is when many of the act’s central provisions take effect, including requirements that most individuals obtain health insurance and that employers of a certain size offer coverage to workers or pay a penalty.
“I think that’s a reasonable proposal; I support it,” Mr. Obama told the governors, who were gathered in the State Dining Room of the White House.
To read the entire artile click here.
Thursday, February 17, 2011
House panel votes to repeal 1099 reporting requirement
WASHINGTON—The House Ways and Means Committee on Thursday unanimously approved legislation that would to repeal a health care reform law requirement that employers to furnish 1099 statements whenever they do more than $600 in business with a corporate vendor.
The measure, H.R. 4, now goes to the full House.
A similar proposal passed the Senate this month with strong bipartisan support. By the end of the week, the Senate is expected by supporters to approve the broader bill, S. 223, which authorizes funds for the Federal Aviation Administration.
Small employers in particular have complained that the 1099 reporting requirement that is scheduled to go into effect in 2012 is too great a burden.
Full article
The measure, H.R. 4, now goes to the full House.
A similar proposal passed the Senate this month with strong bipartisan support. By the end of the week, the Senate is expected by supporters to approve the broader bill, S. 223, which authorizes funds for the Federal Aviation Administration.
Small employers in particular have complained that the 1099 reporting requirement that is scheduled to go into effect in 2012 is too great a burden.
Full article
Monday, January 31, 2011
U.S. Judge strikes down Health Care Reform law
A federal judge in Florida has struck down the Obama administration's requirement that nearly all Americans buy health insurance, and questioned the constitutionality of the entire health care law.
"I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate," wrote U.S. District Judge Roger Vinson, the second federal jurist to rule against law that Obama signed last year.
Two other judges have sided with the administration on the issue that may well wind up in the Supreme Court.
Obama and his aides said the requirement that all Americans, known as the individual mandate, is essential to financing the plan -- and that is exactly the reason opponents of the health care law have targeted it in a series of federal lawsuits. The law requires nearly all Americans to have health insurance in 2014, or face fines.
Vinson, appointed by President Ronald Reagan in 1983, drew a case filed by GOP attorney generals within hours of the law's signing in March; eventually 26 states joined in the lawsuit.
Congressional Republicans who fought the health care bill last year hailed the ruling.
Senate Minority Leader Mitch McConnell, R-Ky., sakid the decision confirms that "the health spending bill is a massive overreach and Democrats 'exceeded the bounds' of Congressional authority." Sen. Orrin Hatch, R-Utah, praised the ruling, saying that "Congress does not have the legal authority to tell Utahns and other Americans that they must buy health insurance or else."
For the entire article click here
"I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate," wrote U.S. District Judge Roger Vinson, the second federal jurist to rule against law that Obama signed last year.
Two other judges have sided with the administration on the issue that may well wind up in the Supreme Court.
Obama and his aides said the requirement that all Americans, known as the individual mandate, is essential to financing the plan -- and that is exactly the reason opponents of the health care law have targeted it in a series of federal lawsuits. The law requires nearly all Americans to have health insurance in 2014, or face fines.
Vinson, appointed by President Ronald Reagan in 1983, drew a case filed by GOP attorney generals within hours of the law's signing in March; eventually 26 states joined in the lawsuit.
Congressional Republicans who fought the health care bill last year hailed the ruling.
Senate Minority Leader Mitch McConnell, R-Ky., sakid the decision confirms that "the health spending bill is a massive overreach and Democrats 'exceeded the bounds' of Congressional authority." Sen. Orrin Hatch, R-Utah, praised the ruling, saying that "Congress does not have the legal authority to tell Utahns and other Americans that they must buy health insurance or else."
For the entire article click here
Bill would repeal employer health care coverage mandate
WASHINGTON—The health care reform law mandate that requires employers to offer coverage to employees or pay a penalty would be repealed under legislation introduced by Sen. Orrin Hatch, R-Utah.
“The employer mandate would force businesses to let people go or raise the cost of doing business to such an extent that they don’t start hiring,” Sen. Hatch said in a statement last week. “Let’s repeal this job-crushing provision so businesses can (get) back in the business of hiring,” he said.
Sen. Hatch’s proposal, S. 20, has 23 co-sponsors, all Republicans.
Effective in 2014, the health care reform law will require employers with more than 50 employees to offer qualified health care coverage or pay an annual assessment of $2,000 for each employee working at least 30 hours a week. In computing the amount of the assessment, the first 30 employees are excluded.
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“The employer mandate would force businesses to let people go or raise the cost of doing business to such an extent that they don’t start hiring,” Sen. Hatch said in a statement last week. “Let’s repeal this job-crushing provision so businesses can (get) back in the business of hiring,” he said.
Sen. Hatch’s proposal, S. 20, has 23 co-sponsors, all Republicans.
Effective in 2014, the health care reform law will require employers with more than 50 employees to offer qualified health care coverage or pay an annual assessment of $2,000 for each employee working at least 30 hours a week. In computing the amount of the assessment, the first 30 employees are excluded.
For the full article click here
Thursday, January 20, 2011
House Passes Repeal of Health Care Law
WASHINGTON—After a spirited debate, the House of Representatives Wednesday approved, on a near party-line 245-189 vote, legislation to repeal last year’s health care reform law. Just three Democrats voted in favor of the measure.
The vote on the measure, H.R. 2, introduced by Majority Leader Eric Cantor, R-Va., with 181 cosponsors, is largely symbolic, fulfilling a campaign promise made by GOP leaders during the 2010 congressional elections.
Few observers expect the Democratic-controlled Senate to join the House. Still, the House action marks the beginning of efforts to amend the law. Republicans and Democrats are united, for example, on stripping a provision from the Patient Protection and Affordable Care Act that requires employers to furnish 1099 reporting statements if they do more than $600 of business with a corporate vendor starting in 2012. Small employers in particular complained that the reporting burden is too great.
Republicans are looking for Democratic support to repeal provisions that will require most employers to offer coverage or pay a $2,000-per-full-time-employee penalty and mandate that individuals enroll in a qualified plan or face financial penalties, beginning in 2014.
Republicans also are exploring ways to deny funding to federal agencies charged with developing regulations to help implement the law.
The democratic controlled Senate has already vowed to block any chance of repeal there and President Obama has also promised a veto were a repeal to make it to his desk.
The vote on the measure, H.R. 2, introduced by Majority Leader Eric Cantor, R-Va., with 181 cosponsors, is largely symbolic, fulfilling a campaign promise made by GOP leaders during the 2010 congressional elections.
Few observers expect the Democratic-controlled Senate to join the House. Still, the House action marks the beginning of efforts to amend the law. Republicans and Democrats are united, for example, on stripping a provision from the Patient Protection and Affordable Care Act that requires employers to furnish 1099 reporting statements if they do more than $600 of business with a corporate vendor starting in 2012. Small employers in particular complained that the reporting burden is too great.
Republicans are looking for Democratic support to repeal provisions that will require most employers to offer coverage or pay a $2,000-per-full-time-employee penalty and mandate that individuals enroll in a qualified plan or face financial penalties, beginning in 2014.
Republicans also are exploring ways to deny funding to federal agencies charged with developing regulations to help implement the law.
The democratic controlled Senate has already vowed to block any chance of repeal there and President Obama has also promised a veto were a repeal to make it to his desk.
Thursday, January 13, 2011
Revisions regarding OTC Drugs Effective 1/16/11
The Internal Revenue Service on Dec. 23, 2010, issued IRS Notice 2011-5allowing the continued use of health flexible spending account (FSA) and health reimbursement arrangement (HRA) debit cards for the purchase of over-the-counter (OTC) medicines and drugs for which the taxpayer has obtained a prescription.
The guidance does not address health savings account (HSA) debit cards, in part because FSA and HRA purchases must be substantiated at the point of sale while HSA purchases are self-substantiated, with documentation saved by the purchaser and presented in the event of an IRS audit; inappropriate or "nonqualified" HSA distributions would then be subject to income tax plus a 20 percent penalty.
However, the accompanying frequently asked questions issued by the IRS note that under the Patient Protection and Affordable Care Act "only prescribed medicines or drugs…and insulin (even if purchased without a prescription) will be considered qualifying medical expenses and subject to preferred tax treatment" for FSAs, HRAs and HSAs.
New Procedures:
Effective Jan. 16, 2011, in accordance with the guidance, the use of FSA and HRA debit cards to purchase OTC medications must comply with procedures reflecting those that pharmacies (as well as mail-order and web-based vendors) follow when selling prescribed medicines or drugs. These include requirements that:
• Prior to purchase, the prescription for the OTC medicine or drug is presented to the pharmacist or other authorized vendor.
• The OTC medicine or drug is dispensed in accordance with applicable law and regulations.
• The debit card system does not accept a charge for an OTC medicine or drug unless an Rx number has been assigned.
• The pharmacy or other vendor retains a record of the prescription number, the name of the purchaser (or the name of the person for whom the prescription applies), and the date and amount of the purchase.
• All of these records are available to the employer or its agent on request.
If all requirements are met, the debit card transaction will be considered fully substantiated at the time and point of sale.
In addition, the guidance clarifies that:
• The prescription requirement applies to OTC medicine and drug purchases made on or after Jan. 1, 2011, and not to purchases made in 2010 even if reimbursed after Dec. 31, 2010.(As noted above, Jan. 16, 2010 is the date on which FSA and HRA debit card over-the-counter purchases must comply with all point of sale substantiation procedures.)
• The requirement applies only to OTC medications. It does not apply to other health care expenses such as medical devices, eyeglasses and contact lenses.
The guidance does not address health savings account (HSA) debit cards, in part because FSA and HRA purchases must be substantiated at the point of sale while HSA purchases are self-substantiated, with documentation saved by the purchaser and presented in the event of an IRS audit; inappropriate or "nonqualified" HSA distributions would then be subject to income tax plus a 20 percent penalty.
However, the accompanying frequently asked questions issued by the IRS note that under the Patient Protection and Affordable Care Act "only prescribed medicines or drugs…and insulin (even if purchased without a prescription) will be considered qualifying medical expenses and subject to preferred tax treatment" for FSAs, HRAs and HSAs.
New Procedures:
Effective Jan. 16, 2011, in accordance with the guidance, the use of FSA and HRA debit cards to purchase OTC medications must comply with procedures reflecting those that pharmacies (as well as mail-order and web-based vendors) follow when selling prescribed medicines or drugs. These include requirements that:
• Prior to purchase, the prescription for the OTC medicine or drug is presented to the pharmacist or other authorized vendor.
• The OTC medicine or drug is dispensed in accordance with applicable law and regulations.
• The debit card system does not accept a charge for an OTC medicine or drug unless an Rx number has been assigned.
• The pharmacy or other vendor retains a record of the prescription number, the name of the purchaser (or the name of the person for whom the prescription applies), and the date and amount of the purchase.
• All of these records are available to the employer or its agent on request.
If all requirements are met, the debit card transaction will be considered fully substantiated at the time and point of sale.
In addition, the guidance clarifies that:
• The prescription requirement applies to OTC medicine and drug purchases made on or after Jan. 1, 2011, and not to purchases made in 2010 even if reimbursed after Dec. 31, 2010.(As noted above, Jan. 16, 2010 is the date on which FSA and HRA debit card over-the-counter purchases must comply with all point of sale substantiation procedures.)
• The requirement applies only to OTC medications. It does not apply to other health care expenses such as medical devices, eyeglasses and contact lenses.
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