Full DC U.S. Circuit Court of Appeals Agrees to Rehear ACA Subsidy Ruling


On September 4, 2014, the full District of Columbia (DC) Circuit Court of Appeals granted the federal government’s petition to rehear en banc (full panel) the 2 to 1 panel decision which held that federal tax subsidies under the Affordable Care Act (ACA) would only be available to low-income purchasers on “state-run exchanges.” In its September 4 order, the full panel vacated the 2 to 1 panel decision (HALBERG v. BURWELL, No. 14-5018, D. C. Cir., July 22, 2014) pending a decision by the full panel. [More]


Kaiser Releases Analysis of 2015 Health Insurance Premium Changes


The Henry J. Kaiser Family Foundation (Kaiser) has released a September 2014 report entitled, “Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces.” Kaiser’s report suggests that competitive forces may be helping to keep premiums down on average, but changes in premiums vary depending on geographic area, insurers, market segments, and competitive dynamics among insurers within each area and segment. [More]

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HHS Report Shows ACA Impact on Medicaid Enrollments


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), released on August 8, 2014 a report showing that 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by June 2014 saw on average a 18.50 percent increase in Medicaid/CHIP enrollments for June 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. States which had not implemented Medicaid expansion saw on average a 4.01 percent increase as compared to their 2013 baselines. Aggregating data for all states shows a 12.43 percent increase overall as compared to 2013 baselines. Total reported Medicaid/CHIP enrollments as of June 2014 reached 66,112,314. [More]

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RWJF Releases Reports on the Uninsured and Medicaid Expansion


The Robert Wood Johnson Foundation (RWJF) and the Urban Institute Health Policy Center released on July 29, 2014 a report entitled, “Who Are the Remaining Uninsured as of June 2014?” The report shows socio-economic, demographic, and geographic shifts in the composition of the uninsured population from September 2013 to June 2014, points-in-time before and after the Medicaid expansion in some states and the first open enrollment period under the Affordable Care Act (ACA). The national data in the report may help states formulate innovative outreach, consumer assistance, and enrollment strategies for 2015 and beyond taking into account the changing attributes of the remaining uninsured. State-specific data not available in that report can be used to supplement the data in the report. [More]

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California Health Exchange Shows 4.2 Percent 2015 Premium Increase


Covered California, the nation’s largest state-based health insurance Exchange, released data on July 31, 2014 showing a 4.2 percent average rate of increase in premiums for health plans in 2015. The California Exchange has tentatively selected ten health insurance companies for the second open enrollment period under the Affordable Care Act. The 4.2 percent increase is an overall weighted average that takes into account the statistical distribution of enrollees in 2014 as well as differences in premium rates among the ten companies, the types of plans (PPOs, HMOs, etc.) offered by each company, cost-sharing options available to consumers under each plan, other actuarial variables (such as enrollee age) allowed in premium rate setting for enrollees, and 19 geographic rating areas in California. [More]


US Department of Justice Requests Review of Adverse Judgment Concerning ACA Subsidies


On Friday, August 1, 2014, the US Department of Justice (DOJ) asked the full (11 Justices) panel of the US Court of Appeals for the District of Columbia Circuit to review the divided decision of a 3-judge panel, which held that subsidies “can be provided only in states that have set up their own” Affordable Care Act (ACA) exchanges. [More]

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U.S. Circuit Court Dismisses Lawsuit Challenging ACA Based on Constitution’s Origination Clause


On Tuesday, July 29, 2014, the U.S. Court of Appeals for the District of Columbia dismissed a lawsuit alleging that the Affordable Care Act’s (ACA’s) mandate to purchase health insurance violated the U.S. Constitution’s Origination Clause, which requires revenue-sharing bills to start in the U.S. House of Representatives rather than the Senate. [More]

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NEJM Report Shows 10.3 Million Persons Gain Coverage


The New England Journal of Medicine (NEJM) published a special report on July 23, 2014 estimating a net increase of 10.3 million insured adults aged 18 - 64 during the October 2013 – March 2014 open enrollment period offered through health insurance Exchanges under the Affordable Care Act (ACA). The study used Gallup-Healthways Well-Being Index (WBI) survey data from 440,429 survey respondents and linear regression models accounting for socio-economic variables to calculate adjusted average rates of uninsured adults aged 18 – 64 before and after the 2013-2014 open enrollment period. [More]

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Courts Issue Conflicting Opinions on Federal Exchanges


The United States Court of Appeals for District of Columbia Circuit issued a ruling on July 22, 2014 stating that a regulation issued by the Internal Revenue Service allowing taxpayers to obtain advance premium tax credits (APTCs) for qualified health plans available through federal Exchanges was not authorized under section 36B(c)(2)(A)(i) of the Internal Revenue Code as established by section 1401 of the Affordable Care Act (ACA). The ruling (in Halbig v. Burwell) was handed down by a three judge appeals panel, not the Circuit Court’s full bench. The appeals panel’s ruling was 2-1, with comprehensive majority and dissenting opinions. The majority opinions in this ruling stressed that section 36B(c)(2)(A)(i) mentions APTCs available through Exchanges “established by the State” but fails to mention federal Exchanges. [More]


HHS Announces Health Care Innovation Awards


The U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (CMMI), announced a new batch of “round two” health care innovation awards on July 9, 2014. These are grants to applicants who have set forth compelling new ideas to improve care and control costs for persons enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). [More]

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