OK Federal District Court Judge Issues Adverse Decision in ACA Tax Credit Controversy


On September 30, 2014, Judge Ronald White of the U.S. District Court for the Eastern District of Oklahoma ruled that language in the Affordable Care Act (ACA) rendered invalid an IRS regulation that authorizes tax credits in federal exchanges as well as state exchanges. [More]

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HHS-OIG Issues First Report on Exchange Data Security


The U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG) issued on September 22, 2014 the first in what will be a series of reports on information security controls in federal and state-based health insurance Exchanges under the Affordable Care Act (ACA). The OIG reviews are based on HHS regulations on administrative, technical, and physical safeguards to safeguard the confidentiality, integrity, and availability of personally identifiable information (PII) obtained and used by Exchanges. The OIG reviews also apply standards developed by the National Institute of Standards and Technology (NIST) which HHS has adopted in instructions to Exchanges about steps necessary to protect PII. [More]

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GAO Confirms That Most of the Largest Health Insurers Are Participating in Most Exchanges


The Government Accountability Office (GAO) issued a report on September 29, 2014 which offers a remarkable comparative overview of the individual and small-group health insurance markets in each state. Most but not all of the largest issuers of health coverage in 2012 in those markets participated in health insurance Exchanges under the Affordable Care Act (ACA) in 2014. [More]

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Report Shows ACA Impact on Uncompensated Care


The U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE) released a report on September 24, 2014 showing the impact of the Affordable Care Act (ACA) on hospitals’ uncompensated care (bad debts and charity care for the uninsured). The report offers the first evidence that 2014 enrollments in qualified health plans (QHPs) through health insurance Exchanges along with Medicaid expansions in 25 states and the District of Columbia are starting to reverse the growth in the cost of uncompensated care. [More]


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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