House Committees move forward on ACA repeal

The House took a major step in advancing action on the Affordable Care Act (ACA) with the filing of the American Health Care Act. The bill, which was filed in the House of Representatives on March 6, 2017, is a compilation of budget reconciliation packages from the House Ways & Means Committee and the House Energy & Commerce Committee, in follow-up to the budget resolution adopted in January. [More]

Transitional health plans to continue through 2018

In November of 2013, the Centers for Medicare & Medicaid Services (CMS) introduced the concept of “grandmothered plans,” coverage in place prior to 2014 that would have been prohibited as of 2014 as a result of changes under the Affordable Care Act (ACA). CMS issued guidance permitting those plans to be renewed for existing policyholders if permitted by states. Specifically, such plans are not considered to be out of compliance with ACA provisions related to... [More]

CMS issues final 2018 Marketplace guidance

The Centers for Medicare and Medicaid Services (CMS) finalized its annual Notice of Benefit and Payment Parameters for 2018 (NBPP) and its 2018 Letter to Issuers in the Federally-Facilitated Marketplaces (Letter) on December 16, 2016. As is typical, the NBPP addresses a breadth of issues relative to health plan regulation as well as Marketplace operations. The Letter provides operational and technical guidance for issuers seeking to offer Qualified Health Plans (QHPs) and Standalone Dental Plans (SADPs) on Federally-Facilitated Marketplaces (FFMs) and State-Based Marketplaces on the Federal Platform (SBM-FPs). [More]

Hawaii receives approval of 1332 State Innovation Waiver submission

Hawaii requested a 1332 State Innovation Waiver in order to preserve the state’s Prepaid Health Care Act (Prepaid) by exempting the state from requirements related to the Small Business Health Options Program (SHOP). Since the enactment of Prepaid in 1974, employers in Hawaii have been required to provide health insurance coverage that meets the evolving standards of Prepaid to employees working 20 hours or more per week, with some exceptions. In 2011, more than 480,000 non-union employees and their dependents were covered under employer-sponsored Prepaid-compliant plans. [More]

Roundup of federal health policy developments

The debate over the future of the Affordable Care Act (ACA) is well-underway and there are a number of significant developments that warrant a closer look. Here we provide a roundup of recent developments.

Administrative Action
Upon entering office, President Trump signed two Executive Orders. The first, on January 20, entitled... [More]

The House considers health policy bills

As debate continues over the future of the Affordable Care Act (ACA), the House has held hearings on four piecemeal bills aimed at making incremental changes to the ACA:

- The State Age Rating Flexibility Act of 2017 would expand permissible age rating bands to 5:1 (currently 3:1) under the ACA or a different ratio adopted by the state. [More]

The Obamacare Replacement Act

Senator Rand Paul introduced the Obamacare Replacement Act on January 25th, which would repeal much of Title 1 of the Affordable Care Act (ACA), including:

• Most consumer protections (except as outlined below)
• Rating restrictions
• Rate review requirements
• Essential Health Benefits
• Medical loss ratio requirements
• Individual and employer coverage mandates [More]

Patient Freedom Act of 2017

On January 23rd, Senators Bill Cassidy and Susan Collins introduced the Patient Freedom Act of 2017 to largely repeal and replace Title 1 of the Affordable Care Act (ACA), which includes insurance reforms. Certain ACA provisions would remain, including changes to the Medicaid program (e.g., Medicaid expansion) and Medicare and ACA revenue provisions. [More]

Administrative Action

Immediately upon entering office, President Trump signed an Executive Order on January 20th entitled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal” stating his commitment to repealing the Affordable Care Act (ACA) and directing administration officials to avail themselves of existing authority to provide flexibility in administration of the ACA. While the Executive Order provided no new authority and made no policy changes itself, it did provide examples of flexibility that should be exercised. [More]

Looking ahead: Key considerations for the future of health policy

There has been much discussion on the future of the Affordable Care Act (ACA) and health policy in general, since the election. While it is tempting to try to predict the future of health policy, in reality it is still too early to know how policy will change, via which vehicles, and according to what timeline. There are, however, some key themes to be mindful of as we approach inauguration day... [More]