Health Care Reform

Overview

The Republican leadership in the U.S. House of Representatives issued two bills on March 6, 2017 to repeal and replace the Affordable Care Act (ACA) through the budget reconciliation process. These bills, which were issued by the Ways and Means Committee and the Energy and Commerce Committee, are collectively known as the American Health Care Act.

To become law, these bills must go through the legislative process, although a budget reconciliation bill can be passed with a simple majority vote. Debate on the legislation is scheduled to begin on March 8, 2017.

Impact on Employers

If enacted, the new law would not repeal the ACA entirely, although it would make significant changes to key provisions.

The ACA’s employer and individual mandates would be repealed retroactively beginning in 2016. Key consumer protections, like the ACA’s prohibition on pre-existing condition exclusions and dependent coverage to age 26, would remain intact.

See below for a summary of the bills’ important provisions:

Legislative Process

The two separate bills that make up the American Health Care Act were released in response to a budget resolution passed by Congress on Jan. 13, 2017. The budget resolution is a nonbinding spending blueprint that directs House and Senate Committees to create federal budget “reconciliation” legislation.

Once drafted, any budget reconciliation bill can be passed by both houses with a simple majority vote. If these bills are passed in both the Senate and the House, the law would then go to President Donald Trump for approval. However, a full repeal of the ACA cannot be accomplished through this process.

ACA Provisions Not Impacted

The majority of the ACA is not affected by the new legislation. For example, the following key ACA provisions would remain in place:

• Cost-sharing limits on essential …
  

When does plan language not mean what it says?  Apparently when it is a poorly written law.  As a result, the United States Supreme Court has agreed to review a lawsuit that challenges the ability of the federal government to provide subsidies under the Affordable Care Act (ACA) to individuals in states that did not establish their own Exchange (that is, states with federally-facilitated Exchanges, or FFEs).

This case, King v. Burwell, is one of several cases filed in response to an Internal Revenue Service (IRS) rule authorizing subsidies in all states, including those with FFEs. The Supreme Court will review this case following a unanimous ruling from the 4th U.S. Circuit Court upholding the availability of the ACA’s subsidies in states with their own Exchanges and in states with FFEs.

A ruling from the Supreme Court is not expected until the end of the current Term, in late June or early July 2015. The 2015 Exchange open enrollment period begins Nov. 15, 2014.

Health Insurance Exchanges

The ACA requires each state to have an Exchange for individuals and small businesses to purchase private health insurance. The ACA delegated primary responsibility for establishing the Exchanges to individual states. However, HHS will operate the FFE in any state that refuses or is unable to set up an Exchange. For 2014, only 16 states and the District of Columbia established their own Exchanges. HHS operates FFEs in the remaining 34 states (with state assistance in some cases, but in most cases, with no state assistance). …