The Biggest Issue in Healthcare Reform Today

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Now that the GOP’s plan to remake healthcare by fiat seems to be failing, the Trump administration has once again pulled out one of its aces in the hole. Funding of cost sharing subsidies is the biggest issue today in the debate, viewed by the health insurance industry as “the single most destabilizing factor in… [Read More]

Rate Shock Will Impact Small Businesses, Individuals

D-Day is coming for small groups and individuals. The release of the January 1, 2014, plans and rates will be an eye-opener for most Americans covered by these plans. In most states, rates for small groups and individuals are based on the age of the insured and health questions. Under PPACA, there will be no… [Read More]

Sequestration: A Threat to Funding for Affordable Care Act (ACA) Implementation, Administration and Enforcement?

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After the Supreme Court upheld the majority of ACA and President Obama won re-election, the proponents of the law felt that all threats to its full implementation were finally squelched. It was full steam ahead for the implementation train. However, a process that many Americans have heard referred to over the past few months may… [Read More]

Planning for Spousal Coverage under PPACA

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With HHS defining “dependents” as children (“individuals under age 26″), employers have been handed a subtle planning opportunity. As we have been advising, there will be very interesting coverage strategies that will crop up as these regulations unfold. The law requires that coverage be offered to “dependents,” but as with many aspects of ACA, substantive… [Read More]

A Toothless Mandate

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The focus on ACA’s provision requiring individuals to maintain health insurance coverage in 2014 (aka “the individual mandate”) is escalating, with insurers leading the charge. In the final helter-skelter days when the legislation was being crafted, there was intense debate on the penalty portion of this mandate. The stark economic reality is that the penalty… [Read More]

HHS Provides Clarity to Non-Calendar Year Plans: 2014 Won’t Start in 2013

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IRS and HHS have issued a dizzying stream of regulations, guidance and clarifications over the last couple of months that are having a real-time impact on our clients’ strategic planning. Just as many companies were forced to make critical decisions at the end of 2010— before grandfathering and nondiscrimination rules were fleshed out—2014 is generating… [Read More]

Healthcare and the Fiscal Cliff

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I can’t recall a time when the spotlight shined so brightly on the legislative process nor a time when partisanship has been so acute. In the earliest hours of the New Year, our country’s leaders rescued our financial markets from the brink of crisis and, on the first trading day of the year, a rally… [Read More]

The Blog Before Christmas

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‘Twas the week before Christmas, in all cyberspace Not a creature was blogging, except to retrace. The SBCs were queued on the printer with care In hopes that HHS would soon make things clear. The pundits were nestled all snug in their beds While visions of ACOs danced in their heads. As election results became… [Read More]

When Lobbying Isn’t

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There is so much press about the negatives of lobbying Congress. And I must admit, I also believe that the special interests and legislative preferences for large campaign contributors are a scar on our otherwise fairly good (in a worldwide perspective) political system. However, as I pack my bags for Washington, I recognize that I… [Read More]

Doc Fix Still in Danger

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Making Medicare financially stable is a significant issue facing the American people.  Congress believes the answer may be in significantly cutting payments to doctors. However, if reimbursement rates are slashed, doctors will likely opt out of the Medicare system, and care for seniors would be disrupted. Dubbed “Doc Fix,” Congress passed this rate cut, avoiding… [Read More]