Second Chance Open Enrollment Through April 30 For ObamaCare: How Will Employers React If a Second Chance Enroller Triggers an Employer Mandate Penalty?

February 23, 2015 at 9:04 am | Posted in Affordable Care Act, Health Care | Leave a comment
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The Hill reported today that the Obama administration (through CMS) will hold a second enrollment period for ObamaCare this year to give people a chance to avoid a new tax penalty for going without insurance. The enrollment period will run from March 15 to April 30, at the height of tax filing season, officials said. The announcement does not address the issue of whether any form of transitional relief would be available to a large employer who, until now, may have avoided a penalty under the employer mandate because of the failure of an employee to sign up for ACA coverage and possibly receive a premium subsidy. Arguably, such an employer would now be exposed again since employees lacking coverage will have another bite at the ACA health coverage subsidy apple.

Congressional Democrats and advocacy groups had been pushing for the new enrollment period, arguing that millions of people are still unaware of the penalty and should be able to sign up for ObamaCare once they learn of it. “Our intention in doing this is not to increase numbers for numbers sake, it’s to make sure that if there were people who were unaware of the fee that they aren’t disadvantaged by that,” Andy Slavitt, the Centers for Medicare and Medicaid Services’ deputy administrator, said on a call with reporters. The administration estimates that up to 6 million people will likely be forced to pay the fine for not having insurance during this year’s tax season, marking the first time that the penalty will be in effect. Officials said that they do not have an estimate for how many people will take advantage of the new enrollment period.
People signing up now will still have to pay a penalty for lacking insurance in 2014. Anyone who was uninsured last year will be hit with penalties of either $95 or 1 percent of their income — whichever is higher. That fine will spike this year to $325 or 2 percent of their income. Officials said that the new period is a one-year-only occurrence. “Our intention is that this is one year only for people who have not been in the communication loop around the tax penalty,” Slavitt said.
Separately, the administration announced that there had been an error on a tax return form for people with coverage under ObamaCare, causing some tax credits to be calculated either too high or too low. Officials said the problem affects around 50,000 people who have already filed their taxes, and that they are being contacted to correct the problem.
A link to the announcement can be found here: CMS Announces Special Enrollment Period for Tax Season

Democratic Pressure Builds to Reopen ACA Exchange Enrollment Through April

February 19, 2015 at 10:33 am | Posted in Affordable Care Act, Health and Human Services | Leave a comment
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The publication The Hill reported today that pressure is building on the Obama administration to give uninsured people a second chance to sign up for ObamaCare before they are required to pay a fine of $325 or 2% of their income, whichever is greater, during next year’s tax season. Democrats and several advocacy groups argue that people without insurance don’t realize they’re in danger of taking a significant economic hit.

“Millions upon millions of people are unaware about these penalties,” Ron Pollack, the executive director of the nonprofit group Families USA, said in a briefing Wednesday. The first time people will actually pay the fine is in this coming tax season. Just one-third of people without health insurance said they were aware of the healthcare law’s penalty in a March 2014 poll by the Kaiser Family Foundation. The administration estimates that as many as 6 million people will be forced to pay up this spring.

The pressure on the administration is coming from advocacy groups, Democratic lawmakers and states that are extending or adding to their enrollment periods. Minnesota on Wednesday became the second state to add a grace period through the end of tax season in April. California and New York – the two largest state exchanges – are also mulling an extension, as is Kentucky, state officials said Wednesday. California will decide by early next week whether to create the special period – an idea that the state’s health secretary said Wednesday that she supports. If the administration doesn’t provide another enrollment period, it could create a situation where residents of some states have more time to avoid the tax, while people on the 37-state federal exchange do not.

The administration hasn’t ruled out adding the enrollment period, and HHS Secretary Sylvia Mathews Burwell said Wednesday that she plans to make a decision by next Friday. Sen. Tammy Baldwin (D-Wis.) is leading a group of 10 Democratic senators this week who wrote a letter to Burwell urging a new period. Separately, Sander Levin (D-Mich.), the top Democrat on the Ways and Means Committee, signed a letter with two other Democrats to “strongly urge” the administration to give extra time.

 

2015 ACA Open Enrollment: More Than 6 Million Receive Premium Tax Credit

February 10, 2015 at 12:37 pm | Posted in Affordable Care Act, Health and Human Services, Health Insurance Marketplace | Leave a comment
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Yesterday the U.S. Department of Health and Human Services (HHS) released  a report outlining the impact of advanced premium tax credits on premiums in the Health Insurance Marketplaces. Almost 6.5 million individuals in the 37 states using the HealthCare.gov platform are estimated to qualify for an average of $268 per person/month in advanced premium tax credits. Among consumers who are signed up for 2015 coverage to date in the 37 HealthCare.gov states, 8 in 10 could choose a plan with a premium of $100 or less after tax credits, based on available options.

A copy of the full HHS announcement can be found here:

Almost 6.5 million consumers qualify for an average tax credit of $268 per month through the Health Insurance Marketplaces

Vast Majority of Enrollees for Health Care through Exchanges are Obtaining Premium Assistance

January 5, 2015 at 1:53 pm | Posted in Affordable Care Act, Health Insurance Exchanges, Health Insurance Marketplace, HHS | Leave a comment
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Last week, HHS released a report on Affordable Care Act enrollment data via the state and federal Healthcare Marketplaces/Exchanges. It is reported that approximately 87 percent of people who selected health insurance plans through HealthCare.gov for coverage beginning Jan. 1, 2015 were determined eligible for financial assistance to lower their monthly premiums, compared to 80 percent of enrollees who selected plans over a similar period last year. In addition, more than 4 million people in both the state and federal Marketplaces signed up for the first time or reenrolled in coverage for 2015 during the first month of open enrollment. That includes more than 3.4 million people who selected a plan in the 37 states that are using the HealthCare.gov platform for 2015, and more than 600,000 consumers who selected plans in the 14 states that are operating their own Marketplace platform for 2015.

 

A complete copy of the HHS Release can be found here: 87 Percent of Those Who Selected 2015 Plans in First Month of Open Enrollment Are Getting Subsidies

 

U.S. Supreme Court to Hear Challenge to ACA Exchanges and Subsidies on March 4th

December 30, 2014 at 10:00 am | Posted in Affordable Care Act | Leave a comment
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The U.S. Supreme Court will hear oral arguments on March 4th in the matter of David King et al. vs. Sylvia Burwell. The case examines whether the provisions in the ACA that created the public exchange system and the premium subsidy tax credits allow the federal exchanges (As opposed to state-run exchanges) run by the U.S. Department of Health and Human Services offer access to the tax credits and premium subsidies. The challengers assert that the ACA only permits state-based exchanges to offer the tax credits.

The 4th U.S. Circuit Court of Appeals ruled 3-0 in July on the King case that the ACA is so unclear that it does not indicate whether the HHS-run exchanges can offer the subsidies or tax credits but that another provision gives the HHS secretary the right to resolve ambiguous exchange program provisions.

The D.C. U.S. Circuit Court of Appeals ruled on the same day, however, in a similar case, Halbig et al. vs. Burwell et al., that the ACA’s statutory text clearly makes the subsidies available only through state-based exchanges. Notwithstanding the difference of opinions in the legal camps, there is a strong consensus that should the Supreme Court side with the D.C. Circuit Court of Appeals, the ACA’s exchanges and premium subsidy structure could unravel, and with it the penalties associated with the employer mandate. A decision is expected by late June 2015.

Supreme Court to Hear Legal Challenge Federal Subsidies and Obamacare in March

December 23, 2014 at 10:53 am | Posted in Affordable Care Act, Health Care, Regulations | Leave a comment
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Supreme Court to Hear Legal Challenge Federal Subsidies and Obamacare in March

The  Supreme Court announced that on  March 4th it will hear arguments in King v. Burwell.  The case addresses the concept of statutory construction and the issue of whether  the federal government can legally hand out healthcare subsidies in 34 states that have federal exchanges since they opted out of creating their own state based exchanges. The plaintiffs  filed their opening brief on Monday which advance the argument that the literal text of the ACA does not allow for subsidies at federal exchanges. If the subsidy arrangement is struck down, the ACA will essentially have two different sets of requirements and risks for employers and employees across the country that will turn on their state of residence. In November the Supreme Court announced that it would take up the case, surprising many court-watchers and healthcare experts, since the matter had yet to be heard on reconsideration by a full en banc panel of judges in the D.C. Circuit Court of Appeals. An earlier 3 judge panel had found the subsidies to be unauthorized under the ACA..

A copy of the plaintiff’s129 page  brief can be found here:  129-page document

Massachusetts: New $254 Million Health Exchange Website is working

November 18, 2014 at 2:30 pm | Posted in Affordable Care Act, Health and Human Services, Health Care, Health Insurance Marketplace, HHS, Medical, Wellness | Leave a comment
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by Steve LeBlanc, Associated Press

BOSTON (AP) — Massachusetts officials are reporting a successful weekend launch of the state’s revamped health insurance website, but cautioned of possible “hiccups” in the system with expected heavier traffic during the week.

Officials said Monday that in the first two days of the new federal open enrollment period, nearly 5,000 eligible people were immediately registered for state Medicaid coverage.

Nearly 7,000 others were able to complete the process of determining eligibility for plans that comply with the federal Affordable Care Act. They still need to review those insurance plans, choose one, and make their first month’s premium payment.

The successful rollout was in sharp contrast to a year ago, when a failed health exchange forced the state to place hundreds of thousands of residents into temporary Medicaid coverage and led to a costly overhaul of the website. The website woes were also an embarrassment for the state that provided a blueprint for the federal health care law.

Maydad Cohen, a special assistant to Gov. Deval Patrick, said Monday that the new website has proven stable and reliable — handling more than 57,000 visitors over the first two days of open enrollment.

“During the weekend we saw excellent performance of the website,” Cohen told reporters Monday. “We had a very successful, very exciting weekend.”

Of the nearly 7,000 people deemed eligible to obtain insurance through the state’s health insurance exchange during the weekend, about 3,600 individuals and families already have selected a plan and 137 already have paid their first month’s premium, state Health Connector officials said.

Those numbers will continue to climb as more people sign up for insurance.
Hundreds of call representatives also are assisting those looking to sign up for coverage, having trouble with the website or are unsure how to use it.

Cohen said one of the main reasons for high call wait times is that many of those seeking one-on-one help want to go through the entire application on the phone, something that can take 45 minutes or more per application.

Cohen urged those seeking to sign up for coverage to try the website first.

As a result of the previous website troubles, the state ended up putting more than 400,000 individuals into temporary subsidized insurance programs, including MassHealth, the state’s Medicaid program.

Secretary of Health and Human Services, John Polanowicz said between 175,000 and 225,000 of those were expected to enroll in new coverage, including through MassHealth.

Polanowizc said the number is lower than the 400,000 because of what he called the natural “churn” of subsidized care, with individuals losing their eligibility because they’ve found a job that offers insurance, or have obtained health care through a spouse, or have moved out of state.

Dec. 23 is the deadline to ensure coverage that starts on Jan. 1. Fixing the website hasn’t been cheap. The original cost of Massachusetts’ website was estimated at $174 million. That has jumped to $254 million.

The D.C. Circuit Court of Appeals Agrees to Rehear ACA State/Federal Exchange Argument: The Obama Administration Gets a Second Bite at the Apple

September 4, 2014 at 12:47 pm | Posted in Affordable Care Act, Health Insurance Exchanges | Leave a comment
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The D.C. Circuit Court of Appeals has agreed to rehear argument and revisit its earlier ruling striking down Affordable Care Act (ACA) subsidies issued through federal exchanges as opposed to state exchanges. The announcement of the second hearing is a procedural victory for the Obama administration, which suffered a defeat in late July when a three-judge panel voted 2-1 that subsidies issued through federal exchanges were not allowed under the ACA. The two judges voting to strike down the subsidy language were appointed by a Republican President. A decision by the full D.C. appellate court (11 judges), in which Democratic appointees outnumber Republican appointee, is scheduled for oral argument on December 17.

 

Thousands at Risk of Losing Health Insurance Acquired Through Federal Marketplaces

August 18, 2014 at 10:07 am | Posted in Affordable Care Act, Compliance, Health Insurance Exchanges, Health Insurance Marketplace | Leave a comment
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The Washington Post reported on August 14th that Federal health officials are warning hundreds of thousands of people who have bought health plans through the federal insurance exchange that their coverage will be cut off unless they quickly provide proof that their citizenship or immigration status makes them eligible to be insured through the new marketplace.

The warnings were mailed last week to 310,000 people in the three dozen states that rely on the exchange. The letters give the recipients until Sept. 5th to send copies of green cards, citizenship documents or other information showing that they qualify for the coverage. If they miss the deadline, their coverage will end on Sept. 30th.

This move is the first step the administration has taken to hold consumers accountable when information on their applications conflicts with records on file at federal agencies or is missing altogether.

The action will affect only people with lingering eligibility issues involving their citizenship or immigration status. They are included in about 2 million cases of several kinds of application discrepancies involving people who have obtained coverage through the exchange.

Federal health officials announced that they will take separate action soon to resolve an even larger group of cases with discrepancies: those in which the income people listed on their insurance applications is out of sync with their federal tax records. In cases of unresolved income inconsistencies, the government could reduce — or eliminate — people’s federal insurance subsidies but could not end their coverage.

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