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.

 

Massachusetts Insurance Commissioner: State Will Not Adopt Obama Initiative to Allow Individuals and Small Groups to Keep Their Cancelled 2013 Policies

November 20, 2013 at 9:18 am | Posted in Affordable Care Act, Creditable Coverage, Health Care | Leave a comment
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Massachusetts Commissioner of Insurance, Joseph Murphy, has advised the Obama Administration that Massachusetts will not accept the President’s November 14th transitional policy proposal that would allow a one year grace period for individual and small group health insurance coverage to keep their 2013 cancelled policies and to delay compliance with the essential benefits coverage (EBC) provision of the Affordable Care Act. The President’s policy proposal was in response to the uproar triggered by his representation that if “You like your plan, you can keep it” in conjunction with the cancellation of millions of policies that were not in compliance with the coming 2014 EBC requirement. The basis for the rejection of the President’s proposal was the state’s successful experience under Massachusetts Health Care Reform, the similarity of Massachusetts creditable coverage requirement, and the conclusion that to allow carriers to make the type of change proposed by the President would “cause confusion and significant market disruption.”

Click Here: to read Commissioner Murphy’s November 18th letter to the U.S. Department of Health and Human Services

And You Thought You Heard It All: Large Employer Sues Federal Government To Enforce Employer Mandate in 2014

October 8, 2013 at 12:01 pm | Posted in Affordable Care Act, Health Care, PPACA | Leave a comment
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(As reported in October 4, 2013 Journal of Accountancy)

While many large employers welcomed the IRS’s recent delay of the so-called employer mandate, requiring them to provide health coverage for their employees, an orthodontics practice in Florida filed suit on Tuesday to force the federal government to reinstate the original effective date of the Sec. 4980H shared-responsibility penalty that was passed as part of the Patient Protection and Affordable Care Act (PPACA), P.L. 111-148 (Kawa Orthodontics, LLP, No. 9:13-cv-80990 (S.D. Fla. complaint filed 10/1/13).

Under Sec. 4980H, “applicable large employers” that fail to provide minimum health coverage for employees are subject to the shared-responsibility penalty. An employer is an “applicable large employer” for a calendar year if, during the preceding calendar year, it employed on average at least 50 full-time employees. An employee is a full-time employee for any month if he or she was employed, on average, at least 30 hours per week.

The penalty was supposed to apply beginning in 2014, but, on July 2, the IRS announced that it was delaying it for one year because a delay in related reporting requirements made it difficult to determine whether employers were subject to the penalty.

The plaintiff in the lawsuit, Kawa Orthodontics LLC of Boca Raton, Fla., which has more than 50 full-time employees, claimed that it spent a considerable amount of money to comply with the employer mandate before the July 2 announcement to determine what options and obligations it had under the mandate and how its current health care coverage would be affected. The plaintiff claimed that delaying the mandate injured it by causing it to lose some or all of the value of the time and resources spent preparing for the mandate to go into effect.

The plaintiff also noted in its complaint that many other employers may have been adversely affected, mentioning the large number of employers with more than 50 employees in the United States, and it cited a Congressional Budget Office estimate that delaying the penalty for a year will cost the federal government $10 billion.

The plaintiff argued that the IRS had no statutory authority to delay the penalty because the statutory language of Sec. 4980H states that it applies to “months beginning after December, 31, 2013.” The plaintiff claimed that no adequate administrative remedy is available. The plaintiff also argued that the IRS’s action violated the Administrative Procedure Act, P.L. 79-404, because it was arbitrary, capricious, and contrary to the law. The plaintiff asked, among other things, that the court enter a preliminary and permanent injunction “prohibiting and setting aside” the unlawful delay of the employer mandate.

The court has ordered the parties to meet and to file a joint scheduling report, proposing a time for trial.

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