Senate Releases Details of Its Obamacare ‘Repeal and Replace’ Legislation

Gearing up for a hoped-for vote before the July 4th holiday, the U.S. Senate (actually, its Republican leadership) this morning released details about its proposed Better Care Reconciliation Act of 2017 in pursuit of the GOP’s goal to “repeal and replace” the Affordable Care Act (ACA, or Obamacare).

The measure is similar to but more moderate than the previously passed House of Representatives bill, the American Health Care Act (AHCA).

The inclusion of “reconciliation” in the title is reflective of the only route whereby the Republicans can get past a Democrat filibuster to pass the legislation — using their majority role and a process called reconciliation. This means that the Republicans can lose only two votes from their ranks and still be able to pass the measure with Vice-President Mike Pence casting the tie-breaking vote as Senate President.

Here are the key elements of the legislation:

  • Repeal the individual mandate that all Americans must buy health insurance or pay a penalty, retroactive to Jan. 1, 2016; likewise, end employer shared responsibility (play or pay)
  • Retain the ACA rule that insurers cannot deny coverage to those with pre-existing conditions, or charge them more, but unlike the ACHA, does not allow states to opt out of this
  • Give states waiver rights to opt out of many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment
  • Allow states to set up work requirements for those applying for Medicaid
  • Continue the payment of cost-sharing reductions (CSRs) to insurers for at least two years to help lower the cost of policies for low-income individuals
  • Change the age rating to 5:1 from the ACA’s 3:1, meaning insurers will be able to charge older adults five times more than young adults
  • Provide $15 billion for a “State Stabilization Fund” to help lower the price of premiums and increase health coverage for 2018 and 2019. The fund would also provide $10 billion a year in 2020 and 2021
  • Expand the annual contribution limits to Health Savings Accounts (HSAs) from $3,400 to $6,700 for individuals and from $6,650 to $13,300 for families
  • Reduce the federal government’s portion of state-managed Medicaid expenses to 57 percent over seven years from the current 90 percent
  • Put the entire Medicaid program on a budget, ending the open-ended entitlement that now exists
  • Repeal the 3.8 percent tax on net investment income retroactive to Jan. 1, 2017
  • Mirror the AHCA’s use of tax credits to help consumers pay for health insurance
  • Peg insurance tax credits to income like the ACA does, and not to age as the AHCA does
  • Reduce the top income level to qualify for a premium tax credit from 400 to 350 percent of the federal poverty level, starting in 2020 (from about $98,000 annually for a family of four to about $86,000 a year)
  • Prohibit those who use tax credits to buy insurance from purchasing plans that fund abortions
  • End funding for Planned Parenthood
  • Establish a $2 billion fund for states for programs to “support substance use disorder treatment and recovery support services for individuals with mental or substance use disorders”

READ THE ENTIRE BILL HERE


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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GSA Orders Fair Pay and Safe Workplaces Clause Stricken from Federal Contracts

The Fair Pay and Safe Workplaces Final Rule, which required anyone bidding for a federal contract to voluntarily report any state or federal labor law violations when applying, has already been killed twice — by legislative and executive action — since Donald Trump was sworn in, and now the General Services Administration (GSA) has ordered it stricken from any contracts.

The recently issued GSA memorandum on the rule states  that no solicitations and contracts dated after Jan. 1, 2017, should contain language based on the Fair Pay and Safe Workplaces Final Rule. If a contract issued after that date contains language pertaining to the rule, the GSA says the contract should be rewritten. Future contracts are barred from containing such language as well.

The Obama-era rule, when it came out, was quickly dubbed the “Blacklisting” and “Bad Actors” executive order because it required anyone bidding for a federal contract to reveal adverse legal and regulatory actions upon applying.

Since the final implementing rule was promulgated with fewer than 60 legislative days remaining, the new 2017 Congress, dominated by business-friendly Republicans, was able to use the Congressional Review Act (CRA) to pass a resolution disabling the rule, while President Trump was able to use his pen to issue an executive order countermanding the original presidential order.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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HHS Faces 500 Million Cyber Attacks Each Week

Beth Killoran, the chief information officer (CIO) for the Department of Health and Human Services (HHS), recently told a tech conference that her department faces “500 million cyber hack attempts each week” due to the millions of medical records that HHS data centers control.

“That’s going to go up,” she said at the MarkLogic Data Integration Summit June 20. “Because health data is the one thing about you that you can’t change, and it’s very powerful information, and the value of that data is going to go up.”

Killoran said HHS maintains “one in three Americans’ PHI [personally identifiable information].”

The CIO admitted that her agency’s biggest challenge is putting all the data to “meaningful use.” She said the goal is to expand avenues of communication between health care professionals and patients and also expanding “telehealth practices.”


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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MSHA Launches Training Assistance Program for Miners

Data recently compiled between October 2015 and March 2017 by the Mine Safety and Health Administration (MSHA) shows that less experienced miners – both at a mine and at a specific occupation – suffer injuries at a higher rate than more experienced miners.

Over this 18-month period, miners with one year or less of experience at a mine suffered 903 injuries, compared to 418 for those who had worked at a mine between one and two years. Miners with one year or less job experience suffered 603 injuries, compared to 409 for those with between one and two years job experience.

Thus, MSHA this week launched a Training Assistance Initiative throughout the nation’s coalfields to address the causes and trends in recent coal fatalities. On June 12, 2017, the agency began informing mine operators of the initiative’s planned launch, and encouraged them to participate and provide information about miners hired within the previous 12 months, and those in their current job for 12 months or less. With this information, MSHA can better focus its resources on the greatest fatality and injury risks.

“Of the eight coal mining fatalities so far in 2017, seven involved miners with one year or less experience at the mine, and six involved miners with one year or less experience on the job,” said Patricia W. Silvey, deputy assistant secretary of labor. “We at MSHA will be working closely with mine operators and miners to eliminate these fatalities.”

The initiative runs through Sept. 30, 2017.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Executive Order Seeks to Expand Apprenticeships

Secretary of Labor Alexander Acosta on June 15 welcomed President Donald J. Trump’s step toward fulfilling his promise to grow the American economy with the announcement of an executive order to expand apprenticeships and vocational training, close the skills gap and reduce regulatory burdens on workforce development programs.

“There are six million job openings in the United States,” said Secretary Acosta. “This is the highest number of job vacancies on record. American companies want to hire Americans, and Americans want to work. Apprenticeships teach the skills needed to find good jobs and to succeed in those jobs. Apprentices are a proven pathway to helping businesses find the workers they need, while helping workers launch prosperous careers without the crushing burden of student debt.”

President Trump signed the executive order expanding apprenticeship programs and vocational training at a White House ceremony that was also attended by Secretary of Commerce Wilbur Ross; Rep. Bobby Scott; Rep. Virginia Scott; the head of the Small Business Administration, Linda McMahon; several governors and a number of apprentices. In their remarks, the president and Secretary Acosta praised the White House Office of American Innovation and Ivanka Trump, a presidential adviser, for their leadership on this initiative.

The executive order calls on the Secretary of Labor, in consultation with the secretaries of education and commerce, to propose regulations that promote the development of apprenticeship programs by industry and trade groups, nonprofit organizations, unions and joint labor-management organizations. It also directs the departments of Commerce and Labor to promote apprenticeships to business leaders in critical industry sectors, including manufacturing, infrastructure, cybersecurity and health care.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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DOL to Request Public Input on Stalled Overtime Rule

Labor Secretary Alexander Acosta informed a House subcommittee on June 7 that the Department of Labor (DOL) will submit a Request for Information  (RFI) to seek input on the Obama-era overtime rule that has been blocked for half a year by a federal judge’s injunction.

An RFI is a “pre-rulemaking” procedure during which an administrative agency, such as the DOL, asks the regulated community for input on a topic or topics. The topic for this RFI is the overtime rule that would have raised the salary threshold for overtime pay exemption from $23,660 a year to $47,476.

The Obama administration filed an appeal on the injunction, and a hearing before the 5th U.S. Circuit Court of Appeals is currently on hold at the request of the Trump administration.

In his confirmation hearing, Acosta said he thought the salary threshold increase far outpaced inflation and should be scaled back. Now the public, employers and employees alike, will get a chance to weigh in.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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CMS Releases County-by-County Map of Obamacare Insurance Options

The Centers for Medicare & Medicaid Services (CMS) has released a county-level mapcounty-by-count-map-of-obamacare-options of 2018 projected Health Insurance Exchanges participation based on the known issuer participation public announcements through June 9, 2017. This map shows that insurance options on the Exchanges continue to disappear. Plan options are down from last year and, in some areas, Americans will have no coverage options on the Exchanges, based on the current data.

“This is yet another failing report card for the Exchanges. The American people have fewer insurance choices and in some counties no choice at all. CMS is working with state departments of insurance and issuers to find ways to provide relief and help restore access to healthcare plans, but our actions are by no means a long-term solution to the problems we’re seeing with the Insurance Exchanges,” said CMS Administrator Seema Verma.

The CMS map displays point in time data and is expected to fluctuate as issuers continue to make announcements on exiting or entering specific states and counties. It currently shows that nationwide 47 counties are projected to have no insurers, meaning that Americans in these counties could be without coverage on the Exchanges for 2018. It’s also projected that as many as 1,200 counties – nearly 40% of counties nationwide – could have only one issuer in 2018. Currently, for 2018 at least 35,000 active Exchange participants live in the counties projected to be without coverage in 2018, and roughly 2.4 million Exchange participants are projected to have one issue.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Age Discrimination Persists, EEOC Public Meeting Concludes

Persistent age discrimination and stereotypes about older workers continue to channel older workers out of the workforce, limiting further economic growth, experts told the Equal Employment Opportunity Commission (EEOC) at a public meeting titled “The ADEA @ 50 – More Relevant Than Ever,” held at agency headquarters in Washington, D.C.

“With so many more people working and living longer, we can’t afford to allow age discrimination to waste the knowledge, skills, and talent of older workers,” said Acting Chair Victoria A. Lipnic. “Outdated assumptions about age and work deprive people of economic opportunity and stifle job growth and productivity. My hope is that 50 years after the enactment of the Age Discrimination in Employment Act (ADEA), we can work together to fulfill the promise of this important civil rights law to ensure opportunities are based on ability, not age.”

Nearly two-thirds of workers age 55-64 report their age as a barrier to getting a job, as reported by a 2017 AARP survey. A comprehensive study in 2015 using resumes for workers at various ages found significant discrimination in hiring for female applicants and the oldest applicants, according to a co-author of the research, Patrick Button, Assistant Professor of Economics at Tulane University and a researcher with the National Bureau of Economic Research Disability Research Center (NBER).

(more…)


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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HHS Seeks Input on Remediating ‘Burdensome’ Obamacare Regulations

The Department of Health and Human Services (HHS), following an executive order to review all regulations to relieve unnecessary burdens on people, businesses and institutions, is now asking for public input on regulations in the Affordable Care Act, with the goal of identifying burdensome ones and fixing or eliminating them.

Here is the exact language from the department’s request for information (RFI) published in the Federal Register:

Among HHS’s goals is to establish a robust and resilient framework for each HHS division to undertake a periodic, thoughtful analysis of its significant existing regulations issued under Title I of the PPACA, to determine whether each rule advances or impedes HHS priorities of stabilizing the individual and small group health insurance markets; empowering patients and promoting consumer choice; enhancing affordability; and returning regulatory authority to the States. We seek public input on changes that could be made, consistent with current law, to existing regulations under HHS’s jurisdiction that would result in a more streamlined, flexible, and less burdensome regulatory structure, including identifying regulations that eliminate jobs or inhibit job creation; are outdated, unnecessary, or ineffective; impose costs that exceed benefits; or create a serious inconsistency or otherwise interfere with regulatory reform initiatives and policies.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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DOL to Seek Public Input on Persuader Rule

The Department of Labor (DOL) has announced it will publish a Notice of Proposed Rulemaking (NPRM) to rescind a rule that would have required employers and labor-management consultants to report consultants’ indirect contact with workers during union organizing campaigns.

The NPRM will be published in the Federal Register and be open for public comment on June 12. The public may submit comments, identified by RIN 1245-AA07, through the Federal eRulemaking Portal, at http://www.regulations.gov. All comments received will be posted without change to the site. The public inspection copy of the NPRM can be viewed on the Federal Register’s website at https://www.federalregister.gov/documents/2017/06/12/2017-11983/interpretation-of-the-advice-exemption-in-the-labor-management-reporting-and-disclosure-act.

Commonly referred to as the “Persuader Rule,” the regulation was published in March 2016. In November of that year, the U.S. District Court for the Northern District of Texas issued a nationwide permanent injunction against the rule. More information is available on the Office of Labor-Management Standards website, https://www.dol.gov/olms/regs/compliance/ecr_finalrule.htm.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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