Short-Term Health Plans to Be Offered Beginning in October

The departments of Health and Human Services (HHS), Labor (DOL) and the Treasury (DOT) today issued a final rule allowing for the sale and renewal of short-term, limited-duration health plans that cover longer periods than the previous maximum period of less than three months. Such coverage can now cover an initial period of less than […]

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New York Leads Attorney General Coalition Fighting AHPs

Twelve “blue state” attorneys general, led by New York Attorney General Barbara Underwood, are taking the Trump administration to court over its final rule allowing the creation of newly invigorated Association Health Plans (AHPs). The coalition is targeting a final rule issued by the Department of Labor (DOL), which loosens and expands the definition of […]

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Three States Join Challenge to Constitutionality of Obamacare

With the addition of North Dakota, South Dakota and Wisconsin this week, the lawsuit against the constitutionality of the Affordable Care Act (ACA, or Obamacare) is now being waged in Texas — where the legal action originated — by a combined 23 states. The crux of the lawsuit, filed by the Texas attorney general, is […]

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CMS Cuts Obamacare Navigator Funding from $36M to $10M

The Affordable Care Act (ACA) Navigator program, which funds groups and individuals to help walk people through the Obamacare sign-up process, is being cut financially once again by the Trump administration, this time from $36 million to $10 million. In 2017, funding stood at $63 million. Regardless of the federal outlay, the Navigator program has […]

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ACA Risk-Adjusted Payments Halted after Judge’s Ruling

UPDATE: On Tuesday, July 24, the Trump administration restored the risk-adjusted payments to prevent “chaos” in the health insurance market. Risk-adjusted payments, a principal component of the Affordable Care Act (ACA, or Obamacare) that seeks to level the playing field among insurers, have been put on hold by the Centers for Medicare and Medicaid Services […]

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IRS Preparing to Send 2016 Obamacare Penalty Notices

Even as many applicable large employers (ALEs) grapple with Employer Shared Responsibility Penalty (ESRP) letters from 2015, the Internal Revenue Service (IRS) is preparing to issue more such letters — known as Letter 226-J — for 2015, with still more coming later this year for 2016. Still down the road later this year, the agency […]

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CMS Proclaims a ‘Death Spiral’ for Unsubsidized Obamacare Policyholders

Though the actual number of open enrollment Obamacare policyholders who paid their premiums the first month rose over 2017 by 3 percent — standing at 10.6 million people for 2018 — those seeking policies who didn’t qualify for subsidies fell by as much as one-third in many states, the Centers for Medicare and Medicaid Services […]

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Trump DOJ Announces It Will No Longer Defend the ACA in Court

Faced with a challenge by 20 attorneys general in a federal court in Texas, the Affordable Care Act (ACA) is going to trial with no defense from the Trump administration’s Department of Justice (DOJ). The case rests on the constitutionality — or unconstitutionality — of the health care act now that the individual mandate has […]

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New Jersey Institutes Statewide Obamacare Individual Mandate

New Jersey has become the second state to legislate an individual Obamacare-like health care mandate following the lead of Massachusetts, which instituted its mandate in 2006 when it passed Romneycare. The New Jersey mandate replaces the financial penalty for not having health insurance that Republicans in Congress repealed in December. In 2015 some 189,000 New […]

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U.S. to Spend $685 Billion on Health Care Coverage for Those Under 65 in 2018

The federal government subsidizes health insurance for most Americans through a variety of programs and tax provisions. In 2018, net subsidies for non-institutionalized people under age 65 will total $685 billion, the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) estimate. That amount includes the cost of preferential tax […]

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