Tim Jost: Continuing Litigation Involving the Affordable Care Act

Within minutes of President Obama signing the Affordable Care Act into law in 2010, lawsuits were filed challenging its constitutionality.  Over the next six years, dozens of cases were filed challenging the ACA or Obama administration regulations implementing it.  Although most of these cases were dismissed, four made it to the Supreme Court, including one that dramatically changed the scope of the ACA’s coverage of the uninsured by making the Medicaid expansions optional with the states.  Many challenges were brought by Republican attorneys general, who championed the battle against the signature legislative triumph of a Democratic administration.

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CMS eliminates barrier to ACA Individual Mandate Exemption

Consumers who abandoned the Obamacare exchanges this year are entitled to a “hardship” exemption to the individual mandate penalty, CMS publicized Wednesday. This will directly affect people who chose to go uninsured or who enrolled in coverage that doesn’t comply with Obamacare protocols. This follows the agency’s April guidance that expanded the exemption to people who live in rural counties or have claims going back to 2016, but applicants still had to give a written explanation for why they required the exemption.

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Texas ACA lawsuit to begin: What you need to know

Today, a Texas lawsuit will be heard determining pivotal laws and regulations concerning the Affordable Care Act. Republican attorney generals, led by Texas’ Attorney General Ken Paxton, will go against the Democratic party, led by California’s Attorney General Xavier Becerra, to debate the fate of the ACA. U.S District Judge Reed O’Connor will hear both sides and determine whether the health law should be put on hold while the case is being contested. GOP Plaintiffs are looking for a “preliminary injunction” on the law.

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NPAG 2018 Recap

Excellus Blue Cross Blue Shield was pleased to host the 2018 National Plan Automation Group (NPAG) Conference in picturesque Lake Placid, NY. The event showcased 4 days of interactive sessions exploring opportunities in EDI, electronic payments, health records, “HEDIS,” and the past, present, and future of authorization transactions. While NPAG sponsored a progressive networking retreat, attendees took advantage of Lake Placid Golf Club, Ausable Chasm, and an adventurous BobSled Experience.

In case you were not able to attend, here’s our recap of what was discussed:

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CMS restores Affordable Care Act risk-adjustment transfers for 2017 benefit year

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released a final rule designed to allow and reissue payments under the Affordable Act risk-adjustment program to balance the insurance market. According to CMS Administrator Seema Verma, “This rule will restore operation of the risk adjustment program and mitigate some of the uncertainty caused by the New Mexico litigation.”  

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The ACA’s vision of a reformed small-group market

Although the political controversy surrounding the Affordable Care Act has focused primarily on its extension of coverage through the individual market and Medicaid expansions, Congress also intended the ACA to reform extensively reform the small-group market. In the decade preceding the ACA, small-group health insurance premiums had more than doubled while the percentage of small firms offering coverage dropped from 66 to 59 percent. Administrative costs and employee cost sharing charges were high and benefits offered by some employers were skimpy. 

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Iowa gov. expected to sign off on legislation allowing some health plans to avoid Affordable Care Act mandates

This week, Iowa senators approved controversial legislation that would make certain health plans exempt from Affordable Care Act mandates. If signed into law, the bill would have a significant impact on the way many Iowans receive health coverage.

The legislation, approved in a 37-11 vote, combines two proposals that would do the following:

  • Allow the Iowa Farm Bureau Federation to partner with Wellmark Blue Cross/Blue Shield to offer an association health plan to qualifying participants
  • Allow multiple small businesses to band together to provide health coverage for their employees under plans that would not be regulated by the state insurance commissioner or subject to ACA rules and regulations.

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