Tag: ACA

  • Taxing Issues continued – whither will the ACA wither when the Supreme Court rules? | Jordan Shields, Partner

    March 10, 2020

    Tags: ,

    The biggest controversy, and the item that pushed the ACA over the goal line, was Chief Justice Roberts siding with his liberal colleagues and approving the law, based on disputed logic that likened the mandate penalty on individuals to a tax, and thus subject to federal approval (and Supreme Court affirmation).  When the federal government decided to eliminate the penalty, they also eliminated the Supreme Court justification for ACA continuation.  That was upheld in a recent US Court of Appeals decision (Fifth Circuit), saying the mandate is now unconstitutional.

    Now the states who joined the original suit and the House of Representatives have filed two petitions asking the Supreme Court to weigh in on the issue immediately for both its constitutional position and the ACA viability if the mandate is struck down.

  • Trust in God – All Others Pay Cash – the government goes after faith based plans | Jordan Shields, Partner

    March 3, 2020

    Tags: ,

    The concept is simple, just like insurance.  Get a group of people in a common pool to pay premiums, collected for the purpose of paying them back in claims.  The problem is it is not insurance, and there is a notable absence of protections against a run on the pool.  Christian cost-sharing ministries that enroll individuals are now facing scrutiny from several state regulators who believe that their claims about claims are not what they seem, and may lack the financial resources to allow faith to function.  Yes, the premiums are lower than what is found in the market, but so are the protections, with either internal or external caps and, of course, faith in the finances of the ministry group holding their money.  State regulators in New Hampshire, Colorado and Texas are doing some investigation on the practices, promises and reality of what is being offered.  Washington State has fined one of the larger health sharing ministries, Trinity Healthshare, $150,000 and banned it from offering its products to state residents.  Nevada has sent out a warning, with the Department of Insurance saying “they may seem enticing because they may be cheap, look and sound like they are in compliance with the ACA, when in reality these plans are not even insurance products.”  Texas has brought suit against Aliera Healthcare.

  • Let the dismantling continue – the ACA | Jordan Shields, Partner

    February 25, 2020

    Tags: ,

    The massive Further Consolidated Appropriations Act, passed in the waning days of December, made several substantive changes to the Affordable Care Act, a goal President Trump first trumpeted in his campaign and has continued to pursue since he began his office term.

    • Repeal of the Cadillac Tax – a classic case of “now that we have it, what do we do with it” given that it was going to charge many medical plan policyholders a tax for having a “rich” plan.  Revenue was supposed to pay for ACA reductions, so now what?
    • Repeal of the 2.3% medical excise tax (will the manufacturers reduce their pricing by a commensurate amount?)
    • Repeal of the Health Insurance Premium Tax (HIT) after 2020 (which carriers have been passing along two policyholders since it was imposed – and now?)

    There is no waiver or end to the PCORI (Patient Centered Outcomes Research Institute) tax, though no one is quite sure what the institute is doing.  This only applies to self-funded plans.

    It is also apparent that the Trump administration, following an executive order filed early in the term, has no intention of pursuing any further action on discrimination testing.

    The repeal of the three taxes, designed to pay for ACA coverage expansion, result in a collective loss of $373.3 billion over ten years.  No replacement for the revenue is suggested.

    There is also something in the bill regarding “silver loading” which deals with allowances for the premium tax credit for those who qualify for the subsidy.  The premium for the second lowest cost marketplace silver plan is used to determine the credit allowance.  As a result, carriers loaded the cost of the silver plan, despite the actual actuarial considerations.  If silver loading were prohibited, it is speculated that carriers would spread the load among all medical plans.  The expected increase was 11% for non-silver plans with a 5% reduction in silver plans.

  • Taxing Issues continued – whither will the ACA wither when the Supreme Court rules? | Jordan Shields, Partner

    March 10, 2020

    Tags: ,

    The biggest controversy, and the item that pushed the ACA over the goal line, was Chief Justice Roberts siding with his liberal colleagues and approving the law, based on disputed logic that likened the mandate penalty on individuals to a tax, and thus subject to federal approval (and Supreme Court affirmation).  When the federal government decided to eliminate the penalty, they also eliminated the Supreme Court justification for ACA continuation.  That was upheld in a recent US Court of Appeals decision (Fifth Circuit), saying the mandate is now unconstitutional.

    Now the states who joined the original suit and the House of Representatives have filed two petitions asking the Supreme Court to weigh in on the issue immediately for both its constitutional position and the ACA viability if the mandate is struck down.

  • Trust in God – All Others Pay Cash – the government goes after faith based plans | Jordan Shields, Partner

    March 3, 2020

    Tags: ,

    The concept is simple, just like insurance.  Get a group of people in a common pool to pay premiums, collected for the purpose of paying them back in claims.  The problem is it is not insurance, and there is a notable absence of protections against a run on the pool.  Christian cost-sharing ministries that enroll individuals are now facing scrutiny from several state regulators who believe that their claims about claims are not what they seem, and may lack the financial resources to allow faith to function.  Yes, the premiums are lower than what is found in the market, but so are the protections, with either internal or external caps and, of course, faith in the finances of the ministry group holding their money.  State regulators in New Hampshire, Colorado and Texas are doing some investigation on the practices, promises and reality of what is being offered.  Washington State has fined one of the larger health sharing ministries, Trinity Healthshare, $150,000 and banned it from offering its products to state residents.  Nevada has sent out a warning, with the Department of Insurance saying “they may seem enticing because they may be cheap, look and sound like they are in compliance with the ACA, when in reality these plans are not even insurance products.”  Texas has brought suit against Aliera Healthcare.

  • Let the dismantling continue – the ACA | Jordan Shields, Partner

    February 25, 2020

    Tags: ,

    The massive Further Consolidated Appropriations Act, passed in the waning days of December, made several substantive changes to the Affordable Care Act, a goal President Trump first trumpeted in his campaign and has continued to pursue since he began his office term.

    • Repeal of the Cadillac Tax – a classic case of “now that we have it, what do we do with it” given that it was going to charge many medical plan policyholders a tax for having a “rich” plan.  Revenue was supposed to pay for ACA reductions, so now what?
    • Repeal of the 2.3% medical excise tax (will the manufacturers reduce their pricing by a commensurate amount?)
    • Repeal of the Health Insurance Premium Tax (HIT) after 2020 (which carriers have been passing along two policyholders since it was imposed – and now?)

    There is no waiver or end to the PCORI (Patient Centered Outcomes Research Institute) tax, though no one is quite sure what the institute is doing.  This only applies to self-funded plans.

    It is also apparent that the Trump administration, following an executive order filed early in the term, has no intention of pursuing any further action on discrimination testing.

    The repeal of the three taxes, designed to pay for ACA coverage expansion, result in a collective loss of $373.3 billion over ten years.  No replacement for the revenue is suggested.

    There is also something in the bill regarding “silver loading” which deals with allowances for the premium tax credit for those who qualify for the subsidy.  The premium for the second lowest cost marketplace silver plan is used to determine the credit allowance.  As a result, carriers loaded the cost of the silver plan, despite the actual actuarial considerations.  If silver loading were prohibited, it is speculated that carriers would spread the load among all medical plans.  The expected increase was 11% for non-silver plans with a 5% reduction in silver plans.

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