IRS to propose rules clarifying ACA penalties

The Internal Revenue Service has drafted a collection of proposed regulations that could determine whether some taxpayers will owe fines for failing to get health coverage.

The individual mandate section in the Patient Protection and Affordable Care Act requires some taxpayers who fail to own a minimum amount of major medical coverage, or “minimum essential coverage,” to pay the fines.

Some sections in the proposed IRS regulations will exempt some people in limited-benefit government programs from paying the fines.

Those affected include state programs for the medically needy, Medicaid pilot programs, and two programs that give people some access to military health care services.

The IRS assumes many enrollees are confused.

Rules on equal coverage delayed

WASHINGTON (Reuters) - The Obama administration is delaying enforcement of a provision of the new healthcare law that prohibits employers from providing better health benefits to top executives than to other employees, the New York Times reported on Saturday.

Tax officials said they would not enforce the provision this year because they had yet to issue regulations for employers to follow, according to the Times.

Internal Revenue Service spokesman Bruce Friedland said employers would not have to comply until the agency issued regulations or other guidance, the newspaper reported.

The IRS was not immediately available to confirm the Times story.

The rollout of the Affordable Care Act, known as Obamacare, has been marked by a number of delays in implementing certain parts of the law. In November, the administration announced a one-year delay in online insurance enrollment for small businesses.

U.S. judge upholds subsidies pivotal to Obamacare

WASHINGTON (Reuters) - A judge on Wednesday upheld subsidies at the heart of President Barack Obama's healthcare overhaul, rejecting one of the main legal challenges to the policy by conservatives opposed to an expansion of the federal government.

A ruling in favor of a lawsuit brought by individuals and businesses in Texas, Kansas, Missouri, Tennessee, West Virginia and Virginia would have crippled the implementation of the law by making health insurance unaffordable for many people.

In his ruling, U.S. District Judge Paul Friedman in Washington D.C. wrote that Congress clearly intended to make the subsidies available nationwide under the 2010 Patient Protection and Affordable Care Act.

Marketplace Enrollment Numbers

The U.S. Department of Health and Human Services released the most detailed information on people who enrolled in health plans through either the federally run marketplace or exchanges operated by 15 states and the District of Columbia.

Almost 2.2 million people enrolled in health plans through Dec. 31 in the federal and state marketplaces. (No data has been released on how many enrollees have secured their enrollment with their first premium payment.) Most residents enrolled in December.

Of the almost 2.2. million:

Statement of the Virginia Bureau of Insurance Regarding Extension of Individual and Small Group Health Insurance Plans

Virginia regulators say they may not have legal authority to require insurers to extend cancelled health policies as long as two years, as President Barack Obama requested last week.

The Bureau of Insurance instead asked insurance carriers today to give individual and small group market customers the option of renewing their existing policies early to extend coverage into 2014, as insurers already have done in many cases for people with policies that do not comply with higher standards under the Affordable Care Act.

HealthCare.gov won't be fixed by end of the month

The Washington Post is reporting that an official with knowledge of the technological demands on the government's online health insurance marketplace says it is not likely the site will be fully functional by the end of the month, as the Obama administration has promised.

Here's Why So Many Americans Are Getting Letters Saying Their Health Insurance Is Canceled

"If you like your health care plan, you can keep your health care plan." This was one of President Obama's key talking points when selling the Affordable Care Act, and it was never true — as many of the 14 million Americans currently covered by individually-purchased health plans are now learning.

As Kaiser Health News reports, individual market insurers are sending out rafts of cancellation notices, telling subscribers they have to change to new plans starting in 2014. Here's why:

Top 4 Obamacare Complaints

The debut of the Obamacare health insurance exchanges has been anything but smooth.

Three weeks after the exchanges opened, Americans are still having a tough time signing onto the Obamacare websites. And once they manage to get in, many aren't so happy with what they're finding.

Homework involved to apply for health insurance

Article from the AP:

WASHINGTON (AP) -- Getting covered under President Barack Obama's health care law might take you more than one sitting. In a media preview, it felt like a cross between doing your taxes and making an important purchase that requires research.

"Nothing like this has ever existed before," said Health and Human Services Secretary Kathleen Sebelius.

You'll need accurate income information for your household, plus some understanding of how health insurance works, so you can get the financial assistance you qualify for and pick a health plan that's right for your needs.

Things to Know About Health Insurance Today

Today begins the biggest expansion of health insurance since Medicare. According to the Congressional Budget Office (PDF), an estimated 7 million Americans will buy private health plans through the new online marketplaces known as insurance exchanges, which are now opening nationwide. That number is expected to more than triple in the years ahead.

 

It could be a bumpy launch, with technical problems and public confusion.

 

Here are 10 things you need to know about the insurance exchange program:

DOL Releases Guidance on HRAs, Health FSAs and Certain Other Employer Healthcare Arrangement Options

On Friday, September 13, 2013, the DOL and the IRS issued guidance on how the annual limit and preventive services rules in the Affordable Care Act (ACA) apply to HRAs.

IRS Notice 2013-54 and DOL Technical Release 2013-03 provided much-awaited answers to questions about what types of HRAs comply with these ACA rules. The guidance also addressed Employee Assistance Programs (EAPs). The Notice and Technical Release mirror each other. The guidance applies to plan years starting on or after January 1, 2014. Additional regulatory guidance will be forthcoming.

Dear seniors, your Medicare benefits aren't changing under the Affordable Care Act

Dear seniors, your Medicare benefits aren't changing under the Affordable Care Act. That's the message federal health officials are trying to get out to elderly consumers confused by overlapping enrollment periods for Medicare and so-called "Obamacare."

Medicare beneficiaries don't have to do anything differently. Medicare open enrollment starts Oct. 15 and closes Dec. 7, while enrollment for the new state exchanges for people 65 and under launches Oct. 1 and runs through March. 

Next month, roughly 50 million Medicare beneficiaries will get a handbook in the mail with a prominent Q&A that stresses Medicare benefits aren't changing.

AP Article:  http://finance.yahoo.com/news/health-overhaul-confuses-medicare-beneficiaries-141050243.html. 

COBRA and the ACA: Compatible or Irreconcilable?

Several key provisions of the Affordable Care Act (ACA) have now been delayed. When the ACA has fully achieved lift off, what will become of COBRA?

 

The simple answer is that COBRA will continue to fly, until and unless another law permanently grounds it. Here are some observations around the interplay between the ACA and COBRA:

• The ACA likes COBRA. Parts of the ACA looked to COBRA concepts as the gold standard for calculations. Case in point is W-2 reporting of health care coverage in IRS Notice 2012-09. More recently, the DOL thought COBRA was important enough to update the Model Election Notice when it released the Exchange Notice. Click here for our article.
• The DOL likes COBRA. Look at this DOL FAQ, which states that the ACA “did not eliminate COBRA or change the COBRA rules.” making it clear that COBRA is not going away. And take a gander at this lengthy 25-year proclamation by the DOL from 2011.
• COBRA fills some ACA gaps. Granted, the Health Insurance Marketplace will provide COBRA qualified beneficiaries with some alternatives for medical coverage. In some cases, the alternatives may be cheaper, but that is not certain. Also, understand that stand-alone dental, vision, prescription drugs are not required to be offered in the marketplace. Neither are flexible benefits like HRAs and Health FSAs. COBRA offers these benefits to the extent that they are employer-sponsored coverage.
• To some extent, the marketplace likes COBRA. To some extent, the Marketplace coordinates with COBRA. For example, take your most common reason for termination of COBRA: premium non-payment. If a qualified beneficiary loses coverage because of non-payment, this person is not entitled to a special enrollment period for Marketplace coverage and must wait until the annual enrollment period. Another thing to consider is when the Marketplace opens in 2014, small employers can obtain Marketplace coverage through the Small Business Health Options Program (SHOP). This coverage would be subject to COBRA because it is employer-sponsored coverage.

 

This is COBRA’s current status: a valid law. The ACA did not change COBRA, as the DOL has pointed out.

 

COBRA and the ACA: Compatible or Irreconcilable? | Infinisource Newsroom

Employer mandate delay, minimum value, out-of-pocket maximum cost sharing: Is there a connection?

Recent headlines from certain news outlets are leading some to think that the out-of-pocket maximum and minimum value plan certification parts of the Affordable Care Act (ACA, or health care reform law) have been delayed until 2015. This is not true. The delay is for combining a shared out-of-pocket maximum for plans that have “multiple service providers” (like a separate pharmacy benefits manager). Medical plans, new and renewing January 1, 2014, and later do need to have out-of-pocket maximums that are not more than $6,350 for single coverage and $12,700 for coverage of spouse or family. Our plans and systems are being updated so that cost shares do not go over the out-of-pocket maximum.

To help sort out the facts from fiction, read this fact sheet that tells what the link is among the employer mandate, the parts that were delayed, the minimum value plan certification requirement and the out-of-pocket maximum cost sharing rule.

Article Courtesy:  Anthem BCBS

A Limit on Consumer Costs is Delayed in Health Care Law

New York Times
WASHINGTON - In another setback for President Obama's health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care.

The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.

The grace period has been outlined on the Labor Department's Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about the language - which appeared as an answer to one of 137 "frequently asked questions about Affordable Care Act implementation" - department officials confirmed the policy.

U.S. relaxes health law income - Health markets to employ honor system

As reported by the Washington Post:

The Obama administration announced Friday that it would significantly scale back the health law's requirements that new insurance marketplaces verify consumers' income and health insurance status.
Instead, the federal government will rely more heavily on consumers' self-reported information until 2015, when it plans to have stronger verification systems in place.

The delay comes after a Tuesday announcement that the federal government would postpone for one year a requirement that employers with 50 or more full-time workers provide health coverage.

"I think that Health and Human Services is doing the best that it can under the circumstances," said Sara Rosenbaum, a health policy professor at George Washington University.

The verification systems are meant to determine who qualifies for new benefits under the Affordable Care Act. The law includes tax subsidies to purchase health insurance for Americans who earn less than 400 percent of the poverty line, about $45,000 for an individual.

Those earning less than 133 percent of the poverty line - about $15,000 - will qualify for Medicaid coverage in the District and 23 states that have decided to expand the program.

The federal government also needs to know who receives health insurance coverage from an employer. Consumers who receive affordable health insurance from their company under a policy that costs less than 9.5 percent of their income do not qualify for tax credits under the Affordable Care Act.

Young Americans may dodge health law; For 20-somethings, penalty may be preferable to buying insurance

Young Americans may have been among the biggest supporters of Obamacare, but they may also be the least likely to comply with the law.

The architects of health reform say the law will make insurance more affordable and widely available. But in 2014, benefits experts say, the cheapest option for 20-somethings will be to pay the penalty for not buying health insurance, rather than paying for any health insurance at all—that is, provided they don’t get sick.

And as more young people do the math, more seem to be deciding the Affordable Care Act isn’t such a good deal for them: Support for a national health-care plan dropped nearly 11% among American college freshmen between 2008 to 2012, with under 63% in favor of it today, down from 70%, according to UCLA’s annual student survey.

Next year, uninsured Americans must pay a penalty of $95, or 1% of their annual salary if they make more than $9,500 for the year. A person earning $50,000, for example, would pay a $500 penalty if they chose not to enroll in a health insurance plan.

Gov't Report: Smooth Launch Unsure for Health Law

There's no guarantee that President Barack Obama's health care law will launch smoothly and on time, congressional investigators say in the first in-depth independent look at its progress.
But in a report to be released Wednesday, the congressional Government Accountability Office also sees positive signs as the Oct. 1 deadline approaches for new health insurance markets called exchanges to open in each state - in many cases over the objections of Republican governors.

Additionally, the report discloses that the administration had spent nearly $400 million as of March to set up the infrastructure of a sprawling system involving major federal agencies, every state, hundreds of insurance companies, and millions of citizens, among them many individuals seeking coverage for the first time.

"Whether (the administration's) contingency planning will assure the timely and smooth implementation of the exchanges by Oct. 2013 cannot yet be determined," the report concluded. A copy was provided to The Associated Press.

Final Rules on Employment Based Wellness Programs Released

On May 23, 2013, the DOL, Treasury and HHS finalized the HIPAA Nondiscriminatory Wellness Programs Regulations that were proposed in November 2012, clarifying what will work and what will not work for 2014 and beyond.

 

The accompanying news release stated that the “final rules ensure flexibility for employers by increasing the maximum reward that may be offered under appropriately designed wellness programs.”

Will Health Care Reform Make Workers Cheaper to Insure?