According to the White House, 28 states are “on their way” to establishing new marketplaces, called health insurance exchanges, where consumers can begin to shop for health insurance starting January 1st, 2014.
Nancy-Ann DeParle, White House Deputy Chief of Staff, remarked, “States are taking strong steps to implement health reform. The Obama Administration is working in partnership with State leaders across the country... we will ensure Americans in every State have access to an Exchange and the same kinds of insurance choices as Members of Congress.”
But does that mean 22 states will not be ready in time? Administration officials said ““it would be premature at this point” to draw that conclusion.
While the government is reviewing another round of grant proposals to assist states, some states, including Wisconsin and Kansas, have said they plan to give the grant back. Last week, South Dakota’s governor said there is
too much uncertainty for the state to move ahead with an exchange until after it learns the results of the Supreme Court case challenging the law, and the outcome of the November Presidential election.
Will that be too late?
“If states decide after the Supreme Court decision, we will work with them to get them as far down the path as possible,” said the official, noting that a state initially could do a partnership with the federal government, if necessary, then get certified to run its exchange solo after that. Residents in states that can’t — or won’t — run their own exchanges will be directed to a federally facilitated fallback exchange.
Still, some policy experts have questioned whether the federal government will have its backup system up and running by the time enrollment is set to open in the fall of 2013. “We are making substantial progress of development of federal exchanges,” the official said, “including signing contracts with private sector vendors to create the systems.”
Do you think the state exchanges will be ready?
Note: None of this should be taken as legal or tax advice.
As part of the
Affordable Care Act (ACA), employers are required to report the cost of health benefits coverage under an employer-sponsored group health plan.
Last week,
the IRS issued a notice confirming that employers
are not required to include the cost of coverage under a
Health Reimbursement Arrangement (HRA) on employee W-2s. If the only coverage provided to an employee is an HRA, the employer is not required to report any amount on the Form W-2 for that employee.
According to
Notice 2012-9, the IRS is granting permanent relief to employers that sponsor HRAs:
"Q-18: Is the cost of coverage under a Health Reimbursement Arrangement (HRA) required to be included in the aggregate reportable cost reported on Form W-2?
A-18: No. An employer is not required to include the cost of coverage under an HRA in determining the aggregate reportable cost. If the only applicable employer-sponsored coverage provided to an employee is an HRA, the employer is not required to report any amount under §6051(a)(14) on the Form W-2 for that employee."
Click here to read the full notice.
Note: None of this should be taken as legal or tax advice.
Citing rising costs, Arizona and Hawaii are next in line for federal approval to limit hospital stays for
Medicaid members.
The USA Today recently reported that Arizona plans to limit Medicaid member stays to 25 days per year starting as early as October 2011, while Hawaii plans to limit stays to 10 days per year beginning April 2012.
Opponents argue that the moves will:
- Restrict access to health care.
- Result in higher costs to health care providers (hospitals).
- Result in higher costs for patients with private insurance.
States argue that the moves are an absolute necessity due to the economic downturn and the end of federal stimulus dollars.
What affect do you think this move will have?
Note: None of this should be taken as legal or tax advice.
Tuesday, April 12th, 2011 marked the five-year anniversary of
Massachusetts' 2006 State Health Care Reform. The reform was signed into law by then-governor Mitt Romney with the goal of providing affordable health insurance coverage to the estimated 6% of Massachusetts residents that were uninsured at the time.
Massachusetts State Health Care Reform and the
Affordable Care Act are virtually identical. Both reforms rely heavily on state-based health insurance exchanges, subsidies for qualifying individuals, and mandates for employers and individuals. As a result, Massachusetts presents the most appropriate example of what to expect from federal health care reform.
So, what have we learned from Massachusetts state reform? The 2006 Massachusetts State Health Care Reform:
- Created the MAHealthConnector (a state health insurance exchange) to provide guaranteed issue health insurance to MA residents;
- Mandated that every resident of the state obtain a minimum level of health insurance or face penalties;
- Mandated that employers provide a "fair and reasonable contribution" to their employees' health insurance premiums or face penalties; and
- Provided free health insurance and partially-subsidized insurance to qualifying residents based on income.
Proponents of the law argue that Massachusetts Health Reform:
- Has resulted in Mass. being the state with the highest percentage of insured residents, at 98% in April 2011, including 99.8% of children.
- Has increased the percentage of private companies that offer health insurance from 70% in 2005 to greater than 77% today.
- Has lowered the cost of individual health insurance premiums in Mass. due to the fact that primarily healthy people have moved to the individual market.
Opponents of the law argue that Massachusetts Health Reform:
- Has increased costs for its residents, $13,788 for a family of four in 2010, in the state that already had the highest medical costs in the nation prior to implementation.
- Was setup for failure from the start due to its reliance on employer-sponsored health plans, plans that employers cannot afford due to rising costs.
- Has resulted in more than half of the newly-insured residents receiving health insurance that is partially or completely subsidized by Massachusetts' taxpayers.
Has Massachusetts health care reform been properly utilized as a test bed for federal reform? Will the costs associated with Massachusetts health care reform be sustainable over the long term?
Note: None of this should be taken as legal or tax advice.
Late last year, the state of Arizona and its governor, Jan Brewer, were heavily criticized for a decision to
drop Medicaid coverage for some organ transplants. The decision was made in an attempt to lessen the $1 billion gap in the state's health care budget.
On April 7th, 2011, Governor Brewer
reinstated the transplant services that were previously eliminated, allowing for the reinstatement of approximately 100 individuals that had lost their eligibility in October 2010. The reinstatements are retroactive to April 1, 2011.
While this is a welcomed move for some Arizona citizens, it did not come without sacrifice.
What are your thoughts on the cuts and subsequent reinstatement? Was the Medicaid transplant cut necessary or was it a temporary fix that bought the time needed to find more appropriate areas for budget reductions?
