Federal Reform News from Council for Affordable Health Insurnace

August 22, 2011
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Federal News
Supreme Court 2012 Review of Reform Law Likely
The recent ruling by the 11th Circuit Court of Appeals makes it almost certain the Supreme Court will decide the federal health care reform law’s constitutionality in its 2012 term. To date, two circuit courts have produced contradictory rulings on the law’s individual mandate. The Obama administration, by virtue of being the loser in the latest ruling, will file the appeal to the Supreme Court, which rarely turns down requests from the federal government.

9th Circuit Rejects Reform Suit
In another case against the federal health care reform law, the 9th Circuit Court of Appeals threw out a suit filed by a former California state lawmaker and the Pacific Justice Institute. The court upheld the decision by a lower court that neither party had a legal standing to challenge the law.
Read more at: http://bit.ly/odeg08

Congress Takes a Break; Supercommittee Formed
Congress has taken its annual August recess after completing a last-minute deal to increase the nation’s debt limit. The House and Senate will not return until after Labor Day. Shortly after leaving town, House and Senate leaders appointed their representatives to the new “supercommittee” that was created as part of the debt limit deal. The supercommittee is charged with creating a proposal to eliminate $1.5 trillion in government spending over the next ten years. Their first meeting is September 16, with results due by Thanksgiving. Members include Representatives Dave Camp (R-MI), Fred Upton (R-MI), Jeb Hensarling (R-TX), James Clyburn (D-SC), Chris Van Hollen (D-MD), and Xavier Becerra (D-CA) and Senators Patty Murray (D-WA), Max Baucus (D-MT), John Kerry (D-MA), John Kyl (R-AZ), Rob Portman (R-OH), and Pat Toomey (R-PA)

Administration Releases Regulations on Exchanges & Subsidies
The Obama administration has published three new proposed regulations to (1) establish processes for enrolling individuals and families in plans offered by state-based exchanges; (2) lay out how an estimated 20 million Americans will get tax credits to help them pay the premiums charged by insurers through the exchanges; and (3) establish a “seamless” enrollment process in which people benefit from “one-stop shopping” in exchanges to easily enroll in Medicaid or the Children’s Health Insurance Program if they don’t qualify for the tax credits. Comments on the proposed regulations are due by October 31. The regulations can be found in the Federal Register at:
Exchange enrollment processes: http://www.gpo.gov/fdsys/pkg/FR-2011-08-17/pdf/2011-20776.pdf

Premium tax credits: http://www.gpo.gov/fdsys/pkg/FR-2011-08-17/pdf/2011-20728.pdf

Medicaid/CHIP eligibility changes: http://www.gpo.gov/fdsys/pkg/FR-2011-08-17/pdf/2011-20756.pdf

HHS May Not Be Able to Fund Federal Exchanges
The U.S. Department of Health and Human Services (HHS) is facing a funding dilemma with respect to establishing a federal health insurance exchange. Although the federal health care reform law gives HHS the authority to create a federal exchange for states that don’t develop their own, it does not provide funding. In comparison, the law provides robust financial resources to help states build their own exchanges. One expert says HHS will have to “get creative about the [federal exchange] financing,” by asking contractors to delay getting paid until the exchange begins collecting fees.
http://www.politico.com/news/stories/0811/61513.html

NAIC Warns Feds about Exchange Loophole
A part of the federal health care reform law requires each state-based health insurance exchange to offer at least two plans which will be available in every exchange nationwide. In a letter to the U.S. Office of Personnel Management (OPM), NAIC President and Iowa Commissioner of Insurance Susan Voss has expressed concern the Multi-State Plan program will create an uneven playing field for insurers by favoring large national insurers who would offer these plans. “Insurance Commissioners and the NAIC have serious concerns about the potential for market disruption and adverse selection, and the resulting negative impact on consumers and health insurance markets which would arise if Multi-State Plans are allowed to operate under different rules than their competitors.” Voss wrote.
Read more at: here

Feds Issue Proposed Rule on Benefits, Coverage Disclosures
The IRS, the Department of Labor (DOL), and HHS have released proposed rules on insurance-related forms required by the federal health care reform law. The “summary of benefits and coverage” and a uniform glossary for group and individual health insurance were released almost five months late due to infighting between HHS and DOL over the extent to which large employer plans will be expected to comply with the provision. Both rules were published in the Aug. 22 Federal Register with comments due 60 days after publication.
The proposed rules can be found at: http://www.ofr.gov/OFRUpload/OFRData/2011-21193_PI.pdf

Issa Questions Why HHS Is Ending Waivers for Mini-Med Plans
House Oversight and Government Reform Chairman Darrell Issa (R-CA) is questioning HHS’s decision to end the waiver process for health plans to comply with certain requirements of the federal health care reform law. Issa said in a letter to HHS Secretary Kathleen Sebelius that he wants HHS to explain why they are shutting down the waiver program and provide the committee will all the documents and communications related to the decision to stop it.
Read more at: here

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