IRS Sends out ACA Compliance Letters, Employers Have 30 Days to Respond

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The IRS has started sending out letters to employers who have failed to comply with the Employer Shared Responsibility provisions under the Affordable Care Act for the year 2015. The IRS seems to be moving forward with notifying employers after attempts to repeal and replace the ACA failed in Congress and since there has been no further rule-making, guidance or legislation that rolls back enforcement of the employer mandate. The IRS will send Letter 226J to applicable large employers (ALEs) if it determines that at least one full-time employee received a subsidy in 2015 in a marketplace to purchase qualified…
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Trump’s New Orders and the Effect on Group Markets

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After months of failed efforts by Congressional Republicans to eliminate the Affordable Care Act, President Trump has stepped in with two sweeping changes that will likely reverberate throughout the health insurance system. The main order he issued immediately eliminates subsidies that are paid to health insurers that participate in government-run exchanges to reduce deductibles and copays for lower-income customers. While some pundits say the move will create chaos in the individual market, they differ on the likely fallout for group policies. But Trump did sign two other orders that will have a more direct effect on the group market over time:…
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More Breaking News From the White House!

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Last night, the White House issued a statement that the Administration would no longer make payments to insurers for the ACA’s cost-sharing reduction (CSR) program, citing agency guidance that the subsidies were illegal because they were never appropriated by Congress as required by the Constitution. These CSRs – which are separate from the ACA’s larger advanced premium tax credits (APTC) for households up to 400% of the Federal Poverty Level (FLP) – help offset out-of-pocket expenses for silver-tiered plans purchased through ACA marketplaces like CoveredCA, for households with incomes under 250% of the FPL.  CoveredCA prepared for this possibility by…
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As Concern over Subsidies Looms, Fate of Exchanges Hangs in Balance

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Even though no legislation repealing the Affordable Care Act has been signed into law, inaction by the Trump administration on a major lawsuit is imperiling one of the key foundations of the law: the government-run exchanges. The administration has asked the court for three more months to decide whether to pursue an appeal against a U.S. district court’s ruling that the subsidies paid to help people purchase insurance on government-run insurance exchanges are illegal. The ruling was stayed pending an appeal first filed by the Obama administration. The added delay is causing concern – if not panic – among insurers…
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ACA Repeal Plan Is Dead; So What Should You Do?

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Now that the American Health Care Act has suffered a defeat in Congress and President Trump has said he’ll move on to other matters, the Affordable Care Act will stand as the law of the land. The big question hanging over the law, however, is the executive order that Trump signed shortly after taking office in January. While that order did not abolish the legislation, it set the stage for agencies to act immediately on regulations that are deemed overly burdensome. However, the administration has not indicated what it will do now that the AHCA has ground to a halt….
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Bill Would Make Collecting Health Information for Wellness Plans Easier

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Legislation has surfaced in Congress that would allow employers to collect biometric and genetic information from employees and their family members as a precondition for participation in a company wellness program. The bill would essentially repeal a portion of the Genetic Information Non-discrimination Act (GINA), which in part bars employers from collecting genetic information on employees or members of their family for certain wellness programs. The GINA bars health insurers and employers from discriminating against people based on information that their genes carry – say, a family history of heart disease or stroke. The law contains an exception for employers…
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GOP Releases Legislation to Gut and Replace ACA

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House Republicans have filed legislation that would repeal most of the Affordable Care Act, including measures to eliminate the employer and individual mandates. But from the get-go the legislation – backed by the House leadership – was panned by the GOP’s conservative wing, which said it doesn’t go far enough to completely get rid of the ACA, casting doubt on the prospects of it getting passed. And Congressional Democrats immediately voiced their absolute opposition to the bill, vowing to vote ‘No’ on the legislation. While passage in the House would be a bit easier, the slim 51-49 vote edge that…
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Republicans Consider Axing Tax Exclusion on Employer-sponsored Plans

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As work on trying to overhaul the Affordable Care Act continues, lawmakers are considering a bold and what would likely be a controversial move to eliminate the tax exclusion for employer-sponsored health benefits. The amount of taxes that are not collected as a result of the exclusion amounts to about $216 billion a year according to the Tax Policy Center, and is therefore a significant pool of untapped funds. The current exclusion has its roots dating back to World War II when the government ordered that wages be frozen and tax-free health insurance be available. The notion of now taxing…
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Republicans Consider Fixing ACA, Not Repealing It

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The steamroller everyone expected from President Trump and the GOP-led Congress to flatten the Affordable Care Act has been put on idle and what was a promised quick outright repeal has morphed into a plan to “repair” the law. In particular, Republican lawmakers, huddling while trying to devise a repeal-and-replace plan, have instead found that it won’t be so easy, unless they want to cut off millions of people from the health insurance they have purchased on exchanges. They are most concerned with the political fallout should that happen, not to mention the fact that a repeal would also do…
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What Does President Trump’s Executive Order on ACA Mean?

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Donald Trump’s first act after assuming the presidency was to sign an executive order that authorizes federal agencies to scale back as many parts of the Affordable Care Act as possible within the confines of the law. The executive order does not abolish the landmark legislation, but sets the stage for agencies to act immediately on regulations that are deemed overly burdensome. The agencies, particularly the Department of Treasury and the Department of Health and Human Services (HHS), will have wide latitude in making regulatory changes thanks to the broad scope of the order. But don’t expect immediate changes in…
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