Category Archives: Individual Health Plans

Court Ruling on Individual Mandate

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ACA’s individual mandate is unconstitutional, appeals court rules

ACA's individual mandate is unconstitutional, appeals court rules
(Joe Raedle/Getty Images)
The US Court of Appeals for the 5th Circuit upheld a lower court ruling that the Affordable Care Act’s mandate for individuals to enroll in health insurance is unconstitutional, sending the case back to the lower court to reconsider how much of the law should be dismantled. The ruling is not expected to affect millions of Americans who enrolled for 2020 coverage in recent weeks, and the law’s protections for people with preexisting conditions remain intact.

CNBC/The Associated Press (12/18),  CNN (12/18),  The Hill (12/18)

Chronic Disease Care – HDHPs with HSAs

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Executive order calls for HDHPs with HSAs to cover chronic disease care

An executive order signed last week by President Donald Trump directs the IRS and the Treasury Department to create rules within 120 days that require high-deductible health plans paired with health savings accounts to cover high-value services and treatments for chronic diseases. A bipartisan bill introduced in the Senate would mandate a similar goal, and a similar measure is expected to be introduced in the House.
No further information.  Will keep you posted
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Legislation Proposed to End Surprise Medical Bills

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Senators unveil revised legislation to end surprise medical bills

Senate Health Committee Chair Lamar Alexander, R-Tenn., and ranking member Sen. Patty Murray, D-Wash., have released a revised version of their health care legislative package with new provisions meant to protect patients against unexpected medical bills. The Lower Health Care Costs Act, released ahead of the expected health committee markup next week, would create a benchmark for health insurer-provider payment disputes, prohibit out-of-network deductibles during emergencies, and limit patients’ out-of-pocket expenses for air ambulance transport.

Becker’s Hospital Review (6/19),  The Hill (6/19)

Health Insurance tax credits to expand in California

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Calif. governor aims to expand health insurance tax credits, impose penalty

California Gov. Gavin Newsom has proposed imposing a tax penalty on people who fail to enroll in health insurance, with the proceeds going toward tax credits for an estimated 850,000 Californians, including some whose incomes are too high for federal assistance. The proposal is being debated by state lawmakers as part of budget negotiations, which should be done by June 15.

California Healthline (6/3)

Medicare for All?

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“Medicare-for-all” would hurt public health, White House says

The “Medicare-for-all” idea backed by some Democrats would increase federal spending by $2.4 trillion in 2022, reduce innovation and lead to health care shortages and extended wait times, according to a report prepared by the White House Council of Economic Advisers. The policy would “be neither more efficient nor cheaper than the current system, and it could adversely affect health,” the report said.

CNN (3/19)

MEDICARE OF ALL

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"Medicare for all" could lead to permanent doctor shortage, Verma says
(Mandel Ngan/AFP/Getty Images)
CMS Administrator Seema Verma said the “Medicare for all” idea being pushed by some Democrats would decimate doctor networks and create a permanent physician shortage because the program doesn’t cover full health care provider costs. “Under ‘Medicare for all,’ you either take private insurance away from those 170 million Americans, or greatly restrict access to it, meaning there is no relief valve for physicians facing up to 40% payment cuts,” Verma told attendees at AHIP’s Medicare conference in Washington.

Kaiser Health News (10/16),  Modern Healthcare (tiered subscription model) (10/16)

Would the ACA proposed fixes help

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ACA fixes would lower premiums, improve access to coverage, analysis finds

A new analysis from Oliver Wyman has found Affordable Care Act stabilization bills that would fund cost-sharing reduction payments for two years and provide $10 billion for state reinsurance programs would reduce premiums by over 40% in the individual market and increase the number of insured Americans by 3.2 million. Sen. Lamar Alexander, R-Tenn., who co-sponsored one of the measures, cited the findings as he defended the legislation against criticism.

The Examiner (Washington, D.C.) (3/12)