ACA

House Files Motion to Intervene in Texas ACA Case

The U.S. House of Representatives recently filed a motion in federal court requesting intervention in the Texas court case that found the Affordable Care Act (ACA) unconstitutional, CNBC reports. U.S. District Court Judge Reed O'Connor last month ruled that the law was unconstitutional after the 2017 Tax Act eliminated penalties for adults without health insurance. A lawyer for the House said in the filing that federal legal rules give “the House an unconditional right to intervene,” given the ACA was passed into law by Congress and that the Trump administration is not defending the law, maintaining that “interest in this action ... is not adequately represented by the existing parties.” O’Connor has stayed his ruling pending appeal.

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AG Slatery Defends Participation in ACA Lawsuit

Tennessee Attorney General Herbert Slatery is defending his participation in the lawsuit that led to a federal judge to rule the Affordable Care Act (ACA) as unconstitutional, saying “the Commerce Clause of our Constitution that, according to the court, prevents Congress from compelling Tennesseans to buy insurance, especially if they can't afford it or don't want it,” The Chattanooga Times Free Press reports. U.S. District Court Judge Reed O'Connor last December ruled in favor of the 19 Republican state attorneys general, who argued that the law was unconstitutional after the 2017 Tax Act eliminated penalties for adults without health insurance. The U.S. Supreme Court had previously upheld the mandate, saying it was constitutional because it fell under Congress's taxing power. State Democrats have blasted the ruling, warning of consequences for the 1.7 million Tennesseans with pre-existing health conditions and the quarter of a million people in the state who obtain their insurance coverage through the ACA.

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State Democrats Ask AG Slatery to Remove Tennessee from ACA Lawsuit

Tennessee Democrats rebuked a federal judge's ruling that the ACA is unconstitutional and are asking Tennessee Attorney General Herbert Slatery to remove Tennessee from the lawsuit, The Chattanooga Times Free Press reports. U.S. District Court Judge Reed O'Connor on Friday ruled that because a 2017 congressional tax bill eliminated penalties for those without health insurance, the ACA is unconstitutional. The lawmakers are calling on Senator Lamar Alexander, who is chairman of the Senate Health Committee, to protect Tennesseans — of which 1.26 million have preexisting health conditions — should the ruling be upheld on appeal. Alexander previously supported a "repeal and replace" plan, saying, "I don't think Tennesseans would be comfortable canceling insurance for 22 million Americans and trusting Congress to find a replacement in two years.”

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New Ad from Dean Touts Medicaid Expansion Under ACA

A new ad for Democratic gubernatorial nominee Karl Dean references the amount of federal money Tennessee has been losing due to not expanding Medicaid under the Affordable Care Act (ACA), calling out Republican nominee Bill Lee for being against Medicaid expansion, The Tennessean reports. Lee has previously voiced support of working with the federal government to obtain block grants rather than expand Medicaid under the ACA. 

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Trump Administration Freezes Affordable Care Act Payments

In a surprise move on Saturday, the Trump administration announced that it will be temporarily halting billions of dollars of “risk adjustment” payments, designed to help insurers meet the Affordable Care Act requirement of providing coverage regardless of whether a person is healthy or sick, reports NPR. The program assists in determining risk for insurers, transferring funds from those who enroll healthier members for relatively less, to those that take on higher costs to enroll sicker members, insulating insurance companies from the cost of enrolling people with pre-existing conditions. Some critics fear that the recent action could spur a spike in insurance premiums for 2019.

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New Iowa Law Allows Controversial Health Plans

Last week, Iowa Governor Kim Reynolds (R) signed into law a bill that allows Iowa Farm Bureau to collaborate with the state’s dominant insurer to sell “health benefit plans,” a strategy that contends that not all health plans are health insurance, reports The Washington Post. The law says such plans “sponsored by a nonprofit agricultural organization… shall be deemed not to be insurance” meaning they will not have to comply with federal requirements. 
 
The law has sparked debate over whether the strategy is a creative path to offer some residents an alternative to increasing prices in the insurance marketplace or a path to substandard coverage that will divide the healthy from the sick. Some feel that this bill is an aftereffect of Congress and the Trump administration’s declaration that Americans who flout the law’s individual insurance mandate will no longer be charged penalties. “If the ACA’s insurance rules can’t be repealed, then an alternative is to get people the option of escaping them,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a non-profit organization that focuses on major health care issues facing the nation. “Without the penalty, the door is wide open for plans like this.”
 
Iowa Insurance Commissioner Doug Ommen said that he is officially undecided about the new Farm Bureau law but that he sympathizes with the need for more-affordable coverage. As consumers have been “hammered” by the Affordable Care Act (ACA) rates, he said, enrollment in Iowa’s marketplace has tumbled from nearly 75,000 in 2016 to about 61,000 last fall to 46,000 last month. According to Ommen, the Farm Bureau modeled its idea after a similar arrangement sponsored by the Tennessee Farm Bureau, which began decades ago and has continued in the ACA era. The Obama administration never challenged it.
 
The Farm Bureau plan is the state’s second attempt to circumvent the ACA. Last year, the state’s insurance commissioner asked federal health officials to allow Iowa to take about $350 million in ACA money for 2018 and use it in different ways to help people pay for plans outside the marketplace. When the government had not given approval as last fall’s ACA enrollment season neared, Iowa withdrew the proposal.
 
In a bill-signing ceremony, the governor contended that Iowa’s individual insurance market had ample choices and “reasonable” premiums before the ACA left it “in collapse.” After urging Congress to “fix this problem,” Reynolds recounted Monday, she said “we are done waiting” and urged state lawmakers to find their own solution. “That is exactly what they did.”
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Congress Delays 'Cadillac Tax' and Other ACA-Related Taxes and Fees

Congress on Monday passed the Federal Register Printing Savings Act, which temporarily continued funding federal government activity and appropriated funds to various health-related programs such as the Children's Health Insurance Program, Medicaid and childhood obesity programs.
 
The Act also addressed the effective date for the controversial 40 percent excise tax on high-cost health care, commonly referred to as the "Cadillac Tax," which has been delayed until 2022. At a minimum, the new two-year delay gives employers and plan sponsors more time to adjust health plan design to avoid the Cadillac Tax, legislation that has been unpopular on both sides of the aisle.
 
The Cadillac tax was created as part of the Affordable Care Act largely to help fund benefits to the uninsured under the law. The U.S. Joint Committee on Taxation estimates that delaying the medical device tax will lower revenue by $3.8 billion over a decade, delaying the Cadillac tax will cost $14.8 billion and suspending the health insurance tax will cost $12.7 billion.
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Idaho to Allow Non-ACA Approved Health Insurance Plans

Idaho officials said they will begin allowing insurers to sell new plans that don't meet requirements set by the Affordable Care Act. In a bulletin issued Wednesday by state Department of Insurance Director Dean Cameron, "state-based health benefit plans" or "state-based plans" will not be subject to the federal restrictions applied to"grandfathered" or "transitional" plans.
 
Under these guidelines, insurers who participate are free to deny people coverage or charge more based on a customer's medical history, a practice that's illegal under Obama Care. Officials argue that the state needed to act to allow for cheaper plans that would help attract younger, healthier people back into an ailing market, however, critics say that this will likely mean steep premium increases for middle-class individuals with pre-existing conditions.
 
State officials said they are trying to press forward with the changes on their own without any action from Washington. The move will almost certainly be met with legal challenges by ACA proponents, as it has drastic implications on federal enforcement of individual market requirements.
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