Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
By Sara Hansard
April 15 --The Protecting Access to Medicare Act of 2014, which was signed into law April 1 by President Barack Obama, repealed the Affordable Care Act's limitation on deductibles for small group employer-sponsored health plans.
The provision was included in Pub. L. No. 113-93, the “doc fix” law that delayed for a year a 24 percent reduction for Medicare payments to physicians as well as implementation of the International Classification of Diseases, 10th Revision, medical claims coding system. Section 213 repealed annual caps on small group health plan deductibles that were included in the ACA. The provision was originally introduced as a bill (H.R. 2995) by Rep. Tom Reed (R-N.Y.) in August 2013.
Previously, Section 1302(c) of the ACA limited deductibles in employer-sponsored health plans covering the equivalent of 50 or fewer full-time employees to $2,000 for single coverage and $4,000 for family coverage for 2014, according to an April 10 analysis issued by law firm Proskauer Rose LLP.
The implementing regulations prohibited insurance carriers from taking into account an employer's health flexible spending account or health reimbursement account contributions in determining compliance with the deductible limits, according to the analysis by Proskauer associate Stacy Barrow.
“This left some small employers with no choice but to purchase plans with lower deductibles if they were to continue offering coverage, which in most cases significantly increased premiums,” Proskauer said. Carriers in some states, however, were able to avoid implementing the deductible limit rules “due to various 'fixes' offered by the Obama administration through the Centers for Medicare and Medicaid Services, as well as an exception in the Health and Human Services regulations, which enabled plans to exceed the deductible limits if it was necessary in order for the plan to achieve a specified actuarial value,” the analysis said.
The repeal of the deductible provision is retroactive to the date of the ACA's enactment, March 23, 2010. “It is unclear how quickly, if at all, carriers offering plans in the small group market will return to offering policies with deductibles that exceed the now-repealed $2,000/$4,000 limits,” Proskauer said.
A release issued April 6 by House Speaker John Boehner (R-Ohio) said, “Repealing this provision will give employers more flexibility over the type of health care options they can offer their employees, and will expand the use of high-deductible plans paired with Health Savings Accounts (HSAs). This will help families keep their private insurance through their employer, rather than be forced to go on an ObamaCare exchange with fewer options and higher costs.”
In other action, on April 9 the House rejected legislation (H.R. 4414) that would have exempted expatriate health plans from the Affordable Care Act's coverage requirements. The bill, introduced April 7 by Rep. John Carney (D-Del.), was voted on a motion to suspend House rules, which required a two-thirds vote. The vote on the legislation was 257-159.
On April 9, Democratic House members Henry Waxman (Calif.), Sander Levin (Mich.), George Miller (Calif.) and Xavier Becerra (Calif.) issued a letter urging members to vote against the bill, the Expatriate Health Coverage Clarification Act.
“While there may be a need to narrowly clarify the law with respect to so-called 'expatriate' coverage, this legislation creates large loopholes that would permit insurance companies to avoid their responsibilities under the law and sell inferior insurance policies to American and foreign workers and their families who live in the United States,” the letter said.
To contact the reporter on this story: Sara Hansard in Washington at email@example.com
To contact the editor responsible for this story: Janey Cohen at firstname.lastname@example.org
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)