Legislative/Regulatory Updates
 On Sept. 17, the CCIIO updated its June 30 summary report on transitional reinsurance payments and permanent risk adjustment transfers for 2014. The report was updated to include additional data and corrections that had been made in the months following its initial release.
Sens. Dean Heller (R-Nev.) and Martin Heinrich (D-N.M.) introduced bipartisan legislation to fully repeal the excise tax on high-cost employer-sponsored health coverage under the ACA. The bill, S. 2045, is a Senate companion to Rep. Joe Courtney’s (D-Conn.) House legislation. It has been referred to the Senate Finance Committee, and the senators suggested the measure could move to the Senate floor this year, possibly as part of a larger piece of legislation.
The House Ways and Means Committee approved the Restoring Access to Medication Act of 2015 by a voice vote. The bill, H.R. 1270, rescinds the ACA’s limits on health savings and flexible spending accounts, and would allow people to use the accounts to purchase over-the-counter drugs instead of just prescription treatments.
The Centers for Medicare & Medicaid Services (CMS) issued a bulletin to insurers on Sept. 18, allowing them to delay issuing rebates to consumers under the law’s medical loss ratio program because of issues with the ACA’s risk corridors program. Under CMS regulations, the rebates were to have gone out to consumers by Sept. 30, but they can now issue rebates by Oct. 30 and still be in compliance with federal rules.
On Oct. 1, CMS announced proration results for 2014 risk corridors payments. Based on current data from qualified health plans issuers’ risk corridors submissions, issuers will pay $362 million in risk corridors charges, and have requested risk corridors payments of $2.87 billion for 2014. At this time, assuming full collections of risk corridors charges, this will result in a proration rate of 12.6 percent. According to the notice, the Department of Health and Human Services (HHS) will begin collection of risk corridors charges in November and will begin remitting risk corridors payments to issuers starting in December.
President Obama signed into law the Protecting Affordable Coverage for Employees Act (H.R. 1624) on Oct. 7, which amends the ACA making it optional for states to participate in the expansion of the small group health insurance market. Under the ACA, in 2016 the small group market was slated to expand from businesses with 50 or fewer employees to those with up to 100 workers. H.R. 1624 amends the ACA so that unless states elect to expand the definition, businesses with 51-100 employees would still be considered large employers and not subject to certain requirements under the ACA. The House passed the legislation on Sept. 28 and the Senate passed it without amendments on Oct. 1. The Congressional Budget Office estimates the bill will save $400 million over 10 years.
The House Budget Committee approved a reconciliation bill in a party-line vote on Oct. 9, sending the package to the full House. The legislation would repeal taxes on medical device manufacturers and high-cost health insurance plans, repeal the Independent Payment Advisory Board, repeal the individual and employer mandates, defund the Prevention and Public Health Fund, and repeal a yet-to-be-implemented requirement for large employers to automatically enroll their workers in health insurance plans. The bill is expected to reach the floor after Congress’s mid-October recess, and if passed by both the House and Senate is expected to be vetoed by President Obama. |
