Posted in Affordable Care Act (ObamaCare), Economic Issues, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Health Insurance, Individual Mandate, Large group insurance market, Medical Costs, Small group market, Subsidies, Uncategorized

The Current Status of the ACA Employer Mandate: 2019 – Integrity Data

Caution Employers!

With all the focus on Transparency mandates and HRA executive orders, much of the ACA remains in force (unfortunately). Even though the individual mandate penalty (uh…tax) will not be enforced beyond 2018, the employer mandate is still in effect, with all the coverage provisions!

https://www.integrity-data.com/current-status-of-aca-employer-mandate-2019/

Posted in Access to healthcare, Affordable Care Act (ObamaCare), American Presidents, Defined Contribution Benefit Plans, Economic Issues, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Government Regulations, Health Insurance, Health Reimbursement Arrangement (HRA), Healthcare financing, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Medical Costs, News From Washington, Patient Choice, Policy Issues, Portable Insurance, Pre-existing Conditions, The Triple Aim, Uncategorized

Donald Trump Takes A Big Step Toward Personal And Portable Health Insurance

READ THIS ARTICLE below if you want to understand the degree to which this ruling is an important step for healthcare reform.

But as John C. Goodman points out, administrative ruling can only go so far without being codified by legislative action.

Some believe the Individual Market is too weak to revive, given the hit it took as as result of the ACA.

I am optimistic that this ruling to utilize HRA is this manner will be a “shot in the arm” and revitalize the market again.

This hopefully highlights the benefits, and spurs popularity, of a defined contribution approach as a means to purchase health insurance.

Anything that makes us less dependent on ESI and gives more portability & options, freeing the labor market from job-lock is a good thing. -Forum for Healthcare Freedom

John C. Goodman

https://www.forbes.com/sites/johngoodman/2019/06/18/donald-trump-takes-a-big-step-toward-personal-and-portable-health-insurance/

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Direct-Pay Practice Models, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Health Insurance, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Individual Mandate, Policy Issues, Tax Policy, Uncategorized

Healthcare: What to Watch For

“…it is important for employers to be fully aware of what the regulations may impact them to safeguard against inadvertently putting themselves, or their employees, in an untenable situation.

It is important for an employer looking to offer an unconventional or untraditional benefit package to speak with an independent health plan attorney or CPA (not employed by the agency selling the program) regarding potential liability and compliance with federal and state laws regarding employer sponsored health plans.

Can your employee afford to reimburse the IRS for taxes not collected on an inappropriately structured HSA? Can your business afford a fine of $100 per day per employee for every day that the unqualified arrangement was offered? These are just some of the potential liabilities.”

http://ushealthmedia.com/healthcare-what-to-watch-for/

Posted in Affordable Care Act (ObamaCare), Cost of labor, Crony Capitalism, Economic Issues, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Free Society, Free-Market, Government Regulations, Health Insurance, Minimum wage, Policy Issues, Poverty, Uncategorized, Wealth

Watch “Whole Foods’ John Mackey: Why Intellectuals Hate Capitalism” on YouTube

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Deductibles, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Health Insurance, Health Savings Accounts (HSA's), Healthcare financing, Individual Mandate, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Large group insurance market, Medicaid, Medical Costs, Medical Practice Models, Medicare, Organizational structure, Policy Issues, Portable Insurance, Pre-existing Conditions, primary care, Reforming Medicaid, Self-Insured Plans, Small group market, Tax Policy, Uncategorized

Obamacare Replacement Act – Senate Bill 222 by Senator Rand Paul – KY

Sen. Rand Paul, R-Ky., speaks during an event at the University of Chicago's Ida Noyes Hall in Chicago on Tuesday, April 22, 2014. (AP Photo/Andrew A. Nelles) ORG XMIT: ILAN114Lots to like and consider here.  We need more details about how tax equalization in the group market vs the individual market will be handled.  The expansion of uses and benefits of HSAs is robust and will go along way to establishing more ways to self-insure and less reliance on networks and government programs; both are a good thing.  The flexible, market-friendly Interstate Market for Health Insurance Cooperative Governing of Individual Health Insurance Coverage will be a welcome change.  Again, devil is always in the details.  Stay tuned for more details and insightful analysis here on the Sovereign Patient; we will post them as available. 

Some highlights:

Effective as of the date of enactment of this bill, the following provisions of Obamacare are repealed:

  • Individual and employer mandates, community rating restrictions, rate review, essential health benefits requirement, medical loss ratio, and other insurance mandates.

Protecting Individuals with Pre-Existing Conditions:

  • Provides a two-year open-enrollment period under which individuals with pre-existing conditions can obtain coverage.
  • Restores HIPAA pre-existing conditions protections. Prior to Obamacare, HIPAA guaranteed those within the group market could obtain continuous health coverage regardless of preexisting conditions.

Equalize the Tax Treatment of Health Insurance:

  • Individuals who receive health insurance through an employer are able to exclude the premium amount from their taxable income. However, this subsidy is unavailable for those that do not receive their insurance through an employer but instead shop for insurance on the individual market.
  • Equalizes the tax treatment of the purchase of health insurance for individuals and employers. By providing a universal deduction on both income and payroll taxes regardless of how an individual obtains their health insurance, Americans will be empowered to purchase insurance independent of employment. Furthermore, this provision does not interfere with employer-provided coverage for Americans who prefer those plans.

Expansion of Health Savings Accounts:

  • Tax Credit for HSA Contributions
    • Provides individuals the option of a tax credit of up to $5,000 per taxpayer for contributions to an HSA. If an individual chooses not to accept the tax credit or contributes in excess of $5,000, those contributions are still tax-preferred.
  • Maximum Contribution Limit to HSA. Removes the maximum allowable annual contribution, so that individuals may make unlimited contributions to an HSA.
  • Eliminates the requirement that a participant in an HSA be enrolled in a high deductible health care plan. This section removes the HSA plan type requirement to allow individuals with all types of insurance to establish and use an HSA.
  • This would also enable individuals who are eligible for Medicare, VA benefits, TRICARE, IHS, and members of health care sharing ministries to be eligible to establish an HSA.
  • Allowance of Distributions for Prescription and OTC Drugs o Allows prescription and OTC drug costs to be treated as allowable expenses of HSAs.
  • Purchase of Health Insurance from HSA Account o Currently, HSA funds may not be used to purchase insurance or cover the cost of premiums. Allowing the use of HSA funds for insurance premiums will help make health coverage more affordable for American families.
  • Medical Expenses Incurred Prior to Account Establishment o Allows qualified expenses incurred prior to HSA establishment to be reimbursed from an HSA as long as the account is established prior to tax filing.
  • Administrative Error Correction Before Due Date of Return o Amends current law by allowing for administrative or clerical error corrections on filings.
  • Allowing HSA Rollover to Child or Parent of Account Holder o Allows an account holder’s HSA to rollover to a child, parent, or grandparent, in addition to a spouse.
  • Equivalent Bankruptcy Protections for HSAs as Retirement Funds o Most tax-exempt retirement accounts are also fully exempt from bankruptcy by federal law. While some states have passed laws that exempt HSA funds from being seized in bankruptcy, there is no federal protection for HSA funds in bankruptcy.
  • Certain Exercise Equipment and Physical Fitness Programs to be Treated as Medical Care. Expands allowable HSA expenses to include equipment for physical exercise or health coaching, including weight loss programs.
  • Nutritional and Dietary Supplements to be Treated as Medical Care o Amends the definition of “medical care” to include dietary and nutritional supplements for the purposes of HSA expenditures.
  • Certain Providers Fees to be Treated as Medical Care o Allows HSA funds to be used for periodic fees paid to medical practitioners for access to medical care.
  • Capitated Primary Care Payments o HSAs can be used for pre-paid physician fees, which includes payments associated with “concierge” or “direct practice” medicine.
  • Provisions Relating to Medicare o Allows Medicare enrollees to contribute their own money to the Medicare Medical Savings Accounts (MSAs).

Interstate Market for Health Insurance Cooperative Governing of Individual Health Insurance Coverage:

  • Increases access to individual health coverage by allowing insurers licensed to sell policies in one state to offer them to residents of any other state.
  • Exempts issuers from secondary state laws that would prohibit or regulate their operation in the secondary state. However, states may impose requirements such as consumer protections and applicable taxes, among others.
  • Prohibits an issuer from offering, selling, or issuing individual health insurance coverage in a secondary state: If the state insurance commissioner does not use a risk-based capital formula for the determination of capital and surplus requirements for all issuers. Unless both the secondary and primary states have legislation or regulations in place establishing an independent review process for individuals who have individual health insurance coverage; or The issuer provides an acceptable mechanism under which the review is conducted by an independent medical reviewer or panel.
  • Gives sole jurisdiction to the primary state to enforce the primary state’s covered laws in the primary state and any secondary state.
  • Allows the secondary state to notify the primary state if the coverage offered in the secondary state fails to comply with the covered laws in the primary state.

Source: Microsoft Word – Obamacare Replacement Act SBS.docx

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Deductibles, Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Federal Exchanges, Individual Mandate, out-of-pocket costs

What Republicans Should Be Doing: Holding Hearings On Obamacare – Forbes

John C. Goodman
John C. Goodman

Now that Paul Ryan is the presumptive new leader of the House of Representatives, what happens next? The single biggest domestic policy issue the country faces is Obamacare. So far, Republicans in Congress haven’t done anything very useful in addressing it. The House has voted 54 times to repeal some or […]

Source: What Republicans Should Be Doing: Holding Hearings On Obamacare – Forbes

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Government Regulations, Health Insurance, Individual Mandate, Individual ObamaCare Market, Insurance subsidies, Medicaid Expansion, Medical Costs, Policy Issues, Reforming Medicaid, Subsidies, Tax Policy, Uninsured

Health Plan: Rubio Gets It Right – Forbes

John C. Goodman
John C. Goodman

So far it’s just an editorial. But it is an editorial that proposes two bold ideas that no other Republican presidential candidate has been willing to endorse: (1) tax relief for the purchase of health insurance should be the same for everyone – whether insurance is acquired at work, in the marketplace or in an exchange, and (2) the best form of tax relief is a fixed sum tax credit.

Although Rubio is a self-described conservative, these are not right wing ideas. In fact, I believe that most health policy experts on the left and the right agree with him. (More on that below.)

For most of the post-World War II period we have had two parallel tax systems with regard to health care and health insurance. Employer sponsored health plans have been treated one way. Individually purchased health insurance has been treated a different way. Under Obamacare, we have created a third parallel system (Medicaid expansion) – all treating people at the same income level very differently.

via Health Plan: Rubio Gets It Right – Forbes.

Posted in Affordable Care Act (ObamaCare), Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Government Regulations, Health Insurance, Individual Mandate, Individual Underwriting Standards, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, Patient Choice, Policy Issues, Reforming Medicaid, Rule of Law, State-Run Insurance Exchanges, Subsidies, Tax Policy

Defending Public Policy: What’s in a Name? | Robert Nelson, MD | LinkedIn

Robert Nelson, MD
Robert Nelson Publisher & Editor, The Sovereign Patient

Let’s pretend a non-partisan, unelected committee had drafted a health reform plan to be reviewed and debated by the people of each state and then voted on with a simple up or down vote. If a minimum of 38 states passed it, then it would become the law of the land. Let’s assume this health reform plan contained the following characteristics:

Read the entire article via Defending Public Policy: What’s in a Name? | Robert Nelson, MD | LinkedIn.