In late April, the Centers for Medicare & Medicaid Services (CMS) issued the final Managed Care Rule, which codifies revisions intended to “improve access to care, accountability and transparency for the approximately 80...more
On September 9, 2021, the U.S. House of Representatives Energy and Commerce Committee released their health care proposals for the Build Back Better Act. On September 10, 2021, the Ways and Means Committee released a summary...more
In a major win for health insurers, the U.S. Supreme Court ruled in an 8-1 decision that the federal government owes roughly $12.3 billion to health insurers who claimed losses under the risk corridor program of the...more
4/28/2020
/ Affordable Care Act ,
Appropriations Bill ,
Court of Federal Claims ,
Damages ,
Government Payments ,
Health Insurance ,
Insurance Industry ,
Land of Lincoln Mutual Health Insurance Co. v. United States ,
Maine Community Health Options v. United States ,
Moda Health Plan Inc. v. United States ,
Reimbursements ,
Remand ,
Repeal ,
Reversal ,
Risk Corridors Statute ,
SCOTUS ,
Tucker Act
In April, 2019, the U.S. Department of Health and Human Services (HHS) finalized a proposal which is intended to further the Trump Administration’s priority of reducing the cost of prescription drug coverage, and to encourage...more
On December 14, 2018, a federal District Court in Texas v. United States1 declared the Affordable Care Act (ACA) invalid because the individual mandate is destined to become unconstitutional under the Interstate Commerce...more
Beginning January 1, 2019, the Tax Cuts and Jobs Act of 2017 reduces to zero dollars the Affordable Care Act (ACA) tax penalty imposed on many individuals who fail to maintain minimum essential coverage (i.e., the individual...more
Since the Fall of 2017, the Trump Administration has used its executive and regulatory authority to roll back coverage requirements for Affordable Care Act (ACA) health plans and expand access to association health plans that...more
Payment models that seek to reward physicians, hospitals and other health care providers for achieving certain quality and cost-saving goals, or “value-based purchasing” (VBP), are not new to the healthcare landscape,...more
On June 26, 2017, the U.S. Senate leadership released a “discussion draft” of The Better Care Reconciliation Act of 2017 (the “Better Care Act”) — i.e., legislation to repeal and replace the Affordable Care Act, better known...more
Welcome to the inaugural edition of The New Era of Health Care Reform which highlights important developments in health care reform under the Trump Administration.
A FIRST LOOK AT HEALTH CARE PRIORITIES OF...more
What was at stake in King v. Burwell?
DH: Perhaps more than initially meets the eye. If the U.S. Supreme Court had sided with the King v. Burwell plaintiffs, federal tax subsidies to reduce the cost of insurance premiums...more
In a landmark decision, the U.S. Supreme Court interpreted the Affordable Care Act (ACA) to allow tax credits for individuals who purchase their health insurance through the federally-run insurance Exchange. Employers and...more
The U.S. Supreme Court’s 6-3 decision in King v. Burwell does more than resolve a question of statutory construction about whether Congress intended for federal tax subsidies to be available to reduce consumer spending on...more
In our previous blog post, we evaluated the legal issues at stake in King v. Burwell. We will now examine some of the ramifications of a Supreme Court decision that goes against the Obama Administration, assuming such were to...more
6/15/2015
/ Affordable Care Act ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
Individual Mandate ,
IRS ,
King v Burwell ,
Obama Administration ,
Political Debates ,
Popular ,
SCOTUS ,
Shared Responsibility Rule ,
State Health Insurance Exchanges ,
Subsidies ,
Tax Penalties
The health care industry has been closely watching four cases challenging whether federal subsidies could be used to reduce costs to consumers for health insurance purchased on an Affordable Care Act (ACA) Exchange in a state...more
6/12/2015
/ Affordable Care Act ,
Employer Mandates ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
King v Burwell ,
Minimum Essential Coverage ,
Obama Administration ,
Pay or Play ,
Popular ,
Split of Authority ,
Subsidies ,
Tax Penalties