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The ACA Supreme Court Litigation: The States’ Medicaid And Minimum Coverage Briefs


February 7th, 2012
by Timothy Jost

Briefs continue to be filed at a furious pace in the Affordable Care Act Supreme Court litigation.  On January 6, the federal government led off with its brief challenging the decision of the Eleventh Circuit federal court of appeals that the ACA’s minimum coverage requirement (individual mandate) is unconstitutional.  The states and the National Federation [...]

Health Reform Briefs: The Minimum-Coverage Requirement And Other Issues


January 7th, 2012
by Timothy Jost

As every reader knows, the Supreme Court has agreed to consider challenges that have been brought to the constitutionality of two provisions of the Affordable Care Act (ACA) by twenty-six states, the National Federation of Independent Businesses, and individual plaintiffs.  The Court has scheduled the case for five and a half hours of oral arguments [...]

Implementing Health Reform: A Bulletin On Essential Health Benefits


December 16th, 2011
by Timothy Jost

On December 16, 2011, HHS released a “bulletin” describing the approach that it intends to take to establishing the “essential health benefits” under the Affordable Care Act.  A bulletin is a form of guidance that lacks the legal stature of a rule.  HHS believed, however, that the states, insurers, consumer advocates, and the public needed [...]

Implementing Health Reform: CO-OPs, MEWAs, And Medicare Data


December 12th, 2011
by Timothy Jost

The week of December 5 was a particularly busy week in health care reform implementation.  After a lull over the Thanksgiving holiday, new regulations, proposed regulations, guidance, and grant announcements have poured out of the agencies.  This post will briefly summarize three of these issuances: the final rule on the Establishment of Consumer Operated and [...]

Implementing Health Reform: Fine-Tuning The Medical Loss Ratio Rules


December 3rd, 2011
by Timothy Jost

On December 2, 2011, the Department of Health and Human Services released both a final rule  and an interim final rule updating the medical loss ratio rule that it issued almost exactly a year ago.  The Department of Labor simultaneously issued a technical release giving direction to employer-sponsored health plans governed by the Employee Retirement [...]

Implementing Reform: Funding And Flexibility For States On Exchanges


November 30th, 2011
by Timothy Jost

As 2011 comes to a close, we draw ever closer to January 1, 2014, the day when the most significant changes wrought by the Affordable Care Act will come into effect.  Indeed, we are only weeks away from the halfway point between March, 2010, when the ACA was signed into law and October, 2013, the [...]

High Court To Review ACA’s Minimum Coverage Requirement, Medicaid Expansion


November 14th, 2011
by Timothy Jost

Today, November 14, 2011, the Supreme Court decided to review a decision of the Eleventh Circuit Court of Appeals striking down the minimum coverage requirement of the Affordable Care Act (ACA) as unconstitutional.  The case will probably be argued before the Court in March and decided in the early summer. Procedurally, the Court “granted certiorari.”  [...]

Appellate Court Upholds ACA In Opinion By Prominent Conservative Judge


November 9th, 2011
by Timothy Jost

Yesterday, November 8, the United States Court of Appeals for the District of Columbia became the second federal court of appeals to uphold the constitutionality of the minimum coverage requirement of the Affordable Care Act. To date, one federal appellate court has held the minimum coverage  requirement to be unconstitutional (although severable from the remainder [...]

The Affordable Care Act Supreme Court Petitions: Issues And Implications


September 29th, 2011
by Timothy Jost

Wednesday, September 28 was a busy day at the Supreme Court clerk’s office. It had been widely expected that there would be a major pleading filed with the clerk in an Affordable Care Act challenge, as the response of the United States to a certiorari petition in the Sixth Circuit’s Thomas More case, which had [...]

Court Says Plaintiffs Have No Standing To Challenge Affordable Care Act


September 9th, 2011
by Timothy Jost

On September 8, 2011, the Fourth Circuit Federal Court of Appeals became the fifth Court of Appeals to rule on cases challenging the Affordable Care Act.  Most public attention has been focused on two of these cases, a Sixth Circuit case which found the ACA’s minimum coverage requirement — sometimes known as the “individual mandate” [...]

Implementing Health Reform: Association Health Plans


September 1st, 2011
by Timothy Jost

The Affordable Care Act comprehensively reforms health insurance in the United States.  Its central reform provisions apply to “a group health plan and health insurance issuer offering group or individual health insurance coverage,” that is, to individual, small group, large group, and even self-insured coverage. In fact, however, the ACA does not cover all forms [...]

Implementing Health Reform: Informing Consumers


August 18th, 2011
by Timothy Jost

One of the most important innovations of the Affordable Care Act (ACA) is that it dramatically increases and improves the information that consumers have available about health insurance and health care.  HHS has already implemented provisions of the ACA requiring insurers to disclose information regarding their medical loss ratios and to publicly justify unreasonable rate [...]

Appellate Court: Individual Mandate Falls But Rest Of Affordable Care Act Survives


August 15th, 2011
by Timothy Jost

Editor’s Note: Below, Tim Jost analyzes Friday’s appellate decision regarding the Affordable Care Act. See Bill Sage’s post for more Health Affairs Blog coverage of this decision and its significance. One August 12, 2011, in a case brought by 26 states and various private parties, the Eleventh Circuit Federal Court of Appeals handed down the [...]

Implementing Health Reform: Medicaid And Exchange Eligibility Determinations


August 13th, 2011
by Timothy Jost

On August 12, 2011, the Department of Health and Human Services issued two notices of proposed rulemaking (NPRMs) in its ongoing efforts to implement the Affordable Care Act (ACA).  The first addresses eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) after the 2014 implementation of the ACA Medicaid expansions.  The second governs eligibility [...]

Implementing Health Reform: Premium Tax Credits


August 13th, 2011
by Timothy Jost

On August 12, the Departments of Health and Human Services and Treasury (Internal Revenue Service) issued three notices of proposed rulemaking (NPRM) as part of their continuing effort to implement the Affordable Care Act (ACA). The proposed rules will be formally published in the Federal Register on August 17 for comment. One NPRM issued by [...]

Implementing Health Reform: Insurance Cooperatives


July 19th, 2011
by Timothy Jost

The exchange and the reinsurance, risk adjustment, and risk corridor (3R) proposed regulations released by HHS on July 11 were only the first two in a series of exchange-related notices of proposed rulemakings (NPRMs) that will be rolled out in the coming weeks and months.  A third NPRM dealing with the Consumer Operated and Oriented [...]

Implementing Health Reform: Health Insurance Exchanges (Part 3)


July 13th, 2011
by Timothy Jost

Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. Although the proposed exchange rule released by HHS on July 12 was [...]

Implementing Health Reform: Health Insurance Exchanges (Part 2)


July 12th, 2011
by Timothy Jost

Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. This is the second part of a three part analysis of the [...]

Implementing Health Reform: Health Insurance Exchanges


July 12th, 2011
by Timothy Jost

Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. Yesterday, on July 11, 2011, the Department of Health and Human Services [...]

In First Appellate Decision, A Significant Victory For The Affordable Care Act


June 30th, 2011
by Timothy Jost

On June 29, 2011, the Sixth Circuit federal court of appeals held that Congress has the power under the Constitution to adopt the minimum coverage requirement of the Affordable Care Act. The decision in Thomas More Law Center v. Obama is very significant for several reasons.  First, it is the first ruling by a federal [...]

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