Update, March 30: Dismissal of IPAB challenge. On March 30, 2015, the curtain fell on another lawsuit challenging the Affordable Care Act when the Supreme Court denied certiorari in Coons v. Lew. Coons had challenged the individual mandate on a number of bases, including that it violated his rights to medical privacy. The Coons case has been best known, however, for its challenge to the constitutionality of the Independent Payment Advisory Board, or IPAB.
In August of 2014 the Ninth Circuit Court of Appeals affirmed a district court decision dismissing all claims in the case. In particular, the Court dismissed the challenge to the IPAB, holding that any injury the IPAB might cause the plaintiffs if the IPAB is ever constituted is currently too remote and speculative to support jurisdiction in the court. The plaintiffs requested Supreme Court review. Today, the Court denied that request. This does not, of course, foreclose a future challenge to a future IPAB, but does settle the issue at least until there actually is an IPAB.
Update March 27: Agent and broker training. The 2016 Benefit and Payment Parameters Final Rule included new regulations for certifying vendors of federally facilitated marketplace broker and agent training. CMS has now released an application form for vendors wishing to offer these training programs. Issues covered by the form include training experience, training offered, information verification experience and programs, compliance history, data privacy and security protection, quality assurance, fee structure, and project staff.
Calculating premium tax credits. I have just discovered IRS Publication 974, which apparently has been available since some time in February. Publication 974 provides a comprehensive overview of the rules governing premium tax credits, including a number of examples and worksheets. It is particularly useful for addressing complex issues like the calculation of premium tax credits when a couple get married mid-year, or the coordination of the self-employed health insurance deduction and premium tax credits.
The instructions for the IRS Form 8962 refer to Publication 974 for further guidance on a number of important questions not fully explored by the instructions. At first glance, the publication seems to offer more comprehensive answers to these questions.
Update, March 24, Medicaid expansion and uncompensated care: On the fifth anniversary of the signing of the Affordable Care Act, the Assistant Secretary for Planning and Evaluation released two new reports documenting progress under the law. The first report reviewed a number of studies that have estimated the impact of Medicaid expansion on increasing state gross domestic product, creating jobs, reducing uncompensated care, and improving the financial circumstances of poor people. The second report specifically addresses reduction in uncompensated care. Read the rest of this entry »