Headlines about "Health plans - mandated benefits"
Gathered from the web by the editors at BenefitsLink.com.
Obama Aides Seek To Calm Storm Over Contraceptive Rule
"Administration suggests there may be ways to meet religious groups' concerns but insists that the president is committed to the policy." (Kaiser Health News)
White House May Look to Compromise on Contraception Decision
The White House may be open to compromising on a new rule that requires religious schools and hospitals to provide employees with access to free birth control, a senior strategist for President Obama said on Tuesday morning. (The New York Times)
Essential Benefits, Summaries Among Implementation Issues in the News
"n this pair of stories, CQ HealthBeat offers the latest news on the health law's benefts summary rule and one state insurance commissioner's views on essential benefits." (Kaiser Health News)
[Guidance Overview] Maintaining 'Grandfathered Plan' Status for Group Health Plan Critical to Avoiding New Mandate on Coverage for Contraceptives
"Multiple religious organizations have expressed opposition to the Section 2713 mandate, including the U.S. Conference of Catholic Bishops, the National Association of Evangelicals, and the Union of Orthodox Jewish Congregations of America, among many others. Given the limited options available for avoiding the new mandate for nongrandfathered group health plans, those employers who will not be able to comply with the new rules due to their religious beliefs but who wish to continue offering group health plans to their employees must pursue other courses of action." (Hinshaw & Culbertson LLP)
[Opinion] An Affront Catholics Agree On
"Liberal and conservative Catholics don't agree on much, but they're both outraged by a new rule on contraception coverage." (Los Angeles Times)
Administration and Catholics Tangle Over Mandatory Contraception Coverage
The administration will not reconsider the decision, White House spokesman Jay Carney said yesterday, according to the Associated Press. (AP via Washington Post)
Domestic Policy Council Director's Statements on White House Blog About Contraceptive Mandate
"Over half of Americans already live in the 28 States that require insurance companies cover contraception: Several of these States like North Carolina, New York, and California have identical religious employer exemptions. Some States like Colorado, Georgia and Wisconsin have no exemption at all." (The White House Blog, written by Cecilia Mu?oz, Director of the White House Domestic Policy Council)
[Opinion] Protestants and Jews Declare to White House: We Stand With Catholics
"[M]ore than 40 non-Catholic religious organizations including Protestant-affiliated colleges, National Association of Evangelicals, Focus on the Family, Assemblies of God, Northwest Nazarene University, and Eastern Mennonite University, sent a letter to the White House demanding religious protection against the newly issued HHS contraceptive mandate." (Becket Fund)
Anger Brewing on the Left About Mandatory Contraceptive Coverage for Employees of Religious Employers
"Megan McArdle, senior editor of the Atlantic, wrote yesterday that it might be in Americans' interest to be more flexible with faith-based organizations because they provide such a depth of social services (publicly funded in many cases, of course) . . . ." (Washington Post)
[Guidance Overview] Agencies Outline Plans for Issuing Rules Under Affordable Care Act
"[An] imminent final rule will establish the requirements of the Summary of Benefits and Coverage (SBC) disclosure that health insurers and group health plans must provide to consumers to enable them to better compare benefits and coverage. The CMS issued a proposed rule on this topic in August 2011. A final rule, which will also 'set standards for the definitions of terms used in health insurance coverage, including specific terms' provided in the Affordable Care Act, is expected to be issued shortly." (Employee Benefits Counsel Blog)
Catholic Bishops Revolt Against Birth Control Rules
"There's a battle going on between U.S. Catholic bishops and the Obama administration over its recent directive requiring religious institutions to offer coverage for contraception in their health care plans. Some have announced they will not comply with the mandate. Others are calling on parishioners to . . . speak out against what they call an intrusion against religious liberty." (National Public Radio)
[Opinion] Obamacare's Contraception Mandate Tramples on Religious Liberty
"Exemption of religious institutions from the Obamacare contraception mandate does not involve a clash of the constitutional rights of a religious employer with the constitutional rights of its employees regarding contraception (as enunciated by the U.S. Supreme Court in Griswold v. Connecticut, 1965) or abortion (Roe v. Wade, 1973). Such an exemption in no way limits the freedom of employees of those religious institutions to obtain contraceptive services, to obtain insurance covering contraceptive services from a source other than their employer, or to seek employment with other than a religious employer." (The Heritage Foundation)
A Guide to The Supreme Court's Review of The 2010 Health Care Reform Law
"[T]his Kaiser Family Foundation brief serves as a primer on the pending case, which challenges the constitutionality both of the law's individual mandate that requires most Americans to obtain health insurance and of provisions requiring states to expand eligibility for their Medicaid programs. The brief provides an overview of . . . the key constitutional questions, and the legal arguments made by the parties involved . . . and the potential implications of the Court's decisions.' (Kaiser Family Foundation)
[Opinion] Aging Groups Argue That Most Health Reform Law Provisions Affecting Seniors Should Not Be Tied To Supreme Court's Ruling on Individual Mandate (PDF)
"The [recently filed amicus] brief . . . highlights the parts of the ACA that greatly benefit people aged 65 and older that should not be affected should the Court decide to invalidate the minimum coverage provision, including: Reduced cost-sharing for Medicare beneficiaries for prescription drugs by substantially reducing the coverage gap or so-called donut hole; Elimination of cost-sharing for annual wellness visits and other screening services; Medicare Advantage plans are prevented from charging higher cost-sharing for chemotherapy and dialysis than permitted under traditional Medicare . . . ." (National Senior Citizens Law Center)
[Opinion] Amicus Brief of AARP and Other Organizations, Arguing in Favor of Severability in Constitutional Challenge to Mandated Health Insurance Coverage (PDF)
56 pages. The brief was filed by AARP; Center For Medicare Advocacy, Inc.; Medicare Rights Center; National Committee to Preserve Social Security and Medicare; National Council on Aging; and the National Senior Citizens Law Center. (AARP)
[Guidance Overview] Health Care Reform Update, by ML Strategies (PDF)
A succinct listing of recent health care reform legislation, regulations, and initiatives. (ML Strategies, LLC)
[Opinion] Disregarding Religious Beliefs: Obama's Radical Power Grab on Health Care
"There would have been no controversy at all if President Obama had simply exempted religious institutions and ministries. But the administration insisted that the University of Notre Dame and St. Mary's Hospital be forced to pay for the privilege of violating their convictions. Obama chose to substantially burden a religious belief, by the most intrusive means, for a less-than-compelling state purpose -- a marginal increase in access to contraceptives that are easily available elsewhere." (Michael Gerson in the Washington Post; free registration required)
Catholic Clergy Come Out Swinging Against HHS Regulation Mandating Cost-Free Contraceptives
"Catholics around the country got an earful on Sunday from the pulpit over a new health insurance policy by the U.S. Department of Health and Human Services that forces employers to cover contraception and abortion as part of preventative care regardless of religious beliefs. The use of abortion and contraceptives violates Catholic teachings." (CNN Belief Blog)
Aging Groups Argue that Most Provisions Affecting Seniors Should Not Be Tied to Supreme Court's Ruling on Individual Mandate (PDF)
"Six national aging groups filed a friend of the court brief with the Supreme Court LAST Friday saying that there are extensive provisions in the Patient Protection and Affordable Care Act (ACA) that are of 'vital importance to the health and well-being of people 65 and older' and that Congress did not intend for any of them to be contingent on whether or not the minimum coverage provision (also called the individual mandate) was constitutional." (National Senior Citizens Law Center)
The State of Massachusetts Health Reform, in 3 Charts
"Health Affairs is out . . . with a four-year look back at Massachusetts health reform. It has some good news (coverage has gone up!) and not-so-good news (health care isn't getting any cheaper). With the Massachusetts reforms serving as the model for the federal law, it's worth taking a look at what has and hasn't worked in the Bay State reforms." (The Washington Post; free registration required)
Following Benchmark Proposal, HHS's List of Largest Small Group Products by State
"This information is intended to complement HHS' December 16, 2011 bulletin, which proposed a benchmarking approach for defining essential health benefits." (Practical Law Company)
[Guidance Overview] HHS Extension of Compliance Date for Contraceptives Coverage for Certain Nonprofit Employers
"The delayed implementation rule does not expand the scope of religious employers who are exempt from the requirement to cover contraceptives under earlier guidance." (Practical Law Company)
[Opinion] Should Everyone Be Required to Have Health Insurance?
"Uninsured individuals who need care, particularly catastrophically expensive care, generally receive these services anyway. A decision not to pay for insurance -- to become a free rider -- leads hospitals and other providers to charge other patients more to make up the difference. People shouldn't have the freedom to shift the burden to everybody else." (The Wall Street Journal)
[Guidance Overview] New California State and Local Health Plan Requirements May Have ERISA Preemption Implications (PDF)
See page 4. 'Starting in 2012, employers in California, and particularly in San Francisco, will be required to comply with a number of new health plan requirements which may have ERISA preemption implications. Two of the most important are California SB 299 and the recent amendment to the San Francisco's health care mandate." (Trucker Huss, APC.)
U.S. Health Care Hits $3 Trillion
"[H]ave we tamed the cost beast with real legislation -- or is it just legislation around the edges? . . . Obamacare took the payers out to the woodshed. Medical Loss Ratios (or basically what the insurance companies pay out for actual healthcare services) will be mandated -- but is this really going to dent our [national health expenditures]?" (Forbes)
Bishops Will Sue Federal Government Over Mandatory Contraception Coverage
"The United States Conference of Catholic Bishops is promising a legal challenge to federal rules the Obama administration reaffirmed Friday requiring health insurers to provide women with a range of preventive health services, including birth control, without charging a co-payment, co-insurance or deductible." (Kaiser Health News)
Administration Rules Insurers Must Cover Contraceptives
"The rule includes an exemption for certain 'religious employers,' including houses of worship. But church groups said the exemption was so narrow that it was almost meaningless. A religious employer cannot qualify for the exemption if it employs or serves large numbers of people of a different faith, as many Catholic hospitals, universities and social service agencies do." (New York Times; free registration required)
[Opinion] Washington Post Editorial: HHS Is Wrong to Disrespect Religious Exemptions
"The best approach would have been for HHS to stick to its original conclusion that contraception coverage should generally be required but to expand the scope of its proposed exemption for religiously affiliated employers who claim covering contraception would violate their religious views. The administration's feint at a compromise -- giving such employers another year to figure out how to comply with the requirement -- is unproductive can-kicking that fails to address the fundamental problem of requiring religiously affiliated entities to spend their own money in a way that contradicts the tenets of their faith." (Washington Post)
Washington State Bill Would Require Abortion Coverage
"Democratic members of the state legislature introduced a bill earlier this month that would maintain or expand abortion coverage. The 'Reproductive Parity Act,' set for its first hearings on Thursday, would require private and public insurers that provide maternity coverage to cover abortion services as well. If passed, the law would be the first of its kind in the nation." (The Henry J. Kaiser Family Foundation)
Religious Employers Given More Time for Contraception Rule
"The religious organizations will have a one-year delay before they must comply with a new rule requiring employers that offer workers health insurance to include access to contraception with no out-of-pocket cost, the Washington Post reported, citing people familiar with the decision. But the rule itself and the employers covered by it remain unchanged." (PLANSPONSOR.COM)
Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform
"We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)
Massachusetts Residents without Health Insurance to Face Higher Penalty in 2012
"Under the guidelines . . . the maximum penalty this year for those with incomes that exceed 300% of the federal poverty level will be $105 for each month that an individual is not covered by health insurance, or $1,260 a year." (Business Insurance)
Compliance of Group Health Plans (and Health Insurance Coverage Offered in Connection with Such Plans) with Requirements of Mental Health Parity and Addiction Equity Act of 2008
"[T]his Report focuses on summarizing DOL's initial implementation efforts. The Report provides an overview of MHPAEA, the Departments' joint interim final rules and sub-regulatory guidance, as well as a discussion of DOL's Employee Benefits Security Administration's efforts in developing an infrastructure for MHPAEA implementation." (U.S. Employee Benefits Security Administration)
Eliminating the Individual Mandate: Effects on Premiums, Coverage, and Uncompensated Care
"The researchers found that without the individual mandate: Between 40 and 42 million would remain uninsured as opposed to 26 million with the mandate; Private coverage would fall 11 million, covering 4 million fewer people than it would have without reform; Uncompensated care spending would be much higher due to the increased number of uninsured; andIndividual premiums in the health benefit exchanges would increase by 10 percent in a scenario assuming high exchange participation and by 25 percent with a low participation scenario." (Robert Wood Johnson Foundation)
Nearly 500 State Lawmakers to Press Supreme Court to Uphold Health Care Mandate
"The state lawmakers say requiring almost all Americans to buy insurance falls well within Congress's power under the Constitution's Commerce Clause. Echoing the Justice Department's arguments in support of the mandate, the state legislators said the Constitution gives Congress broad authority to regulate interstate commerce." (Capitol Hill Publishing Corp.)
[Opinion] Amicus Brief of Texas Public Policy Foundation and Cato Institute, Arguing Against Severability in Constitutional Challenge to Mandated Health Insurance Coverage (PDF)
"Various provisions of the Patient Protection and Affordable Care Act impede state sovereignty and individual liberty, limiting states' ability to chart their own course on matters relating to health care. Holding the entire Act unconstitutional would thus vindicate Amici Curiae's missions." (Texas Public Policy Foundation)
Has Obama Waged a War on Religion?
"If you're looking for evidence that the Obama administration is hostile to faith, conservatives say, the new health care law is Exhibit A. The law requires employers to offer health care plans that cover contraceptives. Churches don't have to, but religiously affiliated charities, hospitals and colleges do." (NPR)
AHIP and BCBSA File Amicus Brief in U.S. Supreme Court
"AHIP and BCBSA today filed an amicus brief in the U.S. Supreme Court stating that certain insurance market reforms in the Affordable Care Act (ACA) are inextricably linked to the law's personal coverage requirement and have to be severed from the ACA if the Court finds the coverage requirement unconstitutional. The brief supports reversal of the 11th Circuit Court of Appeals' severability judgment which struck down the personal coverage requirement but maintained all of the insurance market reforms that were enacted as companions to the coverage requirement." (AHIP)
New Year Means New Health Insurance Laws for Connecticut
"The beginning of 2012 ushered in seven new requirements for health insurance coverage provided by employers to Connecticut residents that proponents say will save lives and money in the long run." (The Day Publishing Company)
Justice Department, Lawmakers File SCOTUS Health Suit Briefs
"The Obama administration brief is the first of four that will be filed before the end of February." (The Henry J. Kaiser Family Foundation)
Brief for State Petitioners on Severability of Coverage Mandate Filed with U.S. Supreme Court (PDF)
"QUESTION PRESENTED: If the Affordable Care Act's mandate that virtually every individual obtain insurance exceeds Congress' enumerated powers, to what extent (if any) can the mandate be severed from the remainder of the Act?" (National Federation of Independent Business, et al., via The Henry J. Kaiser Family Foundation)
Brief Filed with Supreme Court: Department of Health and Human Services, et al., Petitioners v. State of Florida, et al (PDF)
"The question presented is whether the minimum coverage provision [of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010] is a valid exercise of Congress's powers under Article I of the Constitution." (U.S. Department of Justice via The Henry J. Kaiser Family Foundation)
Brief Filed with Supreme Court: Department of Health and Human Services, et al., Petitioners v. State of Florida, et al (PDF)
"The question presented is whether the minimum coverage provision [of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010] is a valid exercise of Congress's powers under Article I of the Constitution." (http://www.kaiserhealthnews.org/~/media/Files/2012/11398tsUnitedStatesfiled.pdf)
[Guidance Overview] New San Francisco Health Care Requirements May Impact Employers with San Francisco Employees
"The amendments impose new requirements for HRAs, FSAs and HSAs that covered employers use to comply with the Ordinance; practically, these requirements may render it impossible to use FSAs and undesirable to use HRAs to comply with the Ordinance. The amendments also add a new employee notice requirement, regulate an employer's use of surcharges on its customers to cover the required health care expenses, and revise the penalty provisions of the Ordinance." (Quarles & Brady)
Recent State Law Changes May Impact Your Health and Welfare Program
"If you operate a group health plan that has some portions that are insured and subject to these laws, and other portions that are not subject to these laws, you may want to analyze whether to extend the higher level of coverage to all of your employees in order to avoid administrative complexity or confusion." (McKenna Long & Aldridge LLP)
[Guidance Overview] Further Guidance Issued on Nonquantitative Treatment Limitations under Mental Health Parity and Addiction Equity Act (PDF)
"COMPLIANCE ALERT: A plan sponsor that wants to impose a special copayment on mental health or substance use disorder benefits has to make certain that at least two-thirds of all medical/surgical benefits in the classification are subject to a copayment and that the specialist copayment applies to more than 50% of all medical/surgical benefits paid within that classification that are subject to a copayment." (Buck Consultants, LLC)
[Guidance Overview] Group Health Plans: Year-End Action Items, Upcoming Changes
"Plan sponsors of grandfathered plans must assess whether 2012 plan design changes will impact the plans' grandfathered status. For example, grandfathered plan status is lost if any increase is made to the percentage of cost sharing borne by a participant or if a co-pay increases by more than $5 (from the co-pay in place when healthcare reform was enacted, not from the prior year). . . . [Further, for non-grandfathered plans,] new content requirements for claim-related notices become effective January 1, 2012." (Morgan, Lewis & Bockius)
[Opinion] Obama's Piecemeal Approach to Health Law in States
"States now collectively mandate more than 1,600 health services but vary widely in which ones they require. With some exceptions, like bariatric surgery or acupuncture, experts expect benefits for most basic services to be fairly consistent across the nation." (New York Times; free registration required)
Affordable Health Insurance Options for Young Adults
"A study by eHealthInsurance.com found that 73% of employers are expecting an increase in dependent coverage in 2012 due to the law passed in 2010." (Fox Business)
[Guidance Overview] FAQs Clarify Parity Requirements for Mental Health and Substance Use Disorder Benefits
"[DOL released a set of [FAQs] responding to questions raised regarding how the new parity requirements apply to nonquantitative treatment limitations, such as medical management standards, formulary designs, standards for provider admission to the network, and methods to determine reasonable and customary fees." (Deloitte via BenefitsLink.com)
[Guidance Overview] Employers Must Comply with Changes to San Francisco Health Care Mandate Beginning January 1, 2012
"While these changes again raise federal [ERISA] preemption concerns, barring a challenge (which seems unlikely), the Ordinance's new requirements will go into effect. Employers, particularly those using a health reimbursement account plan (HRA) or a health savings account (HSA) plan, should consider compliance preparations with the assistance of legal counsel." (Jackson Lewis LLP)
Coalition Urges HHS to Consider Affordability for Employers in Developing the Essential Benefits Package
"In addition to keeping affordability a top concern, the coalition says HHS should also follow the IOM's recommendations for the treatment of state benefit mandates and the basis for making updates to the package." (Employee Benefit News)
[Guidance Overview] DOL FAQ #7 Delays Summary of Benefits and Coverage Requirement under ACA; Clarifies Rules under MHPAEA
"It is expected that when final regulations are released, the applicability date will leave group health plans and health insurers with sufficient time to comply." (Proskauer Rose LLP)
Catholic Groups Fight Contraceptive Mandate, but Many Already Offer Coverage
"[W]hile some insist that the rules, which spring from last year's health law, break new ground, many states as well as federal civil rights law already require most religious employers to cover prescription contraceptives if they provide coverage of other prescription drugs." (NPR)
San Francisco Expands Employer Health Reimbursement Role
"On Jan. 1, employers in San Francisco will have to make sure that employee health reimbursement accounts the city requires them to fund are available to employees for two years, not just one. Amendments to the Health Care Security Ordinance . . . add to the requirements the city already has in place . . . ." (SmartHR)
GAO Report: Employers' Insurance Coverage Maintained or Enhanced Since Parity Act on Mental Health and Substance Use
"The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 . . . requires that employers who offer health insurance coverage for mental health conditions and substance use disorders . . . provide coverage that is no more restrictive than that offered for medical and surgical conditions." (U.S. Government Accountability Office)
[Guidance Overview] Significant Changes to San Francisco Health Care Security Ordinance Require Immediate Employer Action (PDF)
"In particular, the revised Ordinance imposes detailed design and administrative requirements on accounts established to satisfy the employer healthcare expenditure requirement. Because these new requirements directly relate to the operation of such accounts, there is a strong likelihood that the requirements will reopen the long-simmering debate about whether [ERISA] preempts some or all of the revised Ordinance." (Morgan, Lewis & Bockius LLP)
Insurers 'Terrified' of Supreme Court Ruling on Health Care Reform Law
"[I]nsurers say sticking to [rules limiting how much older people can be charged, requiring family plans to cover young people up to age 26, mandating coverage of a broad package of 'essential health benefits' in state-based exchanges] without a mandate would drive up the cost of premiums while leaving insurance plans as the villain, since the law requires plans to justify rate hikes of 10 percent or more." (The Hill)
[Guidance Overview] Summary of Benefits and Coverage Requirements Delayed; FAQs on Mental Health Parity Issued (PDF)
"The latest round of guidance includes several items of interest for employers: (1) a delay of the applicability date for the Summary of Benefits and Coverage . . . requirements under PPACA; (2) clarifications regarding the nonquantitative treatment limitations and copayment variations prohibited for mental health/substance use disorder benefits under MHPAEA, and (3) information on permissible copayment variations for mental health/substance use disorder benefits." (Sutherland Asbill & Brennan LLP)
Health Insurers Fear Consequences of Individual Mandate Being Struck Down
"For insurers, the death of the mandate alone -- one of many plausible outcomes in the blockbuster case -- is the nightmare scenario, one Republican healthcare lobbyist told The Hill. 'They're terrified they're going to be left holding the bag,' the lobbyist said . . . ." (The Henry J. Kaiser Family Foundation)
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