On January 22, 2018, Congress passed an interim funding bill to end the three-day government shutdown that also pushed back the effective date of the Affordable Care Act’s controversial “Cadillac Tax.” The Cadillac Tax imposes an excise tax on group health plans that provide benefits in excess of certain thresholds. The new legislation pushes the effective date back an additional two years to January 1, 2022.
Senate Republicans failed to pass legislation to repeal and replace the Affordable Care at the end of July. After voting to proceed with debate on the American Health Care Act, which was passed by the House in May, the Senate introduced and voted against several replacement amendments and bills, including a new version of the Better Care Reconciliation Act, with amendments by Senators Ted Cruz (R-TX) and Rob Portman (R-OH), and the Obamacare Repeal Reconciliation Act.
Last week, Senate Republicans unveiled draft legislation to move toward repealing portions of the Affordable Care Act (ACA). The draft health care bill, known as the Better Care Reconciliation Act, was hatched behind closed doors without public committee hearings or debate, in response to concerns raised by the House’s American Health Care Act (AHCA), which passed by the slimmest of margins on May 4, 2017. The bill faces an uphill battle as several Republican senators have already come out in opposition to the draft bill, conservatives have criticized the bill not going far enough to repeal the ACA and moderates are uneasy about the impact severe cutbacks to the Medicaid system will have on their constituents. Senator Mitch McConnell has vowed to bring the draft bill to a vote this week before Congress recesses for the Fourth of July holiday.
On Thursday, May 4, 2017, the US House of Representatives passed the American Health Care Act by the slimmest of margins with no Democrats voting in favor of the bill. Amendments to the original bill attracted more support from both moderate and conservative Republicans by the introduction of two amendments: one that gives more leeway to the states to request waivers from the more onerous provisions of the ACA that cannot be changed through the budget reconciliation process, and a second one that adds $8 billion of funding to the bill to help improve the “high-risk pools” that could be set up by states to provide coverage to individuals with pre-existing conditions who cannot find affordable insurance in the open market.
On Monday March 20, 2017, technical and policy amendments to the American Health Care Act of 2017 (AHCA) were introduced to address concerns by more conservative Republicans. The House just announced they are delaying the vote on the AHCA likely due to the uncertainty that it would pass.
On Monday March 6, 2017, the House Republican leadership in the Energy and Commerce and Ways and Means Committees unveiled their signature bill to “repeal and replace” the Affordable Care Act (ACA). The “American Health Care Act” (AHCA) is an effort to make good on President Trump’s promise to dismantle the ACA. Democrats are united in their opposition to the AHCA and other stakeholders have also come out against the bill – while the proposed legislation is subject to modification as it is marked up in committee and debated in Congress, certain provisions of the AHCA, if enacted, will be of particular importance to employers and provide the framework for a strategic road map as employers plan and design future health care benefits for their employees.
In the aftermath of the recent election of Donald Trump as president of the United States and the Republicans’ retention of control over both the House and the Senate, many are beginning to assess the impact of a Republican controlled Congress and presidency on the future of the Affordable Care Act (ACA).
This year’s Employer Healthcare & Benefits Congress featured a presentation by Susan Nash that addressed the many shapes and sizes of wellness programs today. Programs are typically designed to promote health and to educate employees about prevention, but some are disease management oriented, while others are designed to improve the general overall health of an employee population.
Presentation focal points included:
HIPAA Nondiscrimination Rules
Tri-Agency Guidance under ACA on Wellness Programs
Recent year-end delays to important Affordable Care Act requirements have given employers and other stakeholders much needed reprieve. President Obama signed into law a two-year delay of the Cadillac Tax on December 18, 2015.
This two-year delay is part of Congress’s $1.8 trillion omnibus spending deal, the Consolidated Appropriations Act, 2016. In addition, the IRS recently announced a delay in health information reporting requirements for 2015 Forms 1094 and 1095.
Effective for tax years beginning on or after January 1, 2018, an excise tax of 40 percent will be imposed on the cost of employer-sponsored health coverage that exceeds an annual limit. This tax is informally known as the “Cadillac Tax” and will impose a penalty on employers, health insurers and “persons who administer plan benefits” with regard to high-cost health care coverage.