Washington Watch  

 

ACA: Cadillac Tax. A new bipartisan effort to cancel the ACA's "Cadillac tax", the 40 percent levy on high-cost health insurance plans was unveiled last Thursday in the U.S. Senate by Nevada Republican Dean Heller and New Mexico Democrat Martin Heinrich. According to Bloomberg (9/17), the bill "stands little chance of becoming law soon, especially with Barack Obama in the White House. Yet it demonstrates lawmakers' frustration with the tax, which takes effect in 2018." "I have not seen a piece of legislation that brings more sides together," Heller invoking a coalition of business groups and unions opposed to the tax, including those that represent casino workers in Las Vegas. "I think we're going to see a breakthrough," Heller stated.

CMS Rule On Out-Of-Pocket Limits for Families Clarified. The Obama Administration last Tuesday clarified a rule under which "a consumer who purchases a family health insurance plan will have an out-of-pocket cost of $6,850 for themselves or for a single family member - the same amount as someone with individual coverage." A family cap of "$13,700 would apply if more than one person in a family submits claims." HHS, Treasury, and Labor wrote in Tuesday's letter that this rule keeps consumers from being penalized for choosing family coverage rather than individual coverage." The rule goes into effect Jan. 1, 2016. (US News & World Report, 9/16)

  

Employer-sponsored Health Plans Hold Steady. Most people who enrolled in a health insurance plan through an ACA exchange were previously uninsured and were not employees of companies dropping health plans, according to new Census Bureau data. Fewer middle-income Americans took advantage of the marketplace than did people with low incomes, and the uninsured rate dropped by a higher percentage in states that expanded Medicaid eligibility, the data show. (Bloomberg, 9/16) Separately, Politico and BenefitsPro.com (9/16) report that according to Census Bureau Data, the number of Americans without health insurance fell by 8.8 million last year, to 33 million. The poverty rate remained static, at around 14.8%, and median household income was also essentially flat at $53,657. 

  

PA. "Highmark Blue Shield will offer a new tiered-benefit plan in five central Pennsylvania counties designed to hold down health insurance costs while still offering members provider choice. The new plan design, known as Alliance Flex Blue, offers two levels of in-network benefits and results from collaboration with Penn State Milton S. Hershey Medical Center and PinnacleHealth. Beginning on Sept. 8, 2015, this plan design became available to large group clients with employees located in one of the following central Pennsylvania counties: Berks, Cumberland, Dauphin, Lebanon and Perry. The effective start date for all group sizes and individuals is January 1, 2016. Small groups (100 or fewer employees) and individuals in the region will be eligible for enrollment later this year." (PRNewswire, 9/16)