While much of the recent media attention focused on states
establishing health insurance exchanges under the Affordable Care Act (ACA),
the federal government is playing a significant role implementing key parts of
the law. With only sixteen states plus the District of Columbia set to manage
their own exchanges and seven more opting for a partnership approach, the
federal government will assume full responsibility for running the remainder
of the state health insurance exchange marketplaces nationwide. The Department
of Health and Human Services (HHS) also made “expand[ing] health insurance
coverage and ensur[ing] that the American people can rely on their existing
coverage when they need it most” a top regulatory
priority for Fiscal Year 2013. HHS is seeking comments on a number of proposed
rules to achieve this goal:
- Coverage for Preventive Services: Issued in conjunction
with the Departments of Treasury and Labor, the proposed rule addresses
requirements under section 2713 of the ACA requiring insurance coverage of
preventative health measures, including contraceptives. The proposal is part of
an ongoing effort by these departments to ensure insurance coverage for these
services while protecting organizations objecting to contraceptives on
religious grounds. The proposed rule contemplates two key changes: (1) amend
the criteria for the religious exemption to ensure that an employer falling
under this exemption does not face disqualification “because the employer’s
purposes extend beyond the inculcation of religious values or because the
employer serves or hires people of different religious faiths;” and (2)
“establish accommodations for health coverage established or maintained by
eligible organizations . . . with religious objections to contraceptive
coverage.”
- Small Business Health Options Plan: The ACA requires states
running their own exchanges to establish a Small Business Health Options Plan
(SHOP) to help small businesses provide insurance for their employees. The
proposed rule would make a variety of changes to existing regulations governing
the management of these SHOPs. First, it would align various aspects of the
SHOPs with provisions of the Health Insurance Portability and Accountability
Act. Second, the rule proposes a transitional plan for establishing the SHOPs
to grant businesses more preparation time while allowing employees access to small
group benefits. The comment period closes on April 1, 2013.
Visit regulations.gov
for instructions on how to submit comments.
- Essential Coverage: Section 5000A of the Internal Revenue
Code, which requires individuals to maintain minimum essential coverage, is one
of the most controversial aspects of the ACA. Certain classes of individuals
are exempted from this requirement, and the health insurance exchanges are
directed to issue certifications of exemption for qualified individuals. The
proposed rule would establish the procedures by which the exchanges will determine
eligibility for the exemption.
Kevin J. Schmitt is a third-year law student at UC Hastings College of the Law. He is currently a Senior Articles Editor for the Hastings Law Journal.
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