Patient Protection and Affordable Care Act (PPACA)

Late Thursday evening after President Trump issued an Executive Order earlier in the day directing various administrative agencies to take suggested actions for the hope of reducing the cost of health insurance, discussed here, the Trump Administration announced it would terminate cost-sharing reduction (“CSR”) payments based upon guidance to the Administration by the Department of Justice indicating that there is no federal appropriation for the CSR payments.… Read More...

President Trump issued an Executive Order yesterday which purports to suggest three avenues for offering health insurance at a decreased cost to small employers and consumers for the overall goal of reducing healthcare costs on the grounds that the Affordable Care Act (ACA) has limited consumer choice resulting in an increase in healthcare insurance cost.… Read More...

The Affordable Care Act’s current proposed replacement does not include an employer mandate and abolishing the employer mandate is a good thing proposed in the American Health Care Act and the Patient Freedom Act before it.  Employers are not in the business of health insurance and, to some, having to offer health insurance coverage hinders their ability to continue business operations, thereby negatively impacting the ability to offer employment to the detriment of the economy. … Read More...

President Trump issued the “Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal” on January 20, 2017, one of his very first actions upon taking the oath of office.  The Executive Order directs the Department of Health and Human Services (HHS) and “heads of all other executive departments and agencies with authorities and responsibilities under the Act” to “exercise all authority and discretion available to them to waive, defer, grant exemptions from or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any state or a cost, fee, tax, penalty or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products or medications.”[1]  The Executive Order acknowledges that the agencies can only act as he has instructed “to the maximum extent permitted by law.” President Trump reiterated in the Executive Order that “[i]t is the policy of my Administration to seek the prompt repeal of the [ACA].”

In short, the Executive Order mandates that the fines and penalties associated with the ACA not be enforced as long as their enforceability is not mandated by law.… Read More...

During 2015, employers with an aggregate number of full-time and full-time equivalent employees between 50 and 99 have enjoyed a reprieve from the Patient

Protection and Affordable Care Act (“ACA”) Employer Mandate.  Although these employers qualify as Applicable Large Employers (“ALE’s”) under the ACA – and therefore must offer their full-time employees affordable, minimum value health insurance coverage or pay a penalty – the Government promised not to impose such penalties if ALE’s with less than 100 full-time and full-time equivalent employees (“Small ALE’s”) did not comply with the Employer Mandate during 2015. … Read More...

657696_55005379In a 6-3 ruling issued June 25th, the U.S. Supreme Court rendered its opinion in the case of King v. Burwell (slip op. June 25, 2015).  In this case, the Court was asked to interpret language contained in the Patient Protection and Affordable Care Act of 2010 (“PPACA”) that authorizes individuals who purchase health insurance through a marketplace known as an “exchange” to receive tax credits a/k/a subsidies. … Read More...