Week of April 20, 2015
The Equal Employment Opportunity Commission (EEOC) and the Departments of Health and Human Services (HHS), Labor, and Treasury released guidance and proposed rules last week meant to head off confusion over the use of incentives for employer-sponsored wellness programs under the Affordable Care Act (ACA). According to the announcement, wellness programs subject to the EEOC rules must be voluntary. Employees cannot be required to participate or otherwise be subject to a penalty if they do not enroll. For example, health coverage may not be withheld if the employee refuses to take a health risk assessment. Incentives for participation in the wellness program or programs may not exceed 30 percent of the total cost of employee-only coverage under the employer's group health plan. Comments are due 60 days after publication in the Federal Register on April 20.
President Obama signed into law last week the "Medicare Access and CHIP Reauthorization Act of 2015", which passed in both the House and Senate in recent weeks with strong bipartisan support. The core provisions establish a new Medicare physician payment system and provide for a two-year extension of federal funding for the Children's Health Insurance Program (CHIP). Other provisions prohibit Medigap policies from covering the Medicare Part B deductible, but not until 2020 (with a grandfathering provision for Medigap policies sold before that date). Authority for Medicare Advantage Special Needs Plans will be extended through December 2018. The legislation also calls for the Secretary of Health and Human Services (HHS) to develop a draft plan for the development of quality measures, to be posted on the CMS website no later than January 1, 2016. The plan must be finalized by May 1, 2016.
A number of House and Senate committees held hearings last week to examine issues relating to the ACA. The House Ways and Means Subcommittee on Health held a hearing on the ACA's individual mandate and employer responsibility requirements. Subcommittee Chairman Kevin Brady (R-TX) expressed concern that the ACA is making health coverage more expensive and forcing people "to choose from a list of plans that Washington picks for them." Ranking Member Jim McDermott (D-WA) defended the individual mandate, emphasizing that it has helped to reduce adverse selection in the health insurance market. Rep. Bill Pascrell (D-NJ) said that the individual mandate prevents "free-riders" from forcing everyone else to pay for their health care costs.
A House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing last week focused on "How the President's Health Care Law is Affecting America's Workplaces." This hearing included discussion about the ACA's employer responsibility requirements and the excise tax on certain "high-cost" employer-sponsored health coverage. Rep. Brett Guthrie (R-KY) highlighted legislation he has introduced proposing to strike an ACA provision that, beginning in January 2016, will expand the definition of a small employer to include companies with 51 to 100 employees.
From Aetna health reform weekly