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Wednesday, Nov 5 2014

Full Issue

Feds Move To Close Health Law Loophole That Allows Large Employers To Offer Plans Without Hospitalization Benefits

The Obama administration announced Tuesday that large employers who offer plans that don't include coverage for in-patient hospital stays will not meet the health law's standards. The administration outlined steps it will take going forward to address this issue.

Closing what many see as a loophole that could trap millions of people in sub-standard insurance, the Obama administration said Tuesday that large-employer medical plans lacking hospital coverage will not qualify under the Affordable Care Act鈥檚 toughest standard. It also offered relief to workers who may be enrolled in those plans next year. The administration will rule that plans without 鈥渟ubstantial coverage for in-patient hospitalization services鈥 do not meet the law鈥檚 鈥渕inimum value鈥 threshold, the Treasury Department said in a notice Tuesday morning. It will issue final regulations saying so next year, it said. (Hancock, 11/4)

An employer health plan that doesn鈥檛 cover hospital care won鈥檛 quite cut it under the health law, according to federal regulators. A new notice issued Tuesday by the Department of Health and Human Services and the Treasury Department says they believe that 鈥減lans that fail to provide substantial coverage for in-patient hospitalization services or for physician services鈥 or both don鈥檛 meet the law鈥檚 standard for minimum value. That means a big employer offering such a plan to workers could still be subject to one of the law鈥檚 two penalties for failing to provide adequate coverage. Also, an employee offered such a plan could potentially still qualify for federal subsidies to buy coverage through one of the law鈥檚 marketplaces. (Wilde Mathews, 11/4)

Federal regulators Tuesday announced plans to close a loophole in the Affordable Care Act that allows large employers to offer plans that don't cover in-patient hospital stays. ... To meet the ACA's "minimum value" test, health plans for individuals and those working for smaller employers must include coverage within at least 10 categories of "essential health benefits" that include maternity care, prescription drugs and hospitalization.The health care law is much more stringent about what health insurance must cover for these people than it is for those working at large employers. (O'Donnell, 11/4)

Health plans offered by large, self-insured employers that do not include inpatient hospital services as a standard benefit will soon be a thing of the past, according to a notice released Tuesday by HHS and the Treasury Department. The federal government said many healthcare industry stakeholders raised questions and concerns about the viability of these types of 鈥渟kinny plans,鈥 and hospitals are hailing the latest guidance. Many companies have been building health benefits packages for employees to avoid paying a penalty under the Patient Protection and Affordable Care Act. But some of those plans have excluded hospitalization benefits. (Herman, 11/4)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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