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Tuesday, Nov 4 2014

Full Issue

Feds Target Health Law Loophole That Allows Large Employers To Offer Plans That Don't Cover Hospitalization

News outlets cover a range of issues -- from the specific benefits that health plans cover to premium changes that are in the works.

Moving to close what many see as a major loophole in Affordable Care Act rules, the Obama administration will ban large-employer medical plans from qualifying under the law if they don鈥檛 offer hospitalization coverage. The administration intends to disallow plans that 鈥渇ail to provide substantial coverage for in-patient hospitalization services or for physician services,鈥 the Treasury Department said in a notice Tuesday morning. It will issue final regulations banning such insurance next year, it said. (Hancock, 11/4)

The Obama administration plans to close a loophole in the Affordable Care Act that allows large companies to refuse to cover in-patient hospital stays in any of their health insurance plans, according to an official involved in the internal discussions. The official requested anonymity until the announcement is made because "the guidance that will be issued is not finalized." (O'Donnell, 11/3)

Earlier, related KHN coverage:
(Hancock, 10/16).
(Hancock, 9/26).
Flaw In Federal Software Lets Employers Offer Plans Without Hospital Benefits, Consultants Say (Hancock, 9/12).

Just after the election, insurers will send letters to millions of consumers spelling out changes in premiums for coverage under the health care law. Why not before? Under the health law, the federal government is responsible for approving premiums for health plans in 36 states where it is running some or all of the online insurance exchanges through the HealthCare.gov website. The Department of Health and Human Services told insurers in early September they should notify consumers who hold policies with them of their new premiums for 2015 only after HHS approved the rates. HHS can鈥檛 reject the new rates, only criticize them. (Radnofsky, 11/3)

When Obamacare patients learn their deductible is so high they鈥檙e unlikely to get any reimbursement, they often wind up in places like the Denton, Texas Community Care Center. (Angle, 11/4)

Todd Hawkins is a Virginia home builder who insists that the big plans he has for his business are not so big that they will put him in the path of the Affordable Care Act. That, anyway, is what he told You鈥檙e the Boss readers when he commented on a recent post about determining whether a company is subject to the law鈥檚 employer mandate. 鈥淚 can promise we won鈥檛 go over 49 employees, so A.C.A. will affect employment, at least by one company,鈥 he wrote. 鈥淢ine.鈥 But Mr. Hawkins told a different story when I contacted him a few days later to talk about his comment. 鈥淣ext year,鈥 he said, if he and his partner鈥檚 new idea works out, 鈥渢hat鈥檚 when we鈥檒l run into the A.C.A.鈥 He has 21 employees now. (Mandelbaum, 11/3)

The Obama administration is defending its health care law in court, arguing that the text of the law and Congress' intent allow Americans to receive insurance subsidies regardless of whether they're enrolled through insurance markets run by the states or by the federal government. In a federal appeals court filing, the Justice Department on Monday disputed opponents' contention that the law limits tax credits for low- and moderate-income consumers only to those who live in states that have set up their own insurance markets, or exchanges. (11/3)

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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