Weekend update

Congress will be off this week for Thanksgiving. Here’s a link to what happened last week up on Capitol Hill. The continuing resolution funding the federal government expires on December 11.

We are entering our third week of the Federal Benefits Open Season. Open Season ends on December 8. FedSmith writes at length about the ACA’s Cadillac tax which takes effect in 2018 following the next Presidential election. The Cadillac tax is a 40% excise tax imposed on the sum of health plan premiums, flexible spending account contributions, and a couple other things in excess of a threshold. The only thing predictable about the Cadillac tax is that if it is not repealed (which the FEHBlog expects) then employers will convert health care flexible spending accounts into limited dental and vision flexible spending accounts.

The FEHBlog read on Politico Pulse late last week that

WHAT DEFINES A STATE-BASED EXCHANGE? — That’s a pressing question, now that the Supreme Court could potentially block insurance subsidies to non-state-based exchanges in King v. Burwell. This week, concerned state insurance regulators asked CMS Administrator Marilyn Tavenner how a state-based exchange should be defined, but, according to a spokesman, Tavenner “expressed that there is no need to make changes to the law.” The Obama administration has said it’s confident that the lawsuit before SCOTUS won’t succeed next year and that subsidies will be allowed to continue flowing through both types of exchanges.

Consequently, it appears that the Administration does not play to gracefully avoid the Supreme Court decision by negotiating ACA amendments including one that makes it clear that subsidies can be paid on federal exchanges or marketplaces.

The Health and Human Services Department issued a proposed notice of benefits and payments parameters for 2016. Here is a link to a helpful Health Affairs blog summary of the proposed changes in this massive annual rule. As the Health Affairs blog entry indicates, the Internal Revenue Service not to be outdone issued several rules related to the individual shared responsibility mandate. The fun never stops.