AFFORDABLE CARE ACT (ACA) – 2014 MID-YEAR REVIEW – JANUARY & FEBRUARY

With half of 2014 over, it is a good time to review some of the many changes in healthcare reform that have occurred.

January

January 15-A federal district court rejected a lawsuit that challenged the federal government to provide tax credits (subsidies) under the ACA to individuals in states that did not establish their own Exchanges. The court ruled that subsidies can be provided to individuals in states with federally facilitated Exchanges—resulting in federal subsidies being available to eligible individuals in all states. Other lawsuits are still pending. View the Halbig v. Sebelius case here.

February

February 10-Final regulations implementing the employer shared responsibility provisions of the ACA were released by the U.S. Department of the Treasury (Employer Shared Responsibility Final Regulations). These regulations allowed for some further delays in implementation and penalties for compliance issues. The largest impact being that the pay or play rules would apply to large employers with 100 or more full-time employees (including full-time equivalents, or FTEs) for 2015; whereas, compliance with these rules for employers with 50-99 full-time employees (including FTEs) would be delayed until 2016.

The regulations also extended some transitional relief measures.

February 20-The Departments of Labor, Health and Human Services and the Treasury released final regulations on the ACA’s 90-day waiting period limit. In most part these regulations finalized provisions under the March 2013 proposed regulations and apply for plan years beginning on or after 1/1/15.

Additionally, the Departments released a proposed rule for a provision to permit orientation periods under the 90-day waiting period limit. Employers may require employees to successfully complete a reasonable employment-based orientation period (not to exceed one month) as a condition for eligibility for coverage under a plan.