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 Decade: 2010-2019
 Collection: Congressional Research Service Reports
Provisions of the Senate Amendment to H.R. 3762
This report includes a table listing all provisions in H.R. 3762 and the Senate amendment to H.R. 3762 that would amend or repeal Affordable Care Act (ACA) provisions. It also provides a brief explanation of the provisions included in the Senate Amendment to H.R. 3762. digital.library.unt.edu/ark:/67531/metadc824795/
Puerto Rico and Health Care Finance: Frequently Asked Questions
This report provides answers to frequently asked questions (FAQs) about how federal health care programs and requirements are implemented in Puerto Rico, including information about eligibility, coverage, program requirements, and payment rules. Examples provided in the FAQs illustrate that in many circumstances, some health programs in Puerto Rico differ from programs in the US, while in other circumstances, Puerto Rico is treated the same as the states. As such, these questions and answers should be viewed as a discussion of the complexity of health care financing as it relates to Puerto Rico under current law. digital.library.unt.edu/ark:/67531/metadc824672/
The Health Coverage Tax Credit (HCTC): In Brief
This report describes the eligibility criteria for the Health Coverage Tax Credit (HCTC) and the types of health insurance to which the tax credit may be applied. The tax credit's purpose is to make the purchase of health insurance more affordable for eligible individuals. The HCTC has a sunset date of January 1, 2020. The report also briefly describes the administration of the HCTC program and receipt of the credit by eligible taxpayers; it concludes with a summary of the HCTC's statutory history. digital.library.unt.edu/ark:/67531/metadc824691/
Health-Related Tax Expenditures: Overview and Analysis
This report analyzes health-related tax expenditures together at the budget function level, rather than focusing on the size of any single provision. To provide some insights into common questions about health-related expenditures, this report analyzes historical data on health-related tax expenditure estimates published by the Joint Committee on Taxation (JCT). digital.library.unt.edu/ark:/67531/metadc824709/
Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)
This report summarizes the language related to the Affordable Care (ACA) that was added to annual appropriations legislation by congressional appropriators since the ACA was signed into law. The information is presented in a table. While a detailed examination of the ACA itself is beyond the scope of this report, a brief overview of the ACA's core provisions and its impact on federal spending is provided as context for the material in the table. Congress remains deeply divided over implementation of the Affordable Care Act (ACA), which President Obama signed into law in March 2010. digital.library.unt.edu/ark:/67531/metadc824565/
The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs
This report explores how modified adjusted gross income (MAGI) is defined differently across health programs such as Medicare, the health insurance exchanges under the Affordable Care Act (ACA), and Medicaid. It also discusses why MAGI is used, and how it is applied, specific to each program. The report covers that MAGI is used to determine (1) penalty amounts owed if a person does not comply with the individual mandate or whether an individual is exempt from the individual mandate; (2) eligibility for and the amount of a premium credit to purchase coverage through a health insurance exchange; and (3) Medicaid income eligibility for certain populations. digital.library.unt.edu/ark:/67531/metadc824590/
Discretionary Spending Under the Affordable Care Act (ACA)
This report examines the Affordable Care Act's (ACA's) effects on discretionary spending. It first discusses all the ACA authorizations (and reauthorizations) of appropriations for grant and other programs; this information, along with actual funding amounts, is summarized in a series of tables. The report then reviews the ACA administrative costs borne by CMS and the IRS. digital.library.unt.edu/ark:/67531/metadc824419/
The Ebola Outbreak: Quarantine and Isolation Authority
This legal sidebar discusses recent quarantine policies announced by several states, including New York and New Jersey, for travelers arriving from areas affected by the outbreak of Ebola Virus Disease, which have raised legal and constitutional questions about federal and state authority to order quarantine and isolation measures. digital.library.unt.edu/ark:/67531/metadc824427/
Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis
This report discusses the Patient Protection and Affordable Care Act (ACA), P.L. 111-148, as amended, Congress enacted a “minimum coverage provision,” which compels certain individuals to have a minimum level of health insurance. This report provides an analysis of the constitutionality of this provision requiring individuals to obtain health insurance. digital.library.unt.edu/ark:/67531/metadc821696/
Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system, and the annual updates and discusses recent proposals to address this issue. digital.library.unt.edu/ark:/67531/metadc822555/
Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system and the annual updates, and discusses recent proposal to address this issue. digital.library.unt.edu/ark:/67531/metadc821668/
Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate
This report summarizes the workforce, prevention, quality, and related provisions in H.R. 3590, as passed by the Senate. It begins with some background on health care delivery reform, followed by an overview of the report’s content and organization digital.library.unt.edu/ark:/67531/metadc821682/
Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses
This report summarizes the MOE requirements enacted under American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act as modified by the Health Care and Education Reconciliation Act of 2010 and what these requirements have meant for states in terms of their actions to restrict Medicaid and/or CHIP eligibility. It also summarizes recent legislative activity to repeal the MOE requirements. digital.library.unt.edu/ark:/67531/metadc822572/
Self-Insured Health Insurance Coverage
This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans. digital.library.unt.edu/ark:/67531/metadc812033/
Self-Insured Health Insurance Coverage
This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans. digital.library.unt.edu/ark:/67531/metadc822356/
Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions
This report responds to a series of frequently asked questions (FAQs) identified to address some of the major updates included in the proposed rule. The FAQs summarize provisions such as the introduction of a minimum medical loss ratio (MLR), guidance on enrolling the long-term services and supports (LTSS) population in managed care, and network adequacy. digital.library.unt.edu/ark:/67531/metadc822604/
Health Savings Accounts: Overview of Rules for 2012
This report provides a summary of the principal rules governing Health Savings Accounts (HSAs), covering such matters as eligibility, qualifying health insurance, contributions, and withdrawals. digital.library.unt.edu/ark:/67531/metadc822646/
Puerto Rico and Health Care Finance: Frequently Asked Questions
This report provides answers to frequently asked questions (FAQs) about Puerto Rico's health care system, including how federal health care programs (Medicare, Medicaid, and the State Children's Health Insurance Program [CHIP]) and private health insurance requirements apply to Puerto Rico. digital.library.unt.edu/ark:/67531/metadc795577/
The Independent Payment Advisory Board (IPAB): Frequently Asked Questions
This report responds to frequently asked questions about the Independent Payment Advisory Board (IPAB), including the board's background, current status, controversial issues including legal challenges, and recent legislative efforts to repeal the IPAB. digital.library.unt.edu/ark:/67531/metadc795587/
Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)
This report summarizes the Patient Protection and Affordable Care act (ACA)-related language added to annual appropriations legislation by congressional appropriators since the ACA was signed into law. digital.library.unt.edu/ark:/67531/metadc795341/
Potential Impact of No Social Security COLA on Medicare Part B Premiums in 2016
This report provides an overview of Medicare Part B premiums, the relationship between the Social Security cost-of-living increase (COLA) and Part B premiums, and the potential impact of a projected 0% Social Security COLA in 2016 on Medicare premiums, based on recent projections by the Medicare Trustees. digital.library.unt.edu/ark:/67531/metadc795920/
The Ryan White HIV/AIDS Program: Overview and Impact of the Affordable Care Act
This report discusses the impact of the Affordable Care Act on the Ryan White HIV/AIDS Program, which makes federal funds available to metropolitan areas and states to that provide a number of health care services for HIV/AIDS patients. digital.library.unt.edu/ark:/67531/metadc795903/
Public Health Service Agencies: Overview and Funding (FY2010-FY2016)
This report gives a brief overview of the eight agencies within the Department of Health and Human Services (HHS) which are designated components of the U.S. Public Health Services (PHS), and summarizes its funding for FY2010 through FY2016. digital.library.unt.edu/ark:/67531/metadc795421/
Potential Policy Implications of the House Reconciliation Bill (H.R. 3762)
This report provides background on the reconciliation process and summarizes the provisions in the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (H.R. 3762), including their projected budgetary impact. It then briefly examines some of the bill's policy implications. digital.library.unt.edu/ark:/67531/metadc795707/
The Patient Protection and Affordable Care Act's Essential Health Benefits (EHB)
This report provides an overview of the first component of the essential health benefits (EHB) package--a core package of health care services required by the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) for non-group and small-group private health insurance markets. The report examines how the EHB are defined, regulations related to the EHB, state variation in the EHB, applicability of the EHB to health plans, and how the EHB interact with other ACA provisions. digital.library.unt.edu/ark:/67531/metadc770537/
The Affordable Care Act's (ACA) Employer Shared Responsibility Determination and the Potential ACA Employer Penalty
This report describes the potential employer penalties related to the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) as well as regulations to implement the ACA employer provisions. The regulations address insurance coverage requirements, methodologies for determining whether a worker is considered full time, provisions relating to seasonal workers and corporate franchises, and other reporting requirements. digital.library.unt.edu/ark:/67531/metadc743623/
Health Insurance: Small is the New Large
This report discusses aspects of the Patient Protection and Affordable Care Act that expand the definition of small employer to include employers with 100 or fewer employees. States must implement the expanded definition for plan years beginning in 2016, but have the option of implementing the expanded definition prior to the deadline. digital.library.unt.edu/ark:/67531/metadc743516/
Medicare Financial Status: In Brief
This report provides an overview on Medicare, discussing its various components and sources of funding. The report also examines projections for spending within the program. digital.library.unt.edu/ark:/67531/metadc743416/
H.R. 6: The 21st Century Cures Act
Report about H.R. 6, the 21st Century Cures Act, which would reauthorize the National Institutes of Health (NIH) through FY2018 and provide other funding to the agency through FY2020. digital.library.unt.edu/ark:/67531/metadc700571/
Timeline Related to Health Insurance and Exchange Rules: Backdrop to King v. Burwell
This report provides a timeline that identifies selected 2015 dates related to exchange establishment and operation, legislative calendars, and regulation of the individual health insurance market, among other issues. digital.library.unt.edu/ark:/67531/metadc700894/
Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)
Congress remains deeply divided over implementation of the Patient Protection and Affordable Care Act (ACA), the health reform law enacted in March 2010. Since the ACA's enactment, lawmakers opposed to specific provisions in the ACA or the entire law have repeatedly debated its implementation and considered bills to repeal, defund, delay, or otherwise amend the law. This report summarizes the ACA-related language added to annual appropriations legislation by congressional appropriators since the ACA was signed into law. digital.library.unt.edu/ark:/67531/metadc700680/
Maps of 2015 Individual Exchange Enrollment by Zip Code
This report presents a tool to examine exchange enrollment information by zip code with additional geographic boundaries. digital.library.unt.edu/ark:/67531/metadc689339/
An Introduction to Health Insurance: What Should a Consumer Know?
This report provides an overview of private-sector (as opposed to government-provided) health insurance. It serves as an introduction to health insurance from the point of view of many consumers under the age of 65. No background in health insurance is assumed, and all terms are defined in the body of the report. digital.library.unt.edu/ark:/67531/metadc626977/
Health Care-Related Expiring Provisions, First Session of the 114th Congress
This report provides a list of selected health-related programs and activities under specified titles of the Social Security Act (SSA). digital.library.unt.edu/ark:/67531/metadc627239/
Health Coverage Tax Credit
The report describes the expired eligibility criteria, as well as the types of health insurance to which the tax credit may have been applied. It discusses past federal and state roles in administering the HCTC program, and it summarizes analyses on the credit's effectiveness in reaching targeted populations and related equity and efficiency issues. In addition, the report includes a short discussion of relevant current law and summarizes statutory history of the HCTC program. digital.library.unt.edu/ark:/67531/metadc505481/
Noncitizen Eligibility and Verification Issues in the Health Care Reform Legislation
This report focuses on this nexus of immigration law and health care reform in the major health care reform bills that are receiving action. digital.library.unt.edu/ark:/67531/metadc505538/
Security and Prosperity Partnership of North America: An Overview and Selected Issues
This report discusses the Security and Prosperity Partnership of North America (SPP), which was a trilateral initiative that was launched in March 2005 by Canada, Mexico, and the United States to increase cooperation and information sharing for the purpose of increasing and enhancing security and prosperity in North America. digital.library.unt.edu/ark:/67531/metadc505626/
Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief
This report provides a brief background on how Medicare Advantage (Part C or MA) payments are determined through a comparison of a plan's estimated cost (bid) and the maximum amount Medicare will pay a plan (benchmark). digital.library.unt.edu/ark:/67531/metadc503456/
Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) in 2015
This report describes the eligibility criteria applicable to the premium tax credits and cost-sharing subsidies, and the calculation method for the credit and subsidy amounts. It also highlights selected issues addressed in the final regulation and guidance on premium credits and indicates the status of implementation, where relevant data is available. digital.library.unt.edu/ark:/67531/metadc503513/
Tax Options for Financing Health Care Reform
This report reviews the revenue raisers proposed to fund health care reform. Other financing proposals are presented including those made by the Obama Administration and those introduced in earlier congressional work. The final sections discuss other proposals suggested by the round-table discussion participants. digital.library.unt.edu/ark:/67531/metadc503565/
The Community Health Center Fund: In Brief
This report provides information on the Community Health Center Fund (CHCF) that may be useful for discussions about the fund's future. Specifically, it includes information on: the types of grants awarded, total funds disbursed, and the amount of CHCF funds that facilities in each state and territory received. digital.library.unt.edu/ark:/67531/metadc503374/
Appropriations and Fund Transfers in the Affordable Care Act (ACA)
This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the ACA and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending. This report is periodically revised and updated to reflect important legislative and other developments. digital.library.unt.edu/ark:/67531/metadc503381/
Health Care: Constitutional Rights and Legislative Powers
This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. It also discusses legal issues that have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement. digital.library.unt.edu/ark:/67531/metadc503449/
Premium Tax Credits and Federal Health Insurance Exchanges: Questions and Answers
Legal challenges that may have a substantial impact on the implementation and operation of the Patient Protection and Affordable Care Act (ACA) concern whether premium tax credits are available for millions of individuals participating in federally administered health insurance exchanges. The Supreme Court has decided to weigh in on this issue in King v. Burwell. This report provides background on provisions of ACA relevant to this issue. It then answers questions concerning the legal challenges and potential implications of the Court's decision in King. digital.library.unt.edu/ark:/67531/metadc501694/
Medicare Provisions in the Patient Protection and Affordable Care Act (PPACA)
This report, one of a series of CRS products on PPACA and the Reconciliation Act, examines the Medicare related provisions in these Acts. Estimates from CBO on PPACA and the Reconciliation Act indicate that net reductions in Medicare direct spending will reach approximately $390 billion from FY2010 to FY2019. digital.library.unt.edu/ark:/67531/metadc501696/
Ebola: Selected Legal Issues
Several West African countries are currently grappling with an unprecedented outbreak of Ebola virus disease (EVD). Here in the United States, where Ebola is not endemic, a handful of EVD cases have been diagnosed, and domestic transmission of the virus has occurred in only two cases to date. This report provides a brief overview of selected legal issues regarding measures to prevent transmission of Ebola virus and the civil rights of individuals affected by the disease. digital.library.unt.edu/ark:/67531/metadc501695/
TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (PPACA)
The 111th Congress passed, and the President signed into law, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, and hereafter referred to as PPACA. This report addresses key questions concerning how PPACA affects the Department of Defense (DOD) TRICARE program and Department of Veterans Affairs (VA) health care. digital.library.unt.edu/ark:/67531/metadc501910/
TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (PPACA)
The 111th Congress passed, and the President signed into law, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, and hereafter referred to as PPACA. This report addresses key questions concerning how PPACA affects the Department of Defense (DOD) TRICARE program and Department of Veterans Affairs (VA) health care. digital.library.unt.edu/ark:/67531/metadc501914/
The Affordable Care Act and Small Business: Economic Issues
This report explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. Then, it summarizes the three Affordable Care Act (ACA) provisions most relevant to small businesses. Also, it analyzes these provisions for their potential effects on small businesses. Last, this report presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty). digital.library.unt.edu/ark:/67531/metadc501935/
Comparison of the Current World Trade Center Medical Monitoring and Treatment Program and the World Trade Center Health Program Proposed by Title I of H.R. 847
This report compares the current federally supported medical screening and treatment program offered to various persons affected by the terrorist attack on New York City on September 11, 2001, with the federal program proposed to be established by Title I of H.R. 847, the James Zadroga 9/11 Health and Compensation Act of 2010, as amended and passed by the House of Representatives. The World Trade Center (WTC) Medical Monitoring and Treatment Program (MMTP) and the World Trade Center Health Program (WTCHP) are the specific programs compared in this report. digital.library.unt.edu/ark:/67531/metadc501764/
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