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 Collection: Congressional Research Service Reports
Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

Date: February 13, 2013
Creator: Mach, Annie L.
Description: This report discusses the Federal Employees Health Benefits Program (FEHBP), a program administered by the Office of Personnel Management (OPM), which is statutorily given the authority to contract with qualified carriers offering plans and to prescribe regulations necessary to carry out the statute, among other duties.
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Health Insurance: Small is the New Large

Health Insurance: Small is the New Large

Date: August 26, 2015
Creator: Mach, Annie L.
Description: 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.
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Individual Mandate Under ACA

Individual Mandate Under ACA

Date: March 6, 2014
Creator: Mach, Annie L.
Description: This report describes the individual mandate as established under the Affordable Care Act (ACA, P.L. 111-148, as amended). The report also discusses the ACA reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate.
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Individual Mandate Under ACA

Individual Mandate Under ACA

Date: May 5, 2014
Creator: Mach, Annie L.
Description: This report describes the individual mandate as established under the Affordable Care Act (ACA, P.L. 111-148, as amended). The report also discusses the ACA reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate.
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Individual Mandate Under ACA

Individual Mandate Under ACA

Date: unknown
Creator: Mach, Annie L.
Description: Report describing the individual mandate requirements of the Afordable Care Act, as well as penalties for not meeting these requirements and exemptions granted for hardships.
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Potential Policy Implications of the House Reconciliation Bill (H.R. 3762)

Potential Policy Implications of the House Reconciliation Bill (H.R. 3762)

Date: October 21, 2015
Creator: Mach, Annie L.
Description: 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.
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Provisions of the Senate Amendment to H.R. 3762

Provisions of the Senate Amendment to H.R. 3762

Date: February 1, 2016
Creator: Mach, Annie L.
Description: 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.
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Puerto Rico and Health Care Finance: Frequently Asked Questions

Puerto Rico and Health Care Finance: Frequently Asked Questions

Date: February 3, 2016
Creator: Mach, Annie L.
Description: 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.
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Puerto Rico and Health Care Finance: Frequently Asked Questions

Puerto Rico and Health Care Finance: Frequently Asked Questions

Date: November 18, 2015
Creator: Mach, Annie L.
Description: 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.
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Puerto Rico and Health Care Finance: Frequently Asked Questions

Puerto Rico and Health Care Finance: Frequently Asked Questions

Date: June 20, 2016
Creator: Mach, Annie L.
Description: This report provides answers to frequently asked questions (FAQs) about Puerto Rico's health care system.
Contributing Partner: UNT Libraries Government Documents Department
Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

Date: November 13, 2013
Creator: Mach, Annie L. & Cornell, Ada S.
Description: This report discusses the Federal Employees Health Benefits Program (FEHBP), a program administered by the Office of Personnel Management (OPM), which is statutorily given the authority to contract with qualified carriers offering plans and to prescribe regulations necessary to carry out the statute, among other duties.
Contributing Partner: UNT Libraries Government Documents Department
Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Date: May 6, 2014
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
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Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Date: March 13, 2014
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
Contributing Partner: UNT Libraries Government Documents Department
Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Date: July 24, 2014
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
Contributing Partner: UNT Libraries Government Documents Department
Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

Date: February 10, 2016
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each ACA market reform, grouped under the following categories: obtaining coverage, keeping coverage, cost of purchasing coverage, covered services, cost-sharing limits, consumer assistance and other health care protections, and plan requirements related to health care providers.
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Individual Mandate and Related Information Requirements under ACA

Individual Mandate and Related Information Requirements under ACA

Date: July 22, 2013
Creator: Mach, Annie L.; Scales, Manon & Mulvey, Janemarie
Description: Report that describes the individual mandate under Section 1501 and Section 10106 of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended).
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Contractors and HealthCare.gov: Answers to Frequently Asked Questions

Contractors and HealthCare.gov: Answers to Frequently Asked Questions

Date: January 24, 2014
Creator: Manuel, Kate M.; Murrill, Brandon J. & Perry, Rodney M.
Description: This report provides answers to 20 frequently asked questions regarding contractors and HealthCare.gov, the federal online health insurance portal called for by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148, as amended). Over 50 contractors, including CGI Federal and Quality Software Services, Inc. (QSSI), helped in building the site, which was reportedly largely unusable when it first became available to the public on October 1, 2013.
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World Health Organization: A Fact Sheet

World Health Organization: A Fact Sheet

Date: July 1, 1996
Creator: McHugh, Lois
Description: The World Health organization (WHO), established in 1948, is the United Nations system's authority on international public health issues. It assists governments in improving national health services and in establishing worldwide standards for foods, chemicals, and biological and pharmaceutical products. WHO concentrates on preventive rather than curative programs, including efforts to eradicate endemic and other widespread diseases, stabilize population growth, improve nutrition, sanitation, and maternal and child care. WHO is not an operational agency. It works through contracts with other agencies and private voluntary organizations.
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AIDS: International Problems and Issues

AIDS: International Problems and Issues

Date: January 6, 1988
Creator: McHugh, Lois B
Description: This issue brief discusses the AIDS (Acquired Immune Deficiency Syndrome) virus and its effects on the world, especially with regard to the welfare of developing nations and various facets of general international relations. Also discussed are the related issues for Congress and U.S. contributions to international AIDS relief efforts led by the World Health Organization (WHO).
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Medicare Beneficiary Access to Care: The Effects of New Prospective Payment Systems on Outpatient Hospital Care, Home Health Care, and Skilled Nursing Facility Care

Medicare Beneficiary Access to Care: The Effects of New Prospective Payment Systems on Outpatient Hospital Care, Home Health Care, and Skilled Nursing Facility Care

Date: February 2, 2000
Creator: Merck, Carolyn L
Description: This report discusses the Balanced Budget Act of 1997 (BBA 97), which required that prospective payment systems replace retrospective cost-based reimbursement systems for Medicare beneficiaries receiving care in hospital outpatient departments, from home health care agencies, and in skilled nursing facilities.
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Medicaid Reimbursement Policy

Medicaid Reimbursement Policy

Date: November 2, 2004
Creator: Merlis, Mark
Description: This report begins with a summary of basic federal requirements applicable to payments for all services and an overview of major developments in federal Medicaid reimbursement policy over the last 20 years. This overview provides a historical context for current policies and highlights some issues that have been perennial concerns for federal and state policymakers. The next four sections of the report provide a detailed discussion of Medicaid reimbursement for four basic categories of services or providers.
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The ACA Medicaid Expansion

The ACA Medicaid Expansion

Date: December 30, 2014
Creator: Mitchell, Alison
Description: This report provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the report describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. Finally, the report reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
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Medicaid Financing and Expenditures

Medicaid Financing and Expenditures

Date: July 30, 2012
Creator: Mitchell, Alison
Description: This report provides an overview of Medicaid’s financing structure, including both federal and state financing issues. The Medicaid expenditures section of the report discusses economic factors affecting Medicaid, state variability in spending, and projected program spending. Other issues that are examined include congressional proposals to turn Medicaid into a block grant program, federal deficit reduction proposals affecting Medicaid, and state fiscal conditions affecting Medicaid financing and services.
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Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Date: April 9, 2012
Creator: Mitchell, Alison & Paulette, Morgan C.
Description: This report summarizes the President's budget estimates for each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. The explanations of the President's legislative proposals are grouped by the following program areas: Medicare, Medicaid, program integrity, and health insurance programs.
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