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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.
Beverage Industry Pledges to Reduce Americans' Drink Calories
This report briefly covers recent initiatives by leading beverage companies to curb the obesity epidemic.
Medicare: Insolvency Projections
This report focuses on the two separate trust funds that fund Medicare, the Hospital Insurance (HI) trust fund and Supplementary Medical Insurance (SMI) trust fund. Almost from its inception, the HI trust fund has faced a projected shortfall and eventual insolvency. Because of the way it is financed, the SMI trust fund cannot become insolvent; however, the Medicare Trustees continue to express concerns about the rapid growth in SMI costs.
Overview of Health Care Changes in the FY2015 House Budget
This report summarizes the proposed changes to Medicare, Medicaid, and private health insurance as described in H.Con.Res. 96 and accompanying documents, including the committee report and Chairman Ryan's Path to Prosperity report.
Medicare Primer
This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
Summary Cost Data for Health Plans Available in Maine's Exchange, 2014: Fact Sheet
This report discusses the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) that contains a number of provisions that may affect the individual health insurance market.
Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA)
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 on premium credits.
Summary Cost Data for Federally-Facilitated Exchanges, 2014
This report provides fact sheets for Federally-Facilitated exchanges offering individual plans.
Hospital-Based Emergency Departments: Background and Policy Considerations
This report describes Emergency departments (EDs), the role they play in the health care delivery system, and current federal involvement in supporting EDs. It then discusses the causes and consequences of three commonly identified and interrelated challenges that EDs face: (1) crowding, (2) providing repeat care to a subset of patients who are frequent users, and (3) providing care to a large population who have behavioral health conditions when an ED lacks the appropriate resources to provide such treatment. The report concludes with policy options that Congress may consider to potentially improve ED functioning and reduce payer costs.
Health Care for Rural Veterans: The Example of Federally Qualified Health Centers
This report discusses considerations that may arise during possible attempts to increase collaboration between the Department of Veterans Affairs (VA) and federally qualified health centers (FQHCs) and describes policy levers Congress might use to encourage VA-FQHC collaboration. These approaches might also be employed to encourage collaboration between the VA and other types of facilities that may serve rural veterans.
Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress
This report provides a detailed description of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requirements for Medical Loss Ratio (MLR) reporting and rebates as specified in regulations, including components of the MLR formula, state flexibility and waivers, and the nature of rebates to policyholders. The report also addresses issues that have been raised about the MLR provisions since the ACA was enacted, namely the treatment of insurance commissions paid to brokers and agents.
Preventing the Introduction and Spread of Ebola in the United States: Frequently Asked Questions
This report answers common legal and policy questions about the potential introduction and spread of Ebola Virus Disease in the United States.
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 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).
Individual Mandate Under ACA
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.
Individual Mandate Under ACA
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.
Individual Mandate Under ACA
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.
Private Health Insurance Market Reforms in the Affordable Care Act (ACA)
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.
Private Health Insurance Market Reforms in the Affordable Care Act (ACA)
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.
Private Health Insurance Market Reforms in the Affordable Care Act (ACA)
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.
Contractors and HealthCare.gov: Answers to Frequently Asked Questions
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.
The ACA Medicaid Expansion
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.
Patient Protection and Affordable Care Act (ACA): Resources for Frequently Asked Questions
The report provides basic consumer sources, including broad overviews of the Affordable Care Act (ACA) law, and resources related to specific provisions. It also has links to contacts for specific questions (including websites, hotlines, and online chat assistance).
TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (ACA)
This report addresses key questions concerning how the Patient Protection and Affordable Care Act (ACA) affects TRICARE and VA health care.
Appropriations and Fund Transfers in the Affordable Care Act (ACA)
This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the Affordable Care Act (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.
Congress Faces Calls to Address Expiring ACA Appropriations
This report discusses the Affordable Care Act (ACA), enacted in March 2010, which appropriated billions of dollars of mandatory funds to support grant programs and other activities authorized by the law.
Discretionary Spending Under the Affordable Care Act (ACA)
The Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) reauthorized funding for numerous existing discretionary grant programs administered by the Department of Health and Human Services (HHS). The ACA also created many new discretionary grant programs and provided for each an authorization of appropriations. Generally, the law authorized (or reauthorized) appropriations through FY2014 or FY2015. This report summarizes all the discretionary spending provisions in the ACA.
U.S. and International Health Responses to the Ebola Outbreak in West Africa
In March 2014, an Ebola Virus Disease (EVD) outbreak was reported in Guinea, West Africa. The outbreak is the first in West Africa and has caused an unprecedented number of cases and deaths. The outbreak is continuing to spread in Guinea, Sierra Leone, and Liberia (the "affected countries"); it has been contained in Nigeria and Senegal, and has been detected in Mali. As of October 22, 2014, more than 10,000 people have contracted EVD, more than half of whom have died. This report focuses on the health impacts of the outbreak and discusses U.S. and international responses to those health challenges.
Treating Ebola Patients in the United States: Health Care Delivery Implications
This report discusses the recent response to Ebola patients in the United States. While the U.S. health care system has the resources to effectively identify and treat Ebola cases, a situation that is novel, emergent, and resource-intensive may test the system's ability to effectively mobilize those resources.
A Federal Pause in Potentially Risky Influenza Research
This report briefly discusses a recently implemented federal research moratorium that has highlighted concerns about the general appropriateness of research on biological pathogens and the sufficiency of certain biosecurity efforts.
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.
Medicare Home Health Benefit Primer: Benefit Basics and Issues
This report describes home health eligibility criteria, home health services, characteristics of Medicare beneficiaries who use home health services, and home health providers. Further, this report describes in detail the Medicare home health prospective payment system (HH PPS), provides an overview of Medicare home health payments, and discusses issues for Congress related to the Medicare home health benefit.
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.
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