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The Affordable Care Act's (ACA) Employer Shared Responsibility Determination and the Potential Employer Penalty

Description: This report describes potential employer penalties 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.
Date: April 19, 2016
Creator: Whittaker, Julie M.
Partner: UNT Libraries Government Documents Department

Excise Tax on High-Cost Employer-Sponsored Health Coverage: In Brief

Description: This report provides an overview of the excise tax. The report includes cost estimates for the excise tax and explores the excise tax's relationship with the tax advantages for employer-sponsored health coverage. The information in this report is based on statute and two notices issued by the Department of the Treasury (Treasury) and the Internal Revenue Service (IRS).
Date: March 24, 2016
Creator: Mach, Annie L.
Partner: UNT Libraries Government Documents Department

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

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.
Date: February 10, 2016
Creator: Mach, Annie L. & Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Provisions of the Senate Amendment to H.R. 3762

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.
Date: February 1, 2016
Creator: Mach, Annie L.
Partner: UNT Libraries Government Documents Department

The Health Coverage Tax Credit (HCTC): In Brief

Description: 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.
Date: February 18, 2016
Creator: Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Health-Related Tax Expenditures: Overview and Analysis

Description: 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).
Date: January 8, 2016
Creator: Lowry, Sean
Partner: UNT Libraries Government Documents Department

Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)

Description: 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.
Date: January 5, 2016
Creator: Redhead, C. S. & Cornell, Ada S.
Partner: UNT Libraries Government Documents Department

The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

Description: 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.
Date: February 25, 2016
Creator: Baumrucker, Evelyne P.; Davis, Patricia A.; Fernandez, Bernadette; Mach, Annie L. & Pettit, Carol A.
Partner: UNT Libraries Government Documents Department

Discretionary Spending Under the Affordable Care Act (ACA)

Description: 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.
Date: January 13, 2016
Creator: Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J.; Lister, Sarah A. & Sarata, Amanda K.
Partner: UNT Libraries Government Documents Department

The Ebola Outbreak: Quarantine and Isolation Authority

Description: 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.
Date: October 28, 2014
Partner: UNT Libraries Government Documents Department

Puerto Rico and Health Care Finance: Frequently Asked Questions

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.
Date: February 3, 2016
Creator: Mach, Annie L.
Partner: UNT Libraries Government Documents Department

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Description: 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.
Date: April 6, 2012
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Partner: UNT Libraries Government Documents Department

Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate

Description: 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
Date: March 1, 2010
Creator: Redhead, C. Stephen & Williams, Erin D.
Partner: UNT Libraries Government Documents Department

Long-Term Care (LTC): Financing Overview and Issues for Congress

Description: This report provides an overview of long-term care (LTC) and an explanation of the nation’s complex financing system of public and private payers. It also describes some of the major challenges facing Congress as it contemplates LTC reform and whether and how to include LTC in health reform legislation.
Date: February 1, 2010
Creator: Stone, Julie
Partner: UNT Libraries Government Documents Department

Medicare Primer

Description: This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
Date: April 24, 2012
Creator: Davis, Patricia A.; Binder, Cliff; Hahn, Jim; Morgan, Paulette C.; Mulvey, Janemarie; Talaga, Scott R. et al.
Partner: UNT Libraries Government Documents Department

Medicare Home Health Benefit Primer: Benefit Basics and Issues

Description: 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.
Date: March 14, 2013
Creator: Talaga, Scott R.
Partner: UNT Libraries Government Documents Department

Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Description: 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.
Date: May 25, 2011
Creator: Baumrucker, Evelyne P.
Partner: UNT Libraries Government Documents Department

Self-Insured Health Insurance Coverage

Description: 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.
Date: June 25, 2010
Creator: Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Self-Insured Health Insurance Coverage

Description: 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.
Date: May 12, 2010
Creator: Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Description: 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.
Date: July 15, 2015
Creator: Blom, Kirstin B.
Partner: UNT Libraries Government Documents Department

Mental Health Parity and the Patient Protection and Affordable Care Act of 2010

Description: This report provides a brief background on mental health parity and the policy discussion around parity in health insurance coverage; an overview of federal mental health parity law prior to the enactment of the ACA; and an analysis of the impact of the ACA.
Date: December 28, 2011
Creator: Sarata, Amanda K.
Partner: UNT Libraries Government Documents Department