Congressional Research Service Reports - 160 Matching Results

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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

Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Description: This report discusses the Sustainable Growth Rate (SGR), which is the statutory method for determining the annual updates to the Medicare physician fee schedule. The SGR system was established because of the concern that the Medicare fee schedule itself would not adequately constrain overall increases in spending for physicians’ services.
Date: August 2, 2012
Creator: Hahn, Jim & Mulvey, Janemarie
Partner: UNT Libraries Government Documents Department

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

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.
Date: April 9, 2012
Creator: Mitchell, Alison & Paulette, Morgan C.
Partner: UNT Libraries Government Documents Department

Medicaid Coverage of Long-Term Services and Supports

Description: This report provides a description of the various statutory authorities that either require or otherwise allow states to cover LTSS under Medicaid. The Appendix provides a brief legislative history of Medicaid LTSS from Medicaid’s enactment and initial coverage requirements for institutional care through the evolution of HCBS options available to states.
Date: December 5, 2013
Creator: Colello, Kirsten J.
Partner: UNT Libraries Government Documents Department

Contractors and HealthCare.gov: Answers to Frequently Asked Questions

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.
Date: January 24, 2014
Creator: Manuel, Kate M.; Murrill, Brandon J. & Perry, Rodney M.
Partner: UNT Libraries Government Documents Department

TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (ACA)

Description: This report addresses key questions concerning the impact of enactment of the Affordable Care Act (ACA) on the TRICARE and VA health care programs. To provide some context to this discussion, the report begins with a brief overview of the two health systems and eligibility for care under each system.
Date: January 27, 2012
Creator: Panangala, Sidath V. & Jansen, Don J.
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

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: January 7, 2011
Creator: Sarata, Amanda K.
Partner: UNT Libraries Government Documents Department

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Description: This report first analyzes the authority of Congress to enact the minimum essential coverage requirement contained in Patient Protection and Affordable Care Act (PPACA), as well as how a court might analyze this provision if challenged based on various provisions of the Fifth and Tenth Amendments. This report discusses whether there must be exceptions to a requirement to purchase health insurance based on First Amendment freedom of religion, and finally, discusses some of the legal challenges to this federal requirement.
Date: February 1, 2011
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Partner: UNT Libraries Government Documents Department