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

Description: 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.
Date: September 1, 2015
Creator: Whittaker, Julie M.
Partner: UNT Libraries Government Documents Department

The Patient Protection and Affordable Care Act's Essential Health Benefits (EHB)

Description: 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.
Date: August 27, 2015
Creator: Uberoi, Namrata K.
Partner: UNT Libraries Government Documents Department

Health Insurance: Small is the New Large

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.
Date: August 26, 2015
Creator: Mach, Annie L.
Partner: UNT Libraries Government Documents Department

Medicare Financial Status: In Brief

Description: 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.
Date: August 10, 2015
Creator: Davis, Patricia A.
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

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

Description: 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.
Date: July 10, 2015
Creator: Redhead, C. S. & Cornell, Ada S.
Partner: UNT Libraries Government Documents Department

H.R. 6: The 21st Century Cures Act

Description: 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.
Date: July 8, 2015
Creator: Johnson, Judith A.; Thaul, Susan & Bagalman, Erin
Partner: UNT Libraries Government Documents Department

Timeline Related to Health Insurance and Exchange Rules: Backdrop to King v. Burwell

Description: 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.
Date: June 19, 2015
Creator: Fernandez, Bernadette; Mach, Annie L. & Uberoi, Namrata K.
Partner: UNT Libraries Government Documents Department

An Introduction to Health Insurance: What Should a Consumer Know?

Description: 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.
Date: April 30, 2015
Creator: Rapaport, Carol
Partner: UNT Libraries Government Documents Department

Health Coverage Tax Credit

Description: 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.
Date: April 2, 2015
Creator: Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) in 2015

Description: 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.
Date: March 18, 2015
Creator: Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Appropriations and Fund Transfers in the Affordable Care Act (ACA)

Description: 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.
Date: March 6, 2015
Creator: Redhead, C. Stephen
Partner: UNT Libraries Government Documents Department

The Community Health Center Fund: In Brief

Description: 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.
Date: February 12, 2015
Creator: Heisler, Elayne J.
Partner: UNT Libraries Government Documents Department

The Affordable Care Act and Small Business: Economic Issues

Description: 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).
Date: January 15, 2015
Creator: Lowry, Sean & Gravelle, Jane G.
Partner: UNT Libraries Government Documents Department

The ACA Medicaid Expansion

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.
Date: December 30, 2014
Creator: Mitchell, Alison
Partner: UNT Libraries Government Documents Department

Premium Tax Credits and Federal Health Insurance Exchanges: Questions and Answers

Description: 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.
Date: December 19, 2014
Creator: Staman, Jennifer A.; Lunder, Erika K. & Shedd, Daniel T.
Partner: UNT Libraries Government Documents Department

Ebola: Selected Legal Issues

Description: 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.
Date: December 16, 2014
Creator: Cole, Jared P.; Perry, Rodney M.; Dolan, Alissa M.; Shimabukuro, Jon O.; Garcia, Michael J.; Smith, Jane M. et al.
Partner: UNT Libraries Government Documents Department

Hospital-Based Emergency Departments: Background and Policy Considerations

Description: 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.
Date: December 8, 2014
Creator: Heisler, Elayne J. & Tyler, Nancy Leigh
Partner: UNT Libraries Government Documents Department