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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

Federal Requirements on Private Health Insurance Plans

Description: This report provides background information about health plans sold in the private health insurance (PHI) market and briefly describes state and federal regulation of private plans. The second part summarizes selected federal requirements and indicates each requirement's applicability to one or more of the following types of private health plans: individual, small group, large group, and self-insured. Many of the federal requirements described in this report were established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended); however, some were established under federal laws enacted prior to the ACA.
Date: March 29, 2018
Creator: Mach, Annie L.
Partner: UNT Libraries Government Documents Department

NFIB v. Sebelius: Constitutionality of the Individual Mandate

Description: Report that provides an overview of the Court's holding with respect to the individual mandate of the Patient Protection and Affordable Care Act (ACA) under the Commerce Clause and the Taxing Power. It also addresses possible implications of the decision on existing federal law and future legislation.
Date: September 3, 2012
Creator: Lunder, Erika K. & Staman, Jennifer
Partner: UNT Libraries Government Documents Department

The Individual Mandate for Health Insurance Coverage: In Brief

Description: This report provides an overview of the individual mandate, its associated penalty, and the exemptions from the mandate. It discusses the ACA reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate. The report includes some national- and state-level data on the application of the mandate's penalty in tax year (TY) 2014 and TY2015.
Date: October 11, 2017
Creator: Mach, Annie L.
Partner: UNT Libraries Government Documents Department

The Individual Mandate for Health Insurance Coverage: In Brief

Description: This report provides an overview of the individual mandate, its associated penalty, and the exemptions from the mandate. It discusses the ACA reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate. The report includes some national- and state-level data on the application of the mandate's penalty in tax year (TY) 2014 and TY2015.
Date: November 16, 2017
Creator: Mach, Annie L.
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

Unemployment and Health Insurance: Current Legislation and Issues

Description: This report discusses the link between health insurance coverage and unemployment. One consequence of unemployment is that people can also lose their health insurance. The danger of losing insurance is most obvious for coverage that is provided by employers, but people who become unemployed might no longer be able to pay individual market premiums as well. Recent estimates indicate for each percentage point increase in the unemployment rate, the number of uninsured would increase by 1.1 million.
Date: February 17, 2009
Creator: Mulvey, Janemarie & Lyke, Bob
Partner: UNT Libraries Government Documents Department

Federal Requirements on Private Health Insurance Plans

Description: This report discusses federal requirements for private health insurance (PHI) plans. The first part of this report provides background information about health plans sold in the PHI market and briefly describes state and federal regulation of private plans. The second part summarizes selected federal requirements and indicates each requirement's applicability to one or more of the following types of private health plans: individual, small group, large group, and self-insured.
Date: May 1, 2018
Creator: Mach, Annie L. & Fernandez, Bernadette
Partner: UNT Libraries Government Documents Department

Cancellation of Nongroup Health Insurance Policies

Description: This report provides background information about health insurance cancellations, non-renewals and rescissions, including applicable federal rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and ACA.
Date: November 19, 2013
Creator: Fernandez, Bernadette & Mach, Annie L.
Partner: UNT Libraries Government Documents Department

Federal Financing for the State Children's Health Insurance Program (CHIP)

Description: This report provides an overview of the State Children's Health Insurance Program (CHIP) financing, beginning with an explanation of the federal matching rate. It describes various aspects of federal CHIP funding, such as the federal appropriation, state allotments, the Child Enrollment Contingency Fund, redistribution funds, and outreach and enrollment grants. The report ends with a section about the future of CHIP funding, including the options for extending CHIP funding and what could happen if federal funding expires.
Date: September 29, 2017
Creator: Mitchell, Alison
Partner: UNT Libraries Government Documents Department

Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA)

Description: This report outlines the required minimum functions of state health insurance exchanges and explains how exchanges are expected to be established and administered under the Patient Protection and Affordable Care Act (ACA). The coverage offered through exchanges is discussed, and the report concludes with a discussion of how exchanges will interact with selected other ACA provisions.
Date: October 10, 2012
Creator: Fernandez, Bernadette & Mach, Annie L.
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

Does Health Insurance Make a Difference?

Description: This background paper reviews and evaluates the available literature linking health insurance coverage with the utilization and process of health care services and with individual health outcomes.
Date: September 1992
Creator: United States. Congress. Office of Technology Assessment.
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

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: September 10, 2014
Creator: Davis, Patricia A.; Talaga, Scott R.; Binder, Cliff; Hahn, Jim; Morgan, Paulette C.; Mulvey, Janemarie et al.
Partner: UNT Libraries Government Documents Department