Three new sets of proposed federal regulations relating to the Affordable Care Act (ACA) were issued today by the Department of Health and Human Services (HHS) and the Treasury Department. I haven’t reviewed them carefully, but I was pleased to read that Tricia Brooks at the Center for Children and Families (CCF) at Georgetown University said the proposed rules “take a number of positive steps forward to remove administrative barriers to coverage and reduce churning.”
In a CCF blog post, Brooks explained that the draft rules incorporate lessons learned from the Children’s Health Insurance Program (CHIP) about the importance of streamlining eligibility, coordinating enrollment in Medicaid and CHIP, and improving retention. She said that, “the ACA’s vision for seamless, coordinated coverage is reflected in the details of the regulation,” which she said answers “a number of questions states have as they move forward in building the important IT systems that will support these goals.”
The ACA bars individuals from purchasing coverage through an exchange if they are offered “affordable” coverage through an employer. The law defines a health plan as unaffordable if an employee would have to spend more than 9.5 percent of household income. The preliminary IRS interpretation in the proposed rule is that the affordability requirements apply only to the coverage of the employee, not to the cost of family coverage. The result is that far fewer people will be eligible to participate in the exchanges, despite the fact that their employer’s family coverage costs more than they can afford.
- Easy, Simple Access to Coverage for Consumers and Small Businesses
- Insurance Premium Tax Credit
- Medicaid Eligibility
HHS and the Treasury Department are soliciting comments on the proposed rules.
Jon Peacock
