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CRS — Patient Protection and Affordable Care Act (ACA): Resources for Frequently Asked Questions (October 10, 2014)

October 20, 2014 Comments off

Patient Protection and Affordable Care Act (ACA): Resources for Frequently Asked Questions (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) has numerous provisions affecting private health insurance and public health coverage programs. Many of these provisions take effect in 2014. This report provides resources to help congressional staff respond to constituents’ frequently asked questions (FAQs) about the law. The report lists selected resources regarding consumers, employers, and other stakeholders, with a focus on federal sources. It also lists CRS reports that summarize ACA’s provisions.

The report begins with links to contacts for specific ACA questions, such as Consumer Assistance Programs, state agencies, and local organizations that can answer constituents’ questions directly. For example, the federal HealthCare.gov website offers an ACA consumer telephone hotline and online chat assistance. The report also lists sources for congressional staff to contact federal agencies with ACA questions.

The report provides basic consumer sources, including a glossary of health coverage terms. The next sections focus on health coverage: the individual mandate, private health insurance, and exchanges, as well as public health care programs, such as Medicaid and the State Children’s Health Insurance Program (CHIP), Medicare, Indian health care, and veterans’ and military health care. It then lists sources on employer-sponsored coverage, including sources on employer penalties, small businesses, federal workers’ health plans, and union health plans. It also provides sources on ACA’s provisions on mental health, public health, workforce, quality, and taxes. Finally, the report lists sources on ACA costs and appropriations, legal issues, the treatment of noncitizens under ACA, and sources for obtaining the law’s full-text.

This list is not a comprehensive directory of all resources on the ACA, but rather is intended to address a few questions that may arise frequently.

See also:
Another Court Rejects Premium Tax Credits in Federal Exchanges under ACA, CRS Legal Sidebar (October 6, 2014) (PDF)
Appropriations and Fund Transfers in the Affordable Care Act (ACA) (October 10, 2014) (PDF)

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New From the GAO

October 6, 2014 Comments off

New GAO Reports
Source: Government Accountability Office

1. Medicaid: Information on Inmate Eligibility and Federal Costs for Allowable Services. GAO-14-752R, September 5.
http://www.gao.gov/products/GAO-14-752R

2. Private Health Insurance: The Range of Base Premiums in the Individual Market by County in January 2013. GAO-14-772R, September 5.
http://www.gao.gov/products/GAO-14-772R

3. Troubled Asset Relief Program: Treasury Could Better Analyze Data to Improve Oversight of Servicers’ Practices. GAO-15-5, October 6.
http://www.gao.gov/products/GAO-15-5
Highlights – http://www.gao.gov/assets/670/666386.pdf

CRS — The Effect of Firm Bankruptcy on Retiree Benefits, with Applications to the Automotive and Coal Industries (September 22, 2014)

October 2, 2014 Comments off

The Effect of Firm Bankruptcy on Retiree Benefits, with Applications to the Automotive and Coal Industries (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

Benefits for retired employees are of particular interest to policy makers because of the growing number of retirees and forecasts indicating that some future retirees may not have the necessary financial resources to maintain their standards of living. Part of this congressional concern is what happens when bankrupt employers are unable to provide promised pension and health benefits to their retired employees.

In chapter 11 bankruptcy reorganization, the employer receives protections against its financial commitments in the hope that it may once again become profitable. This protection could include not having to honor obligations concerning pensions and retiree health insurance. Its employees may therefore be at risk of not receiving some of their promised benefits. Unionized and nonunionized employees may be treated differently under the law because unionized workers have a legal contract governing their terms and conditions of employment.

Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016

September 30, 2014 Comments off

Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016
Source: Towers Watson

Results of a July 2014 survey of midsize to large employers by global professional services company Towers Watson (NYSE, NASDAQ: TW) showed that 28% said they had already extensively evaluated the viability of private exchanges. Nearly one in four (24%) said private exchanges could provide a viable alternative for their active full-time employees as soon as 2016.

The results are from the 2014 Towers Watson Health Care Changes Ahead Survey, which was completed by 379 employee benefit professionals from a variety of industries and reflect health care benefit decisions for 2016 – 2017.

The survey also revealed that the top three factors that would cause employers to adopt a private exchange for full-time active employees are:

  • Evidence they can deliver greater value than their current self-managed model (64%)
  • Adoption of private exchanges by other large companies in their industry (34%)
  • An inability to stay below the excise tax ceiling as 2018 approaches (26%)

Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act

September 29, 2014 Comments off

Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act
Source: Commonwealth Fund

For decades, Latinos have had the highest uninsured rates of any racial or ethnic group in the United States. Less than one year after the Affordable Care Act’s health insurance marketplaces opened for enrollment, the overall Latino uninsured rate dropped from 36 percent to 23 percent, according to the Commonwealth Fund Affordable Care Act Tracking Survey, conducted April 9 to June 2, 2014. However, the high uninsured rate among Latinos in states that had not expanded their Medicaid program at the time of the survey—33 percent—remained statistically unchanged. These states are home to about 20 million Latinos, the majority of whom live in Texas and Florida.

New From the GAO

September 29, 2014 Comments off

New GAO Reports
Source: Government Accountability Office

1. Disabled Dual-Eligible Beneficiaries: Integration of Medicare and Medicaid Benefits May Not Lead to Expected Medicare Savings. GAO-14-523, August 29.
http://www.gao.gov/products/GAO-14-523
Highlights –  http://www.gao.gov/assets/670/665492.pdf

2. Patient Protection And Affordable Care Act: Largest Issuers of Health Coverage Participated in Most Exchanges, and Number of Plans Available Varied.
GAO-14-657, August 29.
http://www.gao.gov/products/GAO-14-657
Highlights –  http://www.gao.gov/assets/670/665488.pdf

3. Freight Transportation: Developing National Strategy Would Benefit from Added Focus on Community Congestion Impacts. GAO-14-740, September 19.
http://www.gao.gov/products/GAO-14-740
Highlights – http://www.gao.gov/assets/670/665973.pdf

4. Managing for Results: Agencies’ Trends in the Use of Performance Information to Make Decisions. GAO-14-747, September 26.
http://www.gao.gov/products/GAO-14-747
Highlights – http://www.gao.gov/assets/670/666188.pdf

5. U.S. Currency: Reader Program Should Be Evaluated While Other Accessibility Features for Visually Impaired Persons Are Developed. GAO-14-823, September 26.
http://www.gao.gov/products/GAO-14-823
Highlights – http://www.gao.gov/assets/670/666172.pdf

Entrepreneurship and Public Health Insurance

September 24, 2014 Comments off

Entrepreneurship and Public Health Insurance (PDF)
Source: Brown University

The social safety net provides financial security for millions of Americans, yet few studies have explored its influence on firm formation. This paper tests whether the State Child Health Insurance Program (SCHIP) affected business ownership. I use three identification strategies to isolate this effect: difference-in-differences (DID), regression discontinuity (RD) and a differenced version of RD that incorporates pre-policy data as a falsification check. Monte Carlo analysis suggests this differencing technique significantly reduces bias and Type 1 Error relative to RD and DID, and the procedure can be applied to a wide range of policy evaluations. I show that the local average treatment effect of SCHIP eligibility was a 29% reduction in the number of uninsured children and a 23% increase in self-employment. I also show that SCHIP increased incorporated business ownership by 31% and the share of household income from self-employment by 16%, suggesting these are high-quality ventures. The increase is driven by both a 12% rise in firm birth rates and an 8% increase in survival rates. I also document a large increase in labor supply, equivalent to 8.8 million full-time workers. The central mechanism is a reduction in the riskiness of self-employment rather than a relaxation of credit constraints. I find no evidence that observable characteristics are unbalanced between treatment and control groups. To the extent that entrepreneurs contribute to innovation, job creation or economic growth, these findings strongly suggest that public health insurance programs have spillover benefits on the supply of firms.

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