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Tuesday, 16 May 2017 11:14

Updates on ACA Reporting and Repeal

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The American Health Care Act (AHCA) revised bill designed to repeal/replace the Affordable Care Act (ACA) passed on the House Floor on May 4, 2017. The revised bill included several amendments from the original bill, including changes to limits on Flexible Spending Account (FSA) contributions, age-ratio limits, coverage for pre-existing conditions and essential health benefits (EHB). The bill is headed to the Senate floor where it will either be amended, or the Senate could start from scratch with their own bill. 
 Among many other provisions, the AHCA bill as currently written would dramatically reshape the ACA:
  • Cut an estimated $800 Million from Medicaid by ending the expansion in 2020 and converting the program to a block grant;
  • Repeal approximately a trillion dollars in tax increases that largely funded the ACA;
  • Shift the premium subsidies that currently depend on age, geography, premium cost and income to a flat scale varying only by age and number of family members, but capped at $75,000 single/$150,000 family;
  • Delay the Cadillac tax further (currently slated to go into effect in 2020); 
  • Remove the ACA-imposed limits on FSA contributions; and 
  • Eliminate cost-sharing subsidies in 2020 that currently help low-income individuals afford their deductible and out-of-pocket expenses (these subsidies for 2017 – 2019 are already in jeopardy due to a lawsuit filed by the House of Representatives to stop their payment).

The updated CBO score was released on Wednesday May 24th. The revised bill that passed costs a little more than the previous version that was scored, now causing a 10-Year deficit reduction of $119 Billion instead of the previous version of $150 Billion. The bill as passed will result in 23 million fewer people insured, versus the previous version’s 24 million, suggesting that the numerous changes between bill versions will have only a modest impact on the number insured.

In addition to this AHCA update, there has also been an update from the IRS on the Employer Mandate (“Pay or Play”) requirements, which is applicable to large employers with at least 50 full-time employees (including full-time equivalent employees) to reflect adjustments to the penalty and affordability amounts. Remember, until such a time when and if a Repeal/Replace law is passed and signed into law, these reporting requirements and penalties still apply:

Those adjustments are as follows:

  Original 2017
Per Employee $2,000 $2,260
Per Employee who receives a subsidy through a state or federal exchange $3,000 $3,390
Affordability Threshold 9.5% 9.69%

Please reach out to your Fall River client manager with any questions.
Read 1227 times Last modified on Thursday, 25 May 2017 09:21
Juliet Fitzgibbons

Juliet joins Fall River as an Account Executive and brings over 15 years of prior broker and account management experience. Her experience brings extensive knowledge on employee benefit programs, account management and creative cost-saving strategies and compliance solutions for employers of various sizes.

She is responsible for new business proposals, client renewals including plan benchmarking, rate analysis and mid-year reviews. She helps clients navigate healthcare systems and educates employers and employees through open enrollment meetings and day-to-day service requests. Juliet joined Fall River in 2015.

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