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Q2 Legislative Updates
Q1 Legislative Updates 

The Affordable Care Act (ACA) continues to be a popular topic since the mid-term elections. Our Legislative Updates will keep you up to date on the latest news around the ACA. Here are some topics we are following.

In November 2018, Democrats secured 218 seats in the mid-term elections to gain back control over the House of Representatives and deliver a decidedly pro-ACA House of Representatives. Demand for health insurance, without pre-existing condition exclusions, remains high across the country. With the House under Democratic control, congressional opponents of the ACA now lack the votes for a full repeal of the law. Yet, threats to the law still exist. And changes continue.

The Department of Health and Human Services recently released the 2019 federal poverty threshold levels. The Federal Poverty Level (FPL) for an individual increased from $12,140 to $12,490 in 2019. As announced last year, the 2019 affordability threshold also increased from 9.56% to 9.86%. This means, for 2019, many employers will see the maximum employee monthly contribution under the FPL affordability safe harbor increase in comparison to prior years.

In October 2018, the Secretaries of the Treasury, Labor and Health and Human Services announced a proposed regulation intended to expand the flexibility and use of health reimbursement arrangements (HRAs). The new proposed regulation allows employers (in place of their traditional employer plan) to offer an HRA that reimburses premiums for individual market healthcare plans on a pre-tax basis. 

The IRS provided additional guidance on how an employer could offer HRAs in place of their traditional plan, while still meeting ACA affordability and offer of coverage requirements.

In response to a 2017 executive order from President Trump, the Department of Labor passed a rule that loosened restrictions around the formation of new associations—allowing associations to be formed for the purpose of providing health insurance. It also allowed Association Health Plans (AHPs) to form across state lines.

These efforts have been challenged by multiple states that have argued the expansion of these types of plans violate ACA consumer protection clauses.  The DOL rule, and the resulting lawsuits, raise several questions about the future of AHPs.

On December 14, 2018, a Federal judge in a Texas court ruled that the entire Affordable Care Act is unconstitutional. The ruling will most likely be overturned — but the ACA’s battles in the judicial third of our government are only part of the story. 


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