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Beginning in 2017, the Republican majority in Congress and the Trump administration made repeal and replacement of the Affordable Care Act (ACA) a top priority, and in March 2017 the House GOP leadership introduced the American Health Care Act (AHCA) as their designated bill to begin to "repeal and replace" the ACA. The House passed their legislation on May 4, 2017.
In July, Senate GOP leaders released the Senate's repeal and replacement bill, named the Better Care Reconciliation Act (BCRA), but defections by both GOP Senate conservatives and moderates blocked a vote on the measure, effectively keeping the ACA and its wide-ranging employer coverage and reporting obligations in place.
Until the ACA's employer obligations are changed through targeted legislative actions or regulatory adjustments, employers subject to the ACA must comply with all its coverage and administrative requirements.
Draft Executive Order Would Expand High-Deductible Coverage for Chronic ConditionsThe Trump administration is considering a draft executive order to allow high-deductible health plan enrollees to receive insurance payment for the treatment of chronic conditions—including prescription medications—before meeting plan deductibles.
Reminder: PCORI Fees Due by July 31The annual fee to fund the Patient-Centered Outcomes Research Institute (PCORI), paid by employers that sponsor self-insured health plans, are due by July 1. For 2017, the fees rose by an additional 9 cents per plan enrollee.
Telemedicine Missteps: Consider HSA Eligibility and other Compliance TrapsWhen setting up a telemedicine benefit, beware mistakes that could imperil health savings account (HSA) eligibility or trigger group health plan status that's subject to the Affordable Care Act's coverage requirements.
Don't Overlook 2018 Change in 'Affordability' Safe Harbor PercentageThe IRS recently announced the maximum share of income that employees can be required to pay under the Affordable Care Act's affordability provision, as adjusted annually for inflation. Employers should consider this adjustment in determining how much of their plan premiums they can ask employees to pay next year.
Rising Health Benefit Costs Still Outpace Overall InflationThe pace of the rising health plan costs for U.S. employers, having slowed last year, looks to be leveling off at about 7.5 percent for 2017. With plan design changes, most employers will see increases closer to 5 percent this year, insurers say.
IRS Sets 2018 HSA Contribution LimitsNext year, the amounts that employees can contribute to their health savings account (HSA) will Employers should consider these limits when planning for the 2018 benefit plan year and should review plan communications to ensure that the appropriate limits are reflected
Employer Shared Responsibility: Have Penalties Been—or Will Penalties Ever Be—Assessed?It's unclear whether, to date, any Affordable Care Act employer shared responsibility penalties and penalties for failure to timely (and correctly) file 2016 Form 1095-C information returns have been assessed by the IRS. That doesn't mean they won't be.
EEOC Settlement of Wellness Suit Leaves Unresolved IssuesA settlement reached by the U.S. Equal Employment Opportunity Commission (EEOC) and an employer over whether worker participation in a worksite health screening was "voluntary" is a warning signal not to go too far in pressing employees to participate in wellness-promoting initiatives. But conflicting federal rules and court decisions continue to muddy the compliance waters for employee wellness programs.
Expect a Push to Tax Health Benefits, Political Watchers WarnAs part of efforts to reform the tax code—or under a back-from-the-dead effort to repeal and replace the Affordable Care Act—employers could be taxed on group health benefits provided to workers, or employees could be taxed on benefits they've received.
As ACA Remains Law, Focus Turns Back to Compliance and Regulatory ReliefIf GOP efforts to revive the American Health Care Act fail, the ACA and its implementing rules could still see modest changes through targeted legislative actions and regulatory adjustments. In the meantime, employers subject to the ACA should continue complying with the law's wide-ranging coverage mandates and employee tracking and reporting requirements, benefit attorneys advise.
GOP's Health Care Bill Exposed an HSA Political DivideExpanding the use of health savings accounts (HSAs) was a cornerstone of the Republicans' American Health Care Act, and that reinvigorated a debate between those who see HSAs are the key to health care consumerism and those who dismiss HSAs as benefiting only the wealthy.
Relief Extended for 'Grandmothered' Small Group Health PlansThe Trump administration is allowing small business an extra year to renew certain older plans that don't comply with the ACA and that don't fall under the open-ended exemption for grandfathered plans.
IRS to Accept Tax Returns Lacking Health Care Status; Employer Reporting UnchangedAlthough the IRS has announced it will not reject taxpayers' 2016 returns that are missing health coverage information, employers still must distribute 1095 forms to employees and report employee health coverage to IRS, as deadlines loom.
How Trump's First Executive Order Could Affect Employer Health PlansPresident Donald Trump's Jan. 20 executive order directing federal agencies that oversee the Affordable Care Act to waive or delay burdensome taxes, penalties and regulations could affect employer plans' mandates and fees, but won't do so immediately.
New Law Lets Small Employers Use Stand-Alone HRAsEnactment of the 21st Century Cures Act lets small businesses use health reimbursement arrangements (HRAs) to fund employees who buy individual plans on the open market.
IRS Delays Employers' Deadline to Distribute ACA Reporting Form 1095 to EmployeesThe IRS is giving employers an additional 30 days to distribute the Affordable Care Act's tax year 2016 information-reporting forms to employees, extending the deadline from Jan. 31, 2017, to March 2. But the due dates for filing Forms 1094 and 1095 with the IRS remain unchanged: Feb. 28 for paper/mail submissions or March 31 for electronic filing.
For additional information on implementing the Affordable Care Act, SHRM members can contact the
SHRM Knowledge Center.
SHRM Government Affairs
Health Care Public Policy and Advocacy Updates
Types of Employer Payments Under ACA and How They Are Calculated
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