Obamacare (ACA) Ruled Unconstitutional in Texas, but This Fight is Far from Over

Obamacare (ACA) Ruled Unconstitutional in Texas, but This Fight is Far from Over

Uncharacteristically late on Friday evening December the 16th, a Texas U.S. District Court Judge (Reed O’Connor) held that the Affordable Care Act was unconstitutional and should be entirely struck down. The basis of this argument is that the recent decision by Republican Congress to remove the tax penalty for people who do not have health insurance, now places the law in opposition to the constitution.

The decision is certain to be appealed. In fact, house leader Nancy Pelosi almost instantly challenged the decision and said that when Democrats take the house in January, they will certainly appeal. This is widely anticipated to lead to a very long legal battle between Democrats and Republicans.

In the meantime, the current ACA law stands. The white house released a formal statement reiterating just that. White house press secretary Sarah Sanders stated that, “Obamacare will remain in effect while the case is appealed”.

Most legal scholars believe that this case will ultimately be heard by the supreme court. Until then nothing will change with how our current healthcare system operates.

This means that Employers must still comply with the Employer Mandate. ACA Reporting is still required by law and employees must receive their forms 1095C no later than the extended deadline of March 4th 2019, for the 2018 reporting year.

IRS Deadline Extended 2019: Employers get extra time to distribute form 1095-C

IRS Deadline Extended 2019: Employers get extra time to distribute form 1095-C

The IRS has yet again extended the annual deadline for distributing form 1095-C for the 2018 tax year. The new deadline for form distribution to full time employees (required under the Affordable Care Act ACA) is March 4, 2019. This deadline was extended from the original due date of Jan 31, 2019 effectively giving large employers 32 additional days to comply.

On November 29th the IRS released notice 2018-94, which serves to extend the due date for certain 2018 information-reporting requirements for insurers, self-insuring employers, and certain other providers of minimum essential coverage under section 6055 of the Internal Revenue Code (Code) and for applicable large employers under section 6056 of the Code.

The notice specifically mentions that failure to comply with new due dates will result in penalties for Applicable Large Employers (ALEs). The notice states “Employers or other coverage providers that do not comply with the due dates for furnishing Forms 1095-B and 1095-C (as extended under the rules described above) or for filing Forms 1094-B, 1095-B, 1094-C, or 1095-C are subject to penalties under sections 6722 or 6721 for failure to timely furnish and file, respectively. However, employers and other coverage providers that do not meet the relevant due dates should still furnish and file.”

ACA Reporting Service is a leading full service vendor for ACA reporting since the inception of the law in 2014. We work directly with employers as well as partnering with HR firms, Staffing companies and many others needing an expert partner for backend fulfillment for their clientele. Reach out to our customer service team for more details at 888-978-8310 or email us: support@acareportingservice.com.

New Partnerships: SelfInsuredReporting.com

New Partnerships: SelfInsuredReporting.com

We are pleased to announce a strategic partnership with Self Insured Reporting to the benefit of our clients.

SelfInsuredReporting.com is a financial reporting and claim analytics system specifically designed for self insured employers.  Their platform helps you quickly answer questions such as:

  • How is our plan performing versus our budget for the year? How about our stop loss contract?
  • What are the costs expected to be for the rest of the plan year? What is my expected renewal?
  • How are the medical and pharmacy claims trending for each plan? What about network performance?
  • How are claims trending for conditions such as cancer or diabetes?
  • Which providers are the most expensive in an area?
  • Are there opportunities to ‘drive’ services from one provider to a lower cost provider, such as from an emergency room to an urgent care facility?

Learn more at SelfInsuredReporting.com


Individual Health Insurance Mandates Being Signed into Law at the State Level

Individual Health Insurance Mandates Being Signed into Law at the State Level

On Wednesday June 27th the New Jersey Health Insurance Market Preservation Act was signed into law. This was just the latest development in an effort for several states who are attempting to enact Mandated health insurance at the State level.

The New Jersey law in effect enforces residents, by way of penalty, to enroll in qualified health insurance. This law will be enacted on October 1, 2018 and will apply to taxable years beginning Jan 1, 2019.

It is being said that in many ways this Mandate was designed to mirror the Mandates brought forth by the Affordable Care Act (ACA). Here are a few of the similarities:

    • Annual penalty of 2.5 percent of a household’s income or a per-person charge
    • Maximum penalty based on household income will be the average yearly premium of a bronze plan in the state (rather than nation like the federal law)
    • maximum penalty based on per-person charge will be a maximum household penalty of $2,085

Reporting guidelines

Along with this come reporting requirements. Employers will have to report qualified offers of coverage to individuals to track subsidy eligibility. The bill states that “In summary, any reporting that was acceptable under the ACA’s federal guidelines will be accepted under the New Jersey’s state reporting guidelines”.

Other States to Potentially Enact Health Insurance Mandates

Massachusetts was the first state to enact a health insurance mandate (took effect in 2006 and was a model for the health insurance mandate in the ACA).  It is still implementing this mandate.

Vermont governor, Phil Scott, signed a bill on May 28 that would establish an individual mandate. The details for the bill such as financial penalties and enforcement mechanisms will not be determined until the 2019 legislative session, which means the mandate won’t go into effect until January 1, 2020.

Maryland Democrats running for Governor have all agreed to a health insurance program that has many ACA related items. The insurance program will create a state individual mandate where the penalties imposed on individuals for not obtaining health coverage would be used as a “down payment” to obtain health insurance policies.

Other states that have discussed the possibility of a state individual mandate are; California, Connecticut, Hawaii, Minnesota, Rhode Island, Washington, and District of Columbia. Many of these states’ ability to implement an individual mandate will hinge on the results of the midterm elections this November and how many Democrats are voted into office.

It has been rumored that if these states are able to enact Healthcare Mandates they will do so with the intention of having their state laws closely mirror the infrastructure of the Affordable Care Act. Several of the states are attempting to use re-insurance coverage to take care of the expense associated with higher risk individuals. It has been reported that penalties associated with the Mandates and subsequent reporting will be used to fund these re-insurance premiums.

Overall Outlook

A few weeks ago, we published an article outlining the potential impact of the upcoming Mid-Terms as it pertains to Health Care reporting. That Article can be found here.

It seems that the Mid-Terms will take a determining role in how this all plays out. However, these laws being taken to the State level are a sign that no matter the outcome on the Federal level, there are many states who are ready to enact “ACA like” laws of their own.

The IRS is currently enforcing the Individual Mandate at the Federal level for 2018. Additionally, enforcement of the Employer Mandate continues to occur. Letter 226J is being sent out for the tax year 2015, and our sources are saying that 226J letters for 2016 are soon to follow.

Right now, may be a very good time to retroactively review your previous years filings.