As employers, local governments will soon be responsible for ACA implementation in cities and towns across America. This site provides useful resources to help cities take the steps necessary to properly implement the law and inform citizens about how the ACA impacts them personally.
On November 20, the U.S. Department of Health and Human Services (HHS) issued a proposed rule that will implement one of the Affordable Care Act’s (ACA) most important provisions: prohibition of insurance companies from denying health care coverage to individuals with pre-existing conditions.
Highlights of the proposed rule include:
The final version of the rule will take effect in 2014. Comments to HHS are due on or before December 20, 2012. NLC will be reviewing the proposed rule as well to determine whether the organization will submit comments.
A new report, issued by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT), predicts that about 30 million nonelderly Americans would remain uninsured even after the Affordable Care Act individual insurance mandate (Sec. 1501) goes into effect in 2014. Of those, six million—two million more than was predicted about two years ago—would be subject to the penalty tax and would pay a total of $7 billion in 2016 and $8 billion thereafter for not having insurance –about $3 billion more per year than originally predicted. The penalty tax would range from either a flat per person rate of $695 or a household rate of 2.5 percent of the household’s annual income.
Of the 24 million who are not likely to be subject to the penalty tax, 12 to 13 million would be exempted because they are unauthorized immigrants; are not required to file income tax returns; members of an Indian tribe; or required to pay more than eight percent of their household income on insurance. Of the remaining 11 to 12 million, some individuals would be granted exemptions from the penalty because of hardship, and others would be exempted on the basis of their religious beliefs. Unauthorized immigrants are exempted from the individual mandate because they are prohibited from receiving almost all Medicaid benefits and all subsidies through the insurance exchanges.
According to the CBO and JCT, changes in the economic outlook—primarily a higher unemployment rate and lower wages and salaries—would account for about 85 percent of the increase in the numbers subject to the penalty. The remaining 15 percent would come from the increase in the number of uninsured people expected to pay the tax penalty because they reside in states that will opt out of the Medicaid expansion program.
On September 10, the Internal Revenue Service (IRS) issued updated guidance that describes the safe harbor methods small and large employers, including local governments, may use to determine which of their employees are permanent, seasonal and variable, or part-time (not likely to work more than 20 hours per week) when determining qualification for employer-sponsored health care under the Affordable Care Act (ACA). The guidance also describes various methods and parameters that the IRS may use to determine under which circumstances employers, including local governments, will be assessed penalties should they fail to provide health care coverage.
Of note is that the guidance grants employers an extended window of up to 12 months when determining which employees must be considered full-time and which employees may be considered part-time—something that NLC requested in a May 2011 letter to the IRS. The guidance is effective immediately, however, it will have no fiscal impact on cities and towns until 2014 when the requirement that certain employers must provide health care coverage goes into effect.
On September 11, NLC hosted a free webinar designed for cities and towns as employers. View the full presentation by attorneys Rita Patel and Paolo Pasicolan of the law firm DLA Piper, which provided local governments with information on how to effectively implement the ACA. Specifically, the webinar focused on each of the necessary steps cities and towns must take to ensure that the ACA is properly and lawfully implemented. (DOWNLOAD WEBINAR SLIDES)
Statement from NLC President Ted Ellis, mayor of Bluffton, Indiana, regarding the recent U.S. Supreme Court decision on the constitutionality of the Affordable Care Act.