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View Diary: No 'rate shock' for Obamacare in California (204 comments)

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  •  The WSJ article and also the Forbes (0+ / 0-)

    article are all speculating and cherry picking sections of the law and leaving out other parts.  This is the same technique they did with the 'death panels" argument which has been since debunked.

    Large employers as in over 50 are not required to provide healthcare overage.  They just have to pay a fine if they don't.  To avoid the fine they must offer a minimum essential coverage.  Where the WSJ article IMO jumps the shark, is that they are assuming that t these so called skinny plans meet that threshold.  To bolster this claim the use the more official sounding version of "some people say" administration officials confirm.


    A.                 ACA Coverage Mandates
    The HIPAA regulatory scheme is found in the Public Health Service Act ("PHSA"), ERISA, and the Code. Some of the new requirements are added to the PHSA and are incorporated into ERISA and the Code by reference through ERISA section 715 and Code section 9815. It is important to understand the forms of employer-provided arrangements to which these mandates apply.
    Health Benefits Subject to the ACA Coverage Mandates
    The term "group health plan" is not defined in the ACA, but it is defined under the earlier HIPAA rules that are incorporated in ERISA, the Code, and the PHSA, and accordingly such definition will govern for ACA purposes
    . A group health plan is defined to mean "an employee welfare benefit plan … to the extent that the plan provides medical care … to employees or their dependents … directly or through insurance, reimbursement or otherwise." (PHSA § 2791(a)). An employee welfare benefit plan, in turn, means an insured or self-insured health arrangement sponsored or maintained by an employer or union (or both) for employees. (ERISA § 3(1). As such, by imposing new requirements on "group health plans," the ACA effectively imposes them on virtually all employer-provided health benefit arrangements for employees. Furthermore, the term "health insurance issuer" is defined to mean an "insurance company, insurance service, or insurance organization … licensed to engage in the business of insurance in a State and which is subject to State law …." (PHSA § 2791(b)). Thus, the ACA, by also imposing its coverage mandates on health insurance issuers, has effectively imposed mandates on virtually all individual and group insurance market policies.

    So they are erroneously assuming that the ACA health benefits mandates apply only to individual and small group policies.

    Right man, right job and right time

    by Ianb007 on Sun May 26, 2013 at 02:29:03 PM PDT

    [ Parent ]

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