Affordable Care Act: Legislation, Regulation and Guidance

Overview

Exchange Coverage and Tax Credits

  • Federal Register 79: 37262-37269, July 1, 2014. Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs; Health Insurance Issuer Standards Under the Affordable Care Act. This proposed rule would specify additional options for annual eligibility redeterminations and renewal and re-enrollment notice requirements for qualified health plans offered through the Exchange, beginning with annual redeterminations for coverage for plan year 2015. In particular, this proposed rule would provide additional flexibility for Marketplaces, including the ability for Marketplaces to propose unique approaches that meet the specific needs of their State, while streamlining the consumer experience. 
  • ACA Draft Issuer Standard Notices When Discontinuing or Renewing QHP
  • Letter to Secretary Sebelius, April 3, 2014. The letter contains recommendations on ways to strengthen the Navigator and CAC programs so assisters are better able meet the needs of consumers, especially minority and other vulnerable communities
  • Minimum Value of an Employer-Sponsored Health Plan, April 30, 2012. This notice describes and requests comments on several possible approaches to determining whether health coverage under an eligible employer-sponsored plan provides minimum value.
  • Federal Register 77: 25378-25381, April 30, 2012. This document contains proposed regulations relating to the disclosure of tax return information. The regulations define certain terms and prescribe certain items of return information in addition to those items prescribed by statute that will be disclosed.
  • Federal Register 77: 18310-18475, March 27, 2012. This regulation lays out eligibility determinations for Exchange participation and insurance affordability programs, standards for employer participation in SHOP, and establishment of Exchanges and Qualified Health Plans.

• CCF Comments on Final Medicaid Regulation

• CCF Comments on Final Exchange Regulation

Children’s Health Group Comments on Final Medicaid and Exchange Rules

  • Federal Register 76: 51202- 51237, August 12, 2011. This proposed rule provides details on eligibility determinations for Exchange participation and insurance affordability programs and standards for employer participation in SHOP.

CCF Comments on Proposed Exchange Regulation

• CCF addendum on immigrant and mixed status families by Dinah Wiley

  • Federal Register 76: 50931-50949, August 12, 2011. This proposed rule provides details on eligibility for and the calculation of health insurance premium tax credits enacted by the ACA.

CCF Comments on Proposed Premium Tax Credit Regulation

CCF addendum on immigrant and mixed status families by Dinah Wiley

  • Federal Register, 76: 41866-41927, July 15, 2011. This proposed rule would implement the new Affordable Insurance Exchanges which will become operational by January 1, 2014.

CCF Comments on Exchange Establishment Regulation

• Additional Comments on the Partnership Model

  • Federal Register, 76: 13553-13567, March 14, 2011. This proposed rule sets forth a framework for submission and review of initial applications for a Waiver for State Innovation, including processes to ensure opportunities for public input.

HHS Letter to States on Federal Support and Standards for Medicaid and Exchange Information Technology Systems, November 3, 2010

CCF Comments on State-Level Exchanges

  • Federal Register, 75: 24470-24482, May 5, 2010. This interim final rule adopts the categories of information that will be collected and displayed as Web portal content, and the data we will require from issuers and request from States, associations, and high risk pools in order to create this content.

CCF Comments on the Web Portal Requirements

 

Insurance Market Reforms

  • CCF comments on PPACA Market Stabilization, March 7, 2017.
  • CCF letter urging those individuals granted relief under the President’s Immigration Accountability Executive Actions to participate in affordable health coverage options under the Affordable Care Act (ACA), and Medicaid and the Children’s Health Insurance Program (CHIP) in states that have taken up expanded coverage options. Second, we urge the Task Force to consider approaches that alert parents applying for or granted DAPA that their children may be eligible for Medicaid and CHIP or other health coverage programs and facilitate their enrollment.
  • Letter from Center for Consumer Information and Insurance Oversight (CCIIO), December 19, 2014. CMS released a draft 2016 letter to issuers in the Federally-facilitated Marketplaces (FFMs). This letter provides issuers seeking to offer qualified health plans, including stand-alone dental plans, in the FFM or Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance to help them successfully participate in those Marketplaces in 2016.
  • Letter from U.S. Senate Committee on Finance, June 12, 2014. Senate Finance Committee Chairman Ron Wyden, D-Ore., and senior Finance Committee member Chuck Grassley, R-Iowa, are asking providers, patients, advocates, insurers, entrepreneurs and others for new ideas for improving overall transparency in health care.
  • Federal Register, 78: 46558-46560, August 1, 2013. The RFI to inform the Department’s rule making on Section 1557 of the ACA, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities.
  • Federal Register, 77: 70584-70617, November 26, 2012. The proposed rule covers guaranteed issuance and renewability of coverage, protections on premium pricing, and the requirement for insurers to use a single risk pool and offer catastrophic coverage for certain individuals. Provisions important for children and families include those on setting premiums for different ages and family structures.
  • Federal Register, 77: 70644-70676, November 26, 2012. The proposed rule largely codifies guidance on EHBs the department had published earlier, but provides new information on states’ authority to define habilitation benefits and limit substitution of benefits.
  • Essential Health Benefits Bulletin, December 16, 2011. The Department of Health and Human Services released a bulletin to describe its approach to setting the essential health benefits. It proposes to provide states with flexibility to choose from among a selection of benchmark plans.

Frequently Asked Questions on Essential Health Benefits Bulletin

The Secretary’s Letter to Governors, December 16, 2011

Comment letter from CCF and other child health organizations

  • Federal Register, 76: 52442-52475, August 22, 2011. The proposed rule implements sections of the ACA related to the disclosure of the summary of benefits and coverage and the uniform glossary for group health plans and health insurance coverage in the group and individual markets.

CCF Comments on Summary Benefit Regulations

Questions and Answers on Enrollment of Children Under 19 Under the New Policy That Prohibits Pre-Existing Condition Exclusions, October 13, 2010

Secretary Sebelius Letter to the NAIC on Improving Coverage for Children with Pre-Existing Conditions, October 13, 2010

  • Federal Register, 75: 45014-45033, July 30, 2010. This rule implements the Pre-Existing Condition Insurance Plan Program, a temporary high risk health insurance pool program to provide affordable health insurance coverage to uninsured individuals with pre-existing conditions.

CCF Comments on Pre-Existing Condition Insurance Plan Program

  • Federal Register, 75: 41726-41760, July 19, 2010. This document contains interim final regulations implementing the rules for health insurance coverage in the group and individual markets regarding preventive health services.

Children’s Groups Comments on Preventive ServicesRecommendations from the United States Preventive Services Task Force

  • Federal Register, 75: 37187-37241, June 28, 2010. This document contains interim final regulations implementing the rules for health insurance coverage regarding preexisting condition exclusions, lifetime and annual dollar limits on benefits, rescissions, and patient protections.

Children’s Groups Comments on the Patient’s Bill of RightsCCF: FAQs on Child-Only Plans

  • Federal Register, 75: 34538-34570, June 17, 2010. This document contains interim final regulations implementing the rules health insurance coverage regarding status as a grandfathered health plan.

Children’s Groups Comments on Grandfathered Health Plans

  • Federal Register, 75: 27122-27142, May 13, 2010. This document contains interim final regulations implementing the requirements for health insurance issuers regarding dependent coverage of young adults up to age 26.

CCF Comments on Dependent Coverage to Age 26

  • Federal Register, 75: 24470-24482, May 5, 2010. This interim final rule describes the categories of information that will be collected and displayed as Web portal content, and the data we will require from issuers and request from States, associations, and high risk pools in order to create this content.

CCF Comments on the Web Portal Requirements

 

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