Overview
- Consolidated Version of the Affordable Care Act (ACA), March 23, 2010
- Congressional Budget Office (CBO) Cost Estimate for the ACA, March 20, 2010
Exchange Coverage and Tax Credits
- Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2018, October 6, 2016
- Federal Register 79: 78578-78611. December 30, 2014 This document contains proposed regulations regarding the summary of benefits and coverage (SBC) and the uniform glossary for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act. It proposes changes to the regulations that implement the disclosure requirements under section 2715 of the Public Health Service Act to help plans and individuals better understand their health coverage, as well as to gain a better understanding of other coverage options for comparison. It proposes changes to documents required for compliance with section 2715 of the Public Health Service Act, including a template for the SBC, instructions, sample language, a guide for coverage example calculations, and the uniform glossary.
- CCF comments to CMS on 2016 Notice of Benefit and Payment Parameters, December 22, 2014
- Children’s Health Group Comments to CMS on 2016 Notice of Benefit and Payment Parameters, December 22, 2014
- Letter to CMS on NBPP and EHB regulations, December 22, 2014
- Letter to MACPAC on affordable and adequate coverage for children, December 19, 2014
- Letter to MACPAC from 49 organizations on affordable and adequate coverage for children, December 19, 2014
- 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
- Clarification of Existing Practices Related to Certain Health Care Information, October 25, 2013. The ACA requires that individuals seeking coverage under a qualified health plan to provide information regarding their immigration status and certain information about their household members to determine eligibility for such coverage. This memorandum sets forth U.S. Immigration and Customs Enforcement (ICE) civil immigration enforcement policy regarding information concerning such individuals and their household members obtained during the eligibility determination process for such coverage.
- Federal Register 78: 59122-59151, September 25, 2013. This proposed rule would establish the Basic Health Program, as required by section 1331 of the Affordable Care Act.
- Federal Register 78: 54996-55013, September 9, 2013. This proposed rule provides guidance to employers that are subject to the information reporting requirements under section 6056 of the Internal Revenue Code (Code), enacted by the Affordable Care Act.
- Federal Register 78: 54986-54996, September 9, 2013. This proposed rule provides guidance to providers of minimum essential health coverage that are subject to the information reporting requirements of section 6055 of the Internal Revenue Code (Code), enacted by the Affordable Care Act.HHS letter, September 9, 2013. This letter responds to the letter sent to selected Navigator grant awardees in the Federally-facilitated and State Partnership Marketplaces.
- Final rule on Program Integrity: Exchange, SHOP, and Eligibility Appeals. The final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases.
- Federal Register 78: 42824-42862, July 17, 2013. This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants.
- Guidance on Certified Application Counselor (CAC) Program for Federally-Facilitated Marketplace including State Partnership Marketplaces, July 12, 2013.
- Guidance on Eligibility for Minimum Essential Coverage for Purposes of the Premium Tax Credit, June 26, 2013. This notice provides guidance on whether or when, for purposes of the premium tax credit under § 36B of the Internal Revenue Code, an individual is eligible for minimum essential coverage under certain government-sponsored health programs or other coverage designated as minimum essential coverage.Federal Register 78: 37032-37095, June 19, 2013. The proposed rule sets forth financial integrity and oversight standards with respect to Affordable Insurance Exchanges; Qualified Health Plan (QHP) issuers in Federally- facilitated Exchanges (FFEs); and States with regard to the operation of risk adjustment and reinsurance programs.CCF Comments
- Model application forms for enrollment in the Exchanges, April 30, 2013.
- Federal Register 78: 20581-20597, April 5, 2013. The proposed rule would create conflict-of-interest, training and certification, and meaningful access standards applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State-based Exchanges that are funded through federal Exchange Establishment grants.
- Federal Register 78: 7348-7371, February 1, 2013. The proposed rule would implement certain Exchange functions, such as: eligibility for exemptions and miscellaneous minimum essential overage provisions.FAQs on Exchanges, Market Reforms and Medicaid, December 10, 2012. These FAQs clarify questions about the federally-facilitated exchange.
- Federal Register 77: 73118-73217, December 7, 2012. The proposed rule provides further detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for a Federally- facilitated Exchange; advance payments of the premium tax credit; a Federally- facilitated Small Business Health Option Program; and the medical loss ratio program.
- Federal Register 77: 70619-70642, November 26, 2013. The proposed rule looks at nondiscriminatory wellness programs in group health coverage under the ACA.Frequently Asked Questions, September 20, 2012. This notice looks at the Federal data services hub and enrollment systems.
- Federal Register 77: 52614-52616, August 30, 2012. This proposed rule excludes youth considered “lawfully present” under the recently announced Deferred Action for Childhood Arrivals (DACA) from the definition used in the Pre-Existing Condition Insurance Plan program (PCIP), as well as the use of this definition in other provisions of the ACA, effectively making them ineligible for coverage.
- Secretary Sebelius letter to Congress regarding Navigators, July 11, 2012.
- CCF group letter to HHS
- Federal Register, 77: 40061-40063, June 28, 2012. This notice and accompanying appendices describe the data elements for the single, streamline application.
- Federal Register 77: 30377-30400, May 23, 2012. These final regulations describe eligibility for the health insurance premium tax credits, as well as guidance relating to enrollment in qualified health plans.
- General Guidance on Federally-Facilitated Exchanges, May 16, 2012. This document outlines the approach to implementing a Federally-facilitated Exchange (FFE) in any state where a state-based Exchange is not operating.
- Draft Blueprint for Approval of Affordable State-Based and State Partnership Insurance Exchanges, May 16, 2012. To receive HHS approval for an Exchange, a State must complete and submit an Exchange Blueprint that documents how its Exchange meets or will meet all legal and operational requirements associated with the model it chooses to pursue.
- 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.
- Verification of Access to Employer‐Sponsored Coverage Bulletin, April 26, 2012. This bulletin requests comment from the public on a proposed interim strategy and potential regulatory approach for verification of an applicant’s access to qualifying coverage in an employer‐sponsored.
- 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
- Guidance for Exchange and Medicaid Information Technology (IT) Systems, Version 2.0, May 31, 2011. This guidance is designed to help states achieve interoperability between information technology (IT) components in the federal and state entities that work together to provide health insurance coverage through the Exchange, Medicaid or CHIP programs.
- 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 Governors on State Flexibility in Implementing the ACA, February 24, 2011
- HHS Memo on Flexibility in State-Run Exchanges, February 10, 2011
- HHS Initial Guidance to States on Exchanges, November 18, 2010
- Guidance for Exchange and Medicaid Information Technology (IT) Systems, Version 1.0, November 3, 2010. The purpose of this document is to assist states as they design, develop, implement, and operate technology and systems projects in support of the Affordable Care Act relating to the establishment and operation of Exchanges, as well as coverage expansions.
• HHS Letter to States on Federal Support and Standards for Medicaid and Exchange Information Technology Systems, November 3, 2010
- Federal Register, 75: 45584-45590, August 3, 2010. This document is a request for comments regarding the planning and establishment of state-level exchanges.
• 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
- Letter from Richard Popper, Director, Office of Insurance Programs, to Federal High Risk Pool Contractors, February 17, 2011. This letter provides clarification on eligibility affecting children under age 19.
- Department of the Treasury, Department of Labor, Department of Health and Human Services, November 16, 2010. This document lays out the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under provisions of the Affordable Care Act.
• 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
- Secretary Sebelius Letter to America’s Health Insurance Plans on Child-Only Policies, September 24, 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
- Secretary Sebelius Letter to America’s Health Insurance Plans on Pre-Existing Condition Exclusions for Children March 29, 2010
