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ACA Watch – May 2015

ACA Watch – May 2015

The Patient Protection and Affordable Care Act continues to evolve, and more changes are on the horizon for 2016. Read on for three possible changes you’ll want to know more about.

Should they stay or should they go? That’s the question SCOTUS will be ruling on by June 30 in the King v. Burwell case, which charges that the ACA federal tax credit for individuals is only authorized for people who purchase their insurance on state-run exchanges.

What does it mean? As it’s currently worded, the ACA specifies that federal subsidies are for those participating in state-run exchanges. If the Supreme Court rules that those participating in the federal exchange aren’t eligible for federal subsidies, over eight million Americans who use could lose their subsidies. However, the general consensus is that SCOTUS will rule in favor of the federal government, making federal subsidies legal for those using the federally-run exchange.

Small groups are about to get larger (by definition). Unless Congress intervenes, on Jan. 1, 2016, small group – as defined by the ACA – will be those with less than 100 employees. Currently that small group definition caps at 50 employees.

What does it mean? A group with over 50 employees must go through medical underwriting.  If the definition of small group changes to less than 100 employees, then 50-99 will also have community rates.   The debate is still out as to whether this will be a good thing or not.

Are You Playin’ or Payin’? In 2016, employers will be required to file to prove the health coverage they’re offering their employees is compliant with the ACA.

What does it mean? More IRS forms and monthly tracking for large employers, for starters, which will be used to verify the individual and employer mandates are being followed. has a handy article that covers the details and includes links to the forms.

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