Small Group Market Change Gains Bipartisan Support

A bill to amend the definition of the small group market is gaining bipartisan support, according to the Commonwealth Fund. The bill, H.R. 1624, would define businesses with 51 to 100 full-time employees as large businesses, unless a state elects to treat that group as a small business. Members of the House Energy and Commerce Committee have expressed interest in the plan, and 40 of the bill’s 215 cosponsors are Democrats. The Congressional Budget Office estimates the bill would increase federal revenue by $400 million over the next decade.

Court Rules Religiously Affiliated Employers Burdened by Contraceptive Care Mandate

The U.S. Court of Appeals for the 8th Circuit broke from the holdings in all other appellate courts in its recent ruling that religiously affiliated employers are unjustly burdened when seeking accommodation from the Affordable Care Act’s requirement to cover contraceptive care. The accommodation process, developed by the Obama Administration after the Hobby Lobby Supreme Court case, requires health insurance issuers and third party administrators to provide contraceptive services to employers’ health plan enrollees without charging the employer or enrollee for the service. All other circuits of the U.S. Courts of Appeals have previously ruled that this accommodation strikes the appropriate balance between access to care and protecting religious beliefs. When U.S. Courts of Appeals are split on a matter, the Supreme Court often settles the issue.

Community Health Centers Receive $500 Million in ACA Funding

HHS awarded nearly $500 million in Affordable Care Act funding to community health centers throughout the country, $350 million of which was awarded to nearly 1,200 health centers to increase access to a range of services such as medical, oral, behavioral, pharmacy and vision care. The remaining $150 million was awarded to 160 health centers for facility renovation, expansion or construction. HHS estimates that the awards will help provide primary care access to an additional 1.4 million people. The funds may also be used by health centers for outreach and enrollment activities during the 2016 open enrollment period.

GAO Recommends CMS Increase Marketplace Oversight

In a review of states’ use of federal funds for information technology projects to establish and support Marketplaces, the Government Accountability Office (GAO) found a need for increased CMS oversight. Specifically, GAO recommended that CMS articulate to states the agency’s oversight roles and responsibilities, ensure CMS’s senior executives are involved in marketplace IT funding decisions, and ensure states complete system testing prior to putting a system into operation. HHS concurred with GAO's recommendations. States reported spending approximately $1.5 billion in federal Marketplace grants and a portion of the $2.8 billion combined state and federal funding for Medicaid eligibility and enrollment systems on IT projects that supported marketplace development.

OIG Finds CMS’s Management of Federal Marketplace Contracts Inadequate

In a review of 20 of the 62 contracts CMS awarded for the development, implementation, and operation of the Federally-facilitated Marketplace, HHS’s Office of Inspector General found that contracting officers and their representatives did not always manage and oversee contractor performance in accordance with federal requirements and contract terms. Due to lack of oversight, contractor delays and performance issues were not always identified, unauthorized costs were incurred, critical deliverables and management decisions were not always documented, and past-performance evaluations were not always made available when making subsequent contract awards. CMS agreed with OIG’s recommendations to address these issues and has taken, or plans to take, corrective actions.

Uninsured Rate Down to 10.4%, According to Census Bureau

A U.S. Census Bureau report found that the uninsured rate decreased from 13.3% in 2013 to 10.4% in 2014, the largest change in the coverage rate since 2008. Consumers enrolled in individual health plans had the largest increase in coverage rates, from 11.4% in 2013 to 14.6% in 2014. Individuals enrolled in Medicaid had the second largest increase, from 17.5% in 2013 to 19.5% in 2014. The report also found that there was no statistically significant change in the percentage of people covered by employer-sponsored insurance, which was the source of coverage in 2014 for 55.4% of the insured population.