Legislative and Regulatory Updates
 The U.S. Court of Appeals for the 11th Circuit in Atlanta found that portions of the Affordable Care Act (ACA) are unconstitutional. In a 2–1 decision, the court ruled on Aug. 12 that the individual mandate requirement was an improper exercise of federal authority. The lawsuit was brought by Florida and 25 other states that oppose the ACA. Additional legal challenges to the act currently are pending in lower federal courts.
The National Association of Insurance Commissioners (NAIC) said that state insurance rules should be the authority for the large multi-state plans that will show up on health insurance exchanges in 2014. The NAIC's comments were in response to the Office of Personnel Management's (OPM) recently issued request for information about multi-state plans offered through health insurance exchanges. The ACA requires the OPM to organize at least two multi-state health plans to be sold through exchanges beginning in 2014.
The Department of Health and Human Services (HHS) has issued two proposed rules relating to the development of exchanges under the ACA. The first proposed rule outlines the process of enrolling eligible individuals into qualified health plans and the process for implementing premium and cost-sharing subsidies. It also establishes standards for employer participation in the Small Business Health Options Program (SHOP). The second proposed rule implements sections of the ACA related to Medicaid and Children's Health Insurance Program eligibility and coordination. Comments on both proposed rules are due by Oct. 31.
The HHS also is soliciting comments on proposed rules that address the disclosure of, and the instructions and templates for, the summary of benefits and coverage and the uniform glossary for group health plans and health insurance coverage in the group and individual markets under the ACA. Comments are due by Oct. 21.
The Internal Revenue Service (IRS) has proposed regulations that provide guidance on the manner in which an individual enrolled in qualified health exchanges may claim the premium tax credit. Comments are due by Nov. 10. The IRS will hold a public hearing on the proposed regulations on Nov. 17.
President Obama signed the Budget Control Act of 2011 into law on Aug. 2. The act increases the debt ceiling, reduces the federal deficit over the next 10 years, and creates the Joint Select Committee on Deficit Reduction. The committee is charged with identifying $1.5 trillion in additional cuts, which can include changes to entitlement programs. The committee is composed of 12 members—six members from both the Senate and the House, with membership divided equally between Democrats and Republicans. The members of Congress named to the committee are: Sen. Max Baucus, D-Mont.; Sen. Patty Murray, D-Wash.; Sen. John Kerry, D-Mass; Sen. John Kyl, R-Ariz.; Sen. Rob Portman, R-Ohio; Sen. Pat Toomey, R-Pa.; Rep. David Camp, R-Mich.; Rep. Fred Upton, R-Mich.; Rep. Jeb Hensarling, R-Texas; Rep. Chris Van Hollen, D-Md.; Rep. Xavier Becerra, D-Calif.; and Rep. James Clyburn, D-S.C.
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