By a 6-3 decision, the U.S. Supreme Court ruled in King v. Burwell that health insurance subsidies provided by the Affordable Care Act should be available regardless of whether they are in state exchanges or federal exchanges. Had the decision gone the other way, millions of people would have lost tax subsidies causing a major disruption in the healthcare market; but with the challenge defeated, employers won’t see much in the way of change from the status quo.
The biggest change is this: the Supreme Court decision means an increased measure of stability. A statement from the National Association of Insurance Commissioners (NAIC) talks about why this is important.
“Uncertainty in insurance is not a good thing. The decision allows regulators, consumers and the industry a level of certainty that supports stability for insurance markets in our states. The NAIC will continue to support state insurance departments – as we have done since the passage of the ACA – and ensure consumers are protected, regardless of the type of exchange in any given state. There are still a number of challenging issues facing health insurance consumers across the country, and U.S. insurance regulators are working together through the NAIC to promote stable and competitive markets.”
Also see:
BenefitsPro: King v. Burwell decision a relief for HR managers
Dan King offers a roundup of opinions, including NBGH and SHRM
Workforce: Supreme Court Rules in Favor of Insurance Subsidies
Insurance Journal: Supreme Court Upholds Obamacare Tax Subsidies
Inside Counsel: What businesses should do after King v. Burwell
Wellness Incentives EEOC ruling pending
With much of the uncertainty essentially lifted, employers can lay plans accordingly.
One important provision in the Affordable Care Act is the provision that allows employers to offer wellness incentives. In April, the EEOC published a proposed rule applying to employer wellness programs that are part of group health plans. (See our prior post: EEOC’s Proposed Rule on Employer Wellness Permits Incentives) The proposed rule offers guidance for employers who want to offer incentives for employees to participate in wellness programs or to achieve certain health outcomes. Allowable incentives may be up to 30 percent of the total cost of employee-only coverage or as high as 50% of the total cost of employee coverage for tobacco-related wellness programs.
By way of example EEOC notes:
“…if the total cost of coverage paid by both the employer and employee for self-only coverage is $5,000, the maximum incentive for an employee under that plan is $1,500.”
As part of its rule making, EEOC invited comments through June 19 and will issue a final rule at some future date.
Additional resources
EEOC Guidance: Redesigning Wellness Programs to Comply with the ADA