Expect more ACA legislation coming down the pike

Although it's been four years since the Affordable Care Act became law, the Obama administration still has to release several major reform provisions, including details on essential health benefits and the employer mandate, that have been delayed.

More than 12 rules could be published as early as this year, PoliticoPro reported. That means insurers could soon see rules addressing:

  • The employer mandate, which the White House postponed back in July, FierceHealthPayer previously reported. The rule now will take effect next year and requires companies with at least 50 employees to offer health plans or pay fines.
  • A "belly button tax" exemption, which could excuse some groups from paying into the reinsurance program intended to provide insurers with financial protection against a higher percentage of sicker members. The reinsurance fee kicks in this year.
  • Essential health benefits that insurers must include within plans sold on health insurance exchanges.

Another possible change in regulations could come if the U.S. Supreme Court decides the contraceptive mandate allows for certain religious exemptions. That would force the Obama administration to rewrite the reform provision regarding contraception coverage.

But even as Obama officials address these ACA provisions, more issues are certain to appear after open enrollment ends in March. That's when officials will gain a clearer picture of what problems need to be tackled, including ensuring consumers are connected to the right subsidy and decreasing any churning between Medicaid and exchange plans.

"There are so many downstream questions," George Washington University professor Sara Rosenbaum told PoliticoPro. "Like with any program, in implementation you need a second generation of policy, and the problem with the rocky rollout is we're very delayed in focusing on the second-generation questions, which are inevitable in any major health reform effort."

To learn more:
- read the Politico article