Articles Discussing Health Care Reform.

Enhanced subsidies for individual health insurance under the Affordable Care Act (ACA) are set to expire on December 31, 2025, unless the U.S. Congress agrees to retain them. This change could make recruiting and retention more difficult in 2026 for employers filling jobs that do not come with employer-sponsored health

On July 30, 2025, the Departments of Health and Human Services, Labor, and Treasury alongside the Office of Personnel Management (collectively, the “Agencies”), jointly released a new set of FAQs titled “Part 71” as guidance to the ongoing implementation of the No Surprises Act (the “Act”) and certain provisions of the Affordable Care Act (“ACA”). This set of questions builds upon previous releases (i.e., sets 62, 67, and 69, as further detailed below) and reflects developments following the case of Texas Medical Association, et al. v. United States Department of Health and Human Services et al. (the “TMA” case). Earlier FAQs addressed how plans should treat qualified payment amounts (“QPAs”) during recalculation and expectations around compliance timelines.

The Centers for Medicare and Medicaid Services (“CMS”) “60-Day” overpayment rule (“60-Day Rule”) was established as part of the Affordable Care Act (“ACA”) in 2010.[i]  In a nutshell, Section 1128J(d)[ii] of the ACA provides  that a person who has received an overpayment shall report and return the overpayment to CMS[iii] in writing, stating the reason for the overpayment, within 60 days after the overpayment was identified (or the date the corresponding cost report is due).

Last month, in Faulk Company, Inc. v. Xavier Becerra, et al. 4:24-CV-00609-P (April 10, 2025), the U.S. District Court for the Northern District of Texas granted an employer’s challenge to employer shared responsibility penalties assessed by the Internal Revenue Service (“IRS”) and ordered IRS to refund $205,621.71 that Faulk Company, Inc. (“Faulk”), the lone plaintiff in the case, paid in 2019 penalties.  As part of the court’s order, it struck down the employer shared responsibility regulations at 45 C.F.R. § 155.310(i).

The Affordable Care Act (ACA) mandates that all group health plans and insurance companies provide individuals a “summary of benefits and coverage” (SBC) that outlines the key features and coverage under the plan. This month’s Compliance Corner gives an overview of what the SBC is, why it matters, and how employers can ensure compliance with regulations.

On February 21, 2025, the Internal Revenue Service (“IRS”) released Notice 2025-15, providing guidance to employers and insurers regarding the alternative manner of furnishing certain health insurance coverage statements to individuals under sections 6055(c)(3) and 6056(c)(3) of the Internal Revenue Code (the “Code”).

In the first few days of his second presidential term, newly inaugurated President Trump signed a number of executive orders that will have an impact on the health care industry, some issuing new policies and some rescinding policies set forth by prior administrations.

As we turn the page to 2025, employers and HR professionals are turning their attention to ensuring compliance with the reporting and disclosure requirements of the Affordable Care Act (ACA). Traditionally, this process required preparing and mailing Forms 1095-B and 1095-C to all full-time employees—a time-consuming and labor-intensive task. In

Employer-sponsored health plans would be required to cover over-the-counter contraception, including condoms and emergency contraception, without a prescription and without cost sharing under newly proposed Affordable Care Act (ACA) regulations.

Once again, the U.S. Departments of Labor, Health and Human Services, and the Treasury have issued guidance on the Affordable Care Act’s (ACA) required coverage of contraception without cost sharing, clarifying the permitted use of reasonable medical management techniques to set coverage limitations on contraceptive care.

Employers, at least for now, may have some relief from some of the Affordable Care Act (ACA) requirements to cover preventive care services without cost sharing under a nationwide injunction issued March 30, 2023, by a federal judge in Texas.

The Consolidated Appropriations Act, 2023 (CAA 2023) holds some welcome news for employers that offer a high deductible health plan (HDHP) option paired with a health savings account (HSA).