HCERA 1005 - Implementation Funding
Establishes an HHS Health Insurance Reform Implementation Fund for ACA implementation purposes. Appropriates $1B.
Browse the sections of Title I
1001 - PHSA Section 2716: Prohibition on Discrimination in Favor of Highly Compensated Individuals
Replaced by section 10101 of the Manager’s Amendment, summarized here. Requires group health plans other than self-insured plans to satisfy the requirements of section 105(h)(2) of the Internal Revenue Code of 1986 relating to prohibition on discrimination in favor of highly compensated individuals.
1001 - PHSA Section 2719A: Patient Protections
Added by section 10101 of the Manager’s Amendment. Specifies that any available participating primary care provider is permissible for designation by an enrollee if a group health plan or a health insurance issuer offering group or individual coverage requires or provides for designation of such a participating practitioner. Also requires that if a plan covers hospital emergency department services, it does so...
1001 - PHSA Section 2719: Appeals Process
Amended by section 10101 of the Manager’s Amendment. Requires plans offering individual or group coverage to implement an effective process for appeals of coverage determinations and claims meeting specified parameters such as having an internal claims appeal process and notifying enrollees of available internal/external appeals processes. Group health plans and health insurance issuers offering group or individual coverage must comply...
1001 - PHSA Section 2718: Bringing Down the Cost of Health Care Coverage
Replaced by section 10101 of the Manager’s Amendment. Requires plans offering individual or group coverage, including grandfathered plans, to report to HHS for each plan year the ratio of the incurred loss plus the loss adjustment expense (or change in contract reserves) to earned premiums. Reports are to be made public on the HHS website. Starting January 1, 2011, requires...
1001 - PHSA Section 2717: Ensuring Quality of Care
Amended by section 10101 of the Manager’s Amendment. Requires HHS within 2 years of enactment to develop reporting requirements for group health plans and health insurance issuers offering group or individual coverage that address “plan or coverage benefits and health care provider reimbursement structures” that improve health outcomes; prevent hospital readmissions; improve patient safety and reduce medical errors; and involve...
1001 - PHSA Section 2715A: Provision of Additional Information
Added by section 10101 of the Manager’s Amendment. Requires plans not offered through an Exchange to submit information required under section 1311(e)(3) – such as claims payment policies and practices and enrollment/disenrollment data – to HHS and the State insurance commissioner as well as make it available to the public.
1001 - PHSA Section 2715: Development and Utilization of Uniform Explanation of Coverage Documents and Standardized Definitions
Amended by section 10101 of the Manager’s Amendment. By March 23, 2011, requires HHS to develop standards for use by plans offering group or individual health insurance coverage in compiling and providing to applicants and enrollees a summary of benefits and coverage explanation. Requires HHS to consult with the NAIC and a multi-stakeholder working group as well as adhere to...
1001 - PHSA Section 2714: Extension of Dependent Coverage
Amended by section 2301 of HCERA. Requires group and individual plans, including grandfathered plans, that provide dependent coverage of children to continue making such coverage available for an adult child until the child turns age 26. Does not extend to providing coverage to the child of an adult child. Applies to grandfathered group plans in plan years beginning before January...
1001 - PHSA Section 2713: Coverage of Preventive Services
Requires individual and group health plans to cover preventive services without cost sharing if they: Have a current “A” or “B” rating from the U.S. Preventive Services Task Force; Are immunizations recommended by the CDC’s Advisory Committee on Immunization Practices; Are certain infant, children, and adolescent services recommended by HRSA; or Are certain additional women’s services recommended by HRSA. Establishes a...
1001 - PHSA Section 2711: No Lifetime or Annual Limits
Replaced by section 10101 of the Manager’s Amendment, summarized here, and modified by section 2301 of HCERA. Prohibits group health plans – including those that are grandfathered – or health insurance issuers offering group or individual coverage from imposing lifetime or annual limits on the dollar value of benefits. Permits restricted annual limits – to be determined by HHS –...
1001 - Amendments to the Public Health Service Act
Re-designates and adds certain sections to title XXVII of the PHSA (summarized individually). Generally effective for plan years beginning 6 months after the date of enactment, September 23, 2010, unless otherwise noted.
1001 - PHSA Section 2712: Prohibition on Recessions
Amended by section 2301 of HCERA. Prohibits individual and group plans, including grandfathered plans, from rescinding coverage except in cases of fraud or enrollees’ intentional misrepresentation of material fact, and requires prior notice of cancellation to the enrollee.
1002 - PHSA Section 2793: Health Insurance Consumer Information
Creates an HHS grant program for States or Exchanges to establish offices of health insurance consumer assistance or health insurance ombudsman programs to assist with appeals, enrollment, receipt of premium subsidies and other activities, conditioning these grants on offices’ collection and reporting of data to HHS on the types of problems and inquiries encountered by consumers. Appropriates $30M for the...
1003 - PHSA Section 2794: Ensuring Consumers Get Value for their Dollars
Amended by section 10101 of the Manager’s Amendment. Beginning with the 2010 plan year, working with States, HHS will establish a process for the annual review of unreasonable increases in health insurance premiums, including issuers’ submission to HHS of justification for unreasonable premium increases prior to implementation and public disclosure of this information by issuers and HHS. HHS will award...
1004 - Effective Dates
As noted in section-specific summaries (sections 1001-1003), immediate reforms in Subtitle A generally are effective for plan years beginning on or after September 23, 2010. Sections 1002 and 1003 are effective upon enactment.
1101 - Immediate Access to Insurance for Uninsured Individuals with a Pre-Existing Condition
Requires HHS to establish, within 90 days of enactment – either directly or through contracts with States or nonprofit entities – a temporary high-risk health insurance pool program available to individuals with pre-existing conditions (as defined by HHS) who have been without creditable coverage for the preceding 6 months. A qualified risk pool must meet certain rating, out-of-pocket limit and other standards....
1102 - Reinsurance for Early Retirees
Amended by section 10102 of the Manager’s Amendment. Requires HHS, by June 21, 2010, to establish the temporary Early Retiree Reinsurance Program under which HHS reimburses participating employer-based plan sponsors for a portion of the costs of providing health coverage to pre-Medicare-eligible early retirees (age 55+), including eligible spouses, surviving spouses and dependents, who are not “active employees.” HHS will...
1103 - Immediate Information that Allows Consumers to Identify Affordable Coverage Options
Amended by section 10102 of the Manager’s Amendment. By July 1, 2010, requires that HHS establish a website so individuals and small business in States can identify and compare available health insurance options including individual and small group coverage, as well as Medicare, Medicaid and CHIP and high risk pools. HHS must develop a standardized format for presenting information regarding coverage options including information...
1104 - Administrative Simplification
Amended by section 10109 of the Manager’s Amendment. Directs HHS to adopt a single set of operating rules for each of the HIPAA financial and administrative transactions with the goal of creating “as much uniformity in the implementation of the electronic standards as possible.” Adds electronic funds transfers (EFTs) to the list of healthcare transactions for which HHS must adopt a...
1105 - Effective Date
Specifies that Subtitle B (sections 1101-1105) takes effect upon enactment, March 23, 2010.
1201 - PHSA Section 2705: Prohibiting Discrimination Against Individual Participants and Beneficiaries Based on Health Status
Precludes group health plans and health insurance issuers offering group or individual health insurance coverage from establishing eligibility rules, including for continued eligibility, based on specified health status-related factors ranging from claims experience to genetic information. Permits premium variation of up to 30 percent – with HHS, Labor and Treasury discretion to increase the threshold to 50 percent – for certain...
1201 - PHSA Section 2706: Non-Discrimination in Health Care
Bars discrimination by a group health plan and issuer offering group or individual coverage against any healthcare provider who is acting within the parameters of that provider’s license or certification under applicable State law while noting that the section does not require plans to contract with any willing provider or prevent quality-based payment. Applies the provisions of ACA section 1558 –...
1201 - PHSA Section 2707: Comprehensive Health Insurance Coverage
Requires issuers in the individual or small group market to cover ACA essential health benefits. Stipulates that group health plans observe EHB annual cost-sharing limitations. Specifies that if issuers offer any level of coverage in Exchanges, they must offer such coverage in that level as a child-only plan. Provides an exemption from these requirements for dental-only plans. Effective for plan and...
1201 - PHSA Section 2708: Prohibition on Excessive Waiting Periods
Amended by section 10103 of the Manager’s Amendment. Precludes group health plans and group health insurance issuers from applying any waiting period (as defined in section 2704(b)(4)) exceeding 90 days. Effective for plan years beginning on or after January 1, 2014.
1201 - PHSA Section 2709: Coverage for Individuals Participating in Approved Clinical Trials
Added by section 10103 of the Manager’s Amendment. Provides that group or individual plans may not deny individuals participation in a clinical trial, deny or limit coverage for routine costs or discriminate on the basis of such participation. Specifies conditions for inclusion of routine patient costs and defines qualified individual and approved clinical trial. Notes that a plan or issuer may...
1201 - PHSA Section 2704: Prohibition of Preexisting Condition Exclusions or Other Discrimination Based on Health Status
Amended by section 10103 of the Manager’s Amendment. Prohibits a group health plans and issuers offering group or individual coverage from imposing any preexisting condition exclusions. Effective for plan years beginning on or after January 1, 2014. Additionally, applies prohibition on pre-existing conditions exclusion for those under age 19 – including to grandfathered group plans – for plan years beginning on...
1201 - PHSA Section 2703: Guaranteed Renewability of Coverage
Requires issuers to renew or continue in force individual or group coverage at the option of the plan sponsor or the individual. Effective for plan years beginning on or after January 1, 2014.
1201 - PHSA Section 2701: Fair Health Insurance Premiums
Amended by section 10103 of the Manager’s Amendment. Stipulates that premiums in the individual and small group market can vary only by family structure (individual or family), rating area established by the State and reviewed by HHS), age (no more than 3 to 1), tobacco use (no more than 1.5 to 1). Applies these rules to large employers if States permit them in...
1201 - PHSA Section 2702: Guaranteed Availability of Coverage
Provides that each health insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual in the State that applies, with certain allowances for special or open enrollment periods. Effective for plan years beginning on or after January 1, 2014.
1251 - Preservation of Right to Maintain Existing Coverage
Amended by section 10103 of the Manager’s Amendment and section 2301 of HCERA. Affirms no requirement to terminate existing coverage. Generally provides that subtitle C (“insurance market reforms”) and subtitle A (“immediate improvements”) and their amendments do not apply to a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, regardless of...
1252 - Rating Reforms Must Apply Uniformly to All Health Insurance Issuers and Group Health Plans
Specifies that a standard or requirement adopted by a State pursuant to this title, or any amendment made by this title, shall be applied uniformly to all health plans in each applicable insurance market. Effective for plan years beginning on or after January 1, 2014.
1253 - Annual Report on Self-Insured Plans
Requires that by March 23, 2011, the Department of Labor prepare an annual report to Congress with general information on self-insured group health plans, including plan type, number of participants, benefits offered, funding arrangements and benefit arrangements, as well as data from the financial filings of self-insured employers.
1254 - Study of Large Group Market
Added by section 10103 of the Manager’s Amendment. Requires that by March 23, 2011, HHS report to Congress on the fully insured and self-insured group health plan markets, examining such issues as the characteristics of employers, health plan benefits and financial solvency and the extent to which new insurance market reforms are likely to cause adverse selection in the large group market...
1255 - Effective Dates
Amended and re-designated by section 10103 of the Manager’s Amendment. Notes that this subtitle and the amendments comprising it are effective for plan years beginning on or after January 1, 2014, except that section 1251 takes effect upon enactment; section 2704 of the Public Health Service Act (as amended by section 1201), as applicable to enrollees who are under age...
1301 - Qualified Health Plan Defined
Amended by section 10104 of the Manager’s Amendment. Requires Qualified Health Plans (QHPs) to be certified by Exchanges, cover essential health benefits and be offered by state-licensed issuers in good standing that offer at least one silver and one gold QHP. Includes CO-OPs and multi-state plans in the definition of QHPs. Permits a QHP to provide coverage through a qualified direct...
1302 - Essential Health Benefits Requirements
Amended by section 10104 of the Manager’s Amendment. Defines the essential health benefits (EHB) package as coverage providing HHS-defined EHBs, limiting cost sharing and having a certain actuarial value (AV) as denoted by certain metallic categories. Provides for HHS-defined EHBs within at least 10 general, statutory categories. Specifies that such EHBs should be equal in scope to the benefits provided...
1303 - Special Rules
Amended by section 10104 of the Manager’s Amendment. Allows States to prohibit abortion coverage in Qualified Health Plans (QHPs) offered through Exchanges by enacting such a law and provides that subject to this, issuers of QHPs will determine whether plans provide coverage of abortion. If a QHP covers certain abortion services for which the use of federal funds is prohibited,...
1304 - Related Definitions
Amended by section 10104 of the Manager’s Amendment. Defines the large market as the health insurance market under which individuals obtain health insurance coverage through a group health plan maintained by a large employer, defined as employing an average of at least 101 employees on business days during the preceding calendar year. Defines the small group market as applying to those...
1311 - Affordable Choices of Health Benefit Plans
Amended by section 10104 of the Manager’s Amendment. Appropriates funding to HHS by March 23, 2011, to award planning and establishment grants to States to assist with the creation of Exchanges – available through January 1, 2015 – and provides for renewability if certain parameters are met. Requires States to create an Exchange, including a Small Business Health Options Program...
1312 - Consumer Choice
Amended by section 10104 of the Manager’s Amendment. Permits qualified individuals, excluding incarcerated individuals and including only U.S. citizens or nationals or aliens who are lawfully present, to enroll in any available Qualified Health Plan (QHP) for which they are eligible. Specifies that qualified employers – generally defined as a small employer that elects to make all full-time employees of...
1313 - Financial Integrity
Amended by section 10104 of the Manager’s Amendment. Requires Exchanges to account for activities, receipts and expenditures, with annual reporting to HHS, and provides for HHS investigations and audits of Exchanges. Specifies protocol for rescissions of HHS payments for serious misconduct and allows HHS to implement approaches to reduce fraud and abuse. Includes provisions regarding the application of the False...
1321 - State Flexibility in Operation and Enforcement of Exchanges and Related Requirements
Requires HHS to issue regulations “as soon as practicable after the date of enactment” – consulting with the National Association of Insurance Commissioners – regarding the establishment and operation of Exchanges, including SHOP Exchanges, the offering of Qualified Health Plans through Exchanges and the establishment of the reinsurance and risk adjustment programs. Requires HHS to – directly or through agreement...
1322 - Federal Program to Assist Establishment and Operation of Nonprofit, Member-Run Health Insurance Issuers
Amended by section 10104 of the Manager’s Amendment. Directs HHS to establish the Consumer Operated and Oriented Plan (CO-OP) program under which qualified nonprofit health insurance issuers – subject to specified criteria, excluding organizations that were health insurance issuers on July 16, 2009 – will offer Qualified Health Plans in the individual and small group markets. Provides for HHS to...
1323 - Community Health Insurance Option [stricken]
Stricken by section 10104 of the Manager’s Amendment.
1323 - Funding for the Territories
Added by section 1204 of HCERA. Provides that territories electing to establish an Exchange will be treated as States for such purposes and entitled for Federal funding and that territories not making this election will be given an increase in the Federal dollar limitation for Medicaid funding. Specifies terms and conditions for territories electing to establish Exchanges and appropriates $1B...
1324 - Level Playing Field
Amended by section 10104 of the Manager’s Amendment. Provides that notwithstanding any other provision of law, any health insurance coverage offered by a private health insurance issuer shall not be subject to any Federal or State law described in this section – including such laws and regulations as guaranteed renewal, rating and solvency and financial requirements, among others – if...
1331 - State Flexibility to Establish Basic Health Programs for Low-Income Individuals not Eligible for Medicaid
Amended by section 10104 of the Manager’s Amendment. Directs HHS to establish a Basic Health Plan Program in which States may contract to offer 1 or more standard health plans offering essential health benefits to eligible individuals – those who are under age 65, are not eligible for Medicaid, generally have incomes between 133 and 200 percent of the Federal...
1332 - Waiver for State Innovation
Allows States to apply to HHS for waivers of up to five years starting in plan years beginning in January 1, 2017, of ACA health insurance coverage requirements including Exchanges, Qualified Health Plans, cost-sharing reductions, advance premium tax credits, employer shared responsibility requirements and individual responsibility requirements. Provides for HHS to annually determine and provide via alternate means to the...
1333 - Provisions Relating to Offering of Plans in More than One State
By July 1, 2013, requires HHS, in consultation with the National Association of Insurance Commissioners, to issue regulations for the creation of healthcare choice compacts under which States – beginning January 1, 2016 – may enter into an agreement to offer Qualified Health Plans in their individual markets but, with certain conditions, be subject only to the laws and regulations of...
1334 - Multi-State Plans
Modified by section 10104 of the Manager’s Amendment. Directs the Office of Personnel Management (OPM) to contract with health insurance issuers, at least one of which is a non-profit, to offer at least 2 Multi-State Qualified Health Plans (QHPs) through each Exchange in each State in a manner similar to that under the Federal Employees Health Benefits Program contracting process....
1341 - Transitional Reinsurance Program for Individual Market in Each State
Amended by section 10104 of the Manager’s Amendment. Requires States to implement a reinsurance program created under this section for the individual market under which an applicable reinsurance entity, which must be a non-profit, collects mandatory reinsurance payments from health insurance issuers, and third party administrators on behalf of group health plans during a 3-year period beginning on January 1, 2014,...
1342 - Establishment of Risk Corridors for Plans in Individual and Small Group Markets
Requires HHS to establish and administer a risk corridor program for calendar years 2014, 2015 and 2016 providing payment adjustments to Qualified Health Plans offered in the individual or small group market based on the ratio of the allowable costs of the plan to the plan’s aggregate premiums. Enumerates a methodology under which participating plans receive payments from HHS if...
1343 - Risk Adjustment
Requires States to assess a charge on health plans and health insurance issuers in the individual and small group market (except grandfathered plans) that have enrollees with below-average actuarial risk and make a payment to health plans and health insurance issuers with above-average-risk enrollees in the same year.
1401 - Refundable Tax Credit Providing Premium Assistance for Coverage under a Qualified Health Plan
Amended by sections 1001 of HCERA and 10105 of the Manager’s Amendment. Creates a refundable credit for premium assistance to be used for Qualified Health Plans (QHPs). Specifies that the credit is the lesser of the monthly premiums for 1 or more QHPs offered in the individual market within a State which cover the taxpayer, the taxpayer’s spouse or any...
1402 - Reduced Cost-Sharing for Individuals Enrolling in Qualified Health Plans
Amended by section 1001 of HCERA. Reduces cost sharing for individuals between 100 percent and 400 percent of the Federal Poverty Level (FPL) who enroll in a silver-level Qualified Health Plan (QHP) in the individual market. First, reduces out-of-pocket (OOP) limits under ACA section 1302(c)(1) – set at Health Savings Account dollar amounts – by: two-thirds for those 100-200 percent...
1411 - Procedures for Determining Eligibility for Exchange Participation, Premium Tax Credits and Reduced Cost-Sharing, and Individual Responsibility Exemptions
Requires HHS to establish a program for making determinations regarding whether individuals to be covered by Qualified Health Plans (QHPs) in the individual market, or who are claiming premium tax credits or cost-sharing reductions, meet the applicable criteria of being a citizen or national of the United States or an alien lawfully present, as well as satisfying the relevant income...
1412 - Advance Determination and Payment of Premium Tax Credits and Cost-Sharing Reductions
Provides for HHS, consulting with Treasury, to make advance determinations of income eligibility for individuals enrolling in a Qualified Health Plan (QHP) in the individual market through the Exchange for the premium tax credit and cost-sharing reductions upon an Exchange’s request. Treasury makes advance payments of these credits or reductions to the QHP issuers in order to reduce the premiums...
1413 - Streamlining of Procedures for Enrollment through an Exchange and State Medicaid, CHIP, and Health Subsidy Programs
Directs HHS to establish a system under which residents of each State may apply for enrollment, receive a determination of eligibility for participation, and continue participation in applicable State health subsidy programs, assuring that if an individual applying to an Exchange is found to be eligible for medical assistance under Medicaid or CHIP, the individual is enrolled for such assistance....
1414 - Disclosures to Carry Out Eligibility Requirements for Certain Programs
Provides for the disclosure of certain tax return information by Treasury, upon HHS’s request, relevant to determining any premium tax credit, cost-sharing reduction or eligibility for Medicaid, CHIP or the Basic Health Plan Program.
1415 - Premium Tax Credit and Cost-Sharing Reduction Payments Disregarded for Federal and Federally-Assisted Programs
Prohibits – for purposes of determining eligibility for or the amount of benefits or assistance under any Federal program or State or local program financed with Federal funds – taking credits or refunds made to any individual via a premium tax credit into account as income for the month of receipt and the following two months. Furthermore, any cost-sharing reduction payment or...
1416 - Study of Geographic Variation in Application of FPL
Requires an HHS study on the plausibility and implications of adjusting the application of the Federal poverty level under this subtitle for different geographic areas to reflect variations in the cost of living. Due January 1, 2013.
1421 - Credit for Employee Health Insurance Expenses of Small Businesses
Amended by section 10105 of the Manager’s Amendment. Creates a tax credit for small employers with no more than 25 full-time equivalent employees whose average annual wages are less than $50,000. Provides that the credit amount is 50 percent (35 percent for tax-exempt eligible small employers) of the lesser of the employer’s aggregate non-elective contributions during the taxable year: under an arrangement...
1501 - Requirement to Maintain Minimum Essential Coverage
Amended by section 10106 of the Senate Manager’s Amendment and 1002 of HCERA. Effective January 1, 2014, mandates that all individuals with access to affordable coverage purchase minimum essential coverage or pay a penalty. The penalty phases up as follows: 2014: $95 or 1% of income (whichever is greater) 2015: $325 or 2% of income 2016: $695 or 2.5% of...
1502 - Reporting of Health Insurance Coverage
Requires individuals to report information about the status of their health insurance coverage to the IRS.
1511 - Automatic Enrollment for Employees of Large Employers
Requires employers of over 200 employees to default enroll new full-time employees into health insurance coverage provided by the employer. Employees must be given sufficient notice and the opportunity to opt out.
1512 - Employer Requirement to Inform Employees of Coverage Options
Mandates that employers inform employees about the availability of the health insurance exchange in their state. If the employer’s plan does not cover at least 60% of the actuarial value of the total benefit under the plan, then the employee is eligible to purchase insurance in that exchange. If an employee enrolls in the exchange, they are not eligible for...
1513 - Shared Responsibility for Employers
Amended by section 10106 of the Senate Manager’s Amendment and section 1002 of HCERA. For employers with at least 50 full-time employees that do not offer qualifying coverage, if at least one full-time employee qualifies for premium tax credits to purchase insurance in an exchange, the employer must pay a penalty of $2000 for each of all of their full-time...
1514 - Reporting of Employer Health Insurance Coverage
Requires employers with over 50 employees to report to HHS whether it offers minimum essential coverage to its employees and their dependents. Employers must also report any waiting periods they impose, the lowest cost option in each plan category offered by the employer, and the employer’s contribution to the costs of the plans offered. These large employers must also report...
1515 - Offering of Exchange-Participating Qualified Health Plans through Cafeteria Plans
Prohibits employees eligible for employer-sponsored cafeteria plans from accessing products in the individual market portion of the exchange in their state. Qualifying employers (small and, after 2017, large businesses) may offer a variety of plans procured through the exchange to their employees.
1551 - Definitions
Notes that unless otherwise specified, the definitions contained in section 2791 of the Public Health Service Act apply to Title I of the ACA.
1552 - Transparency in Government
Specifies that within 30 days of enactment, HHS will publish on its website a list of all of ACA authorities provided to the Secretary.
1553 - Prohibition Against Discrimination on Assisted Suicide
Stipulates that the Federal government and any State or local government or healthcare provider receiving Federal financial assistance under the ACA may not subject an individual or institutional healthcare entity to discrimination on the basis that the entity does not provide any healthcare item or service furnished for the purpose of causing, or for the purpose of assisting in causing,...
1554 - Access to Therapies
Provides that HHS shall not promulgate any regulation that creates any unreasonable barriers to the ability of individuals to obtain appropriate medical care; impedes timely access to healthcare services; interferes with communications regarding a full range of treatment options between the patient and provider; restricts the ability of healthcare providers to provide full disclosure of all relevant information to patients making...
1555 - Freedom Not to Participate in Federal Health Insurance Programs
Provides that no individual, company, business, nonprofit entity or health insurance issuer offering group or individual health insurance coverage shall be required to participate in any Federal health insurance program created or expanded by the ACA. Specifies that there will not be a fine imposed upon any issuer for choosing not to participate in such programs.
1556 - Equity for Certain Eligible Survivors
Makes certain amendments to the Black Lung Benefits Act and applies these amendments to specified types of claims filed after January 1, 2005, that are pending on or after the date of ACA enactment (March 23, 2010).
1557 - Nondiscrimination
Generally articulates that individuals shall not – on grounds prohibited by the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975 and section 504 of the Rehabilitation Act of 1973 – be denied the benefits of, or be subjected to discrimination under, any health program or activity receiving Federal financial...
1558 - Protections for Employees
Amends the Fair Labor Standards Act of 1938 to preclude employers from discharging or discriminating against any employee through compensation, terms, conditions or other privileges of employment because the employee (or an individual acting at the request of the employee) has: Received an ACA premium tax credit; Provided to certain parties information relating to any violation of, or any act...
1560 - Rules of Construction
Notes that nothing in this Title (or an amendment made by this Title) shall be construed to modify, impair or supersede the operation of referenced antitrust laws; modify or limit the application of the exemption for Hawaii’s Prepaid Health Care Act under ERISA; or prohibit an institution of higher education from offering a student health insurance plan otherwise allowed by...
1561 - Health Information Technology Enrollment Standards and Protocols
By September 23, 2010, requires HHS to develop interoperable and secure standards and protocols that facilitate enrollment of individuals in Federal and State health and human services programs, as determined by the Secretary. Specifies that these standards shall allow for functions such as electronic matching against existing Federal and State data, including vital records, employment history, enrollment systems, tax records,...
1562 - GAO Study Regarding the Rate of Denial of Coverage and Enrollment by Health Insurance Issuers and Group Health Plans
Added by section 10107 of the Manager’s Amendment. Requires a GAO study on the incidence of denials of coverage for medical services – including the types of services and reasons for denial – as well as denials of applications to enroll in health insurance plans by group health plans and health insurance issuers. Report is due by March 23, 2011.
1563 - Small Business Procurement
Added by section 10107 of the Manager’s Amendment. Precludes the waiver of specified small business procurement requirements with respect to any contract awarded under any ACA program or other authority associated with the ACA or its amendments.
1563 [sic.] - Conforming Amendments
Makes a variety of specified conforming amendments.
1563 [sic.] - Sense of the Senate Promoting Fiscal Responsibility
Notes the Senate findings that based on CBO estimates, the ACA will reduce the Federal deficit in 2010-2019 and post-2019, as well as extend the solvency of the Medicare HI Trust Fund and increase the surplus in the Social Security Trust Fund; and that the initial net savings generated by the Community Living Assistance Services and Supports (CLASS) program are necessary...
10108 - Free Choice Vouchers
Requires employers offering minimum essential coverage and contributing to employees’ premiums to provide free choice vouchers to qualifying employees. Such employees’ required contribution to the employer-sponsored plan must be between 8% and 9.8% of their income, which must not exceed 400% FPL, and they must not enroll in the employer-sponsored plan. Free choice vouchers would be used to purchase a Qualified...
10109 - Development of Standards for Financial and Administrative Transactions
Amendments to section 1104 are incorporated in the summary of that section; standalone provisions of this section are summarized here. Amends the Social Security Act regarding the development of additional transaction standards and operating rules so that, by January 1, 2012, HHS must seek input from the National Committee on Vital and Health Statistics, the Health Information Technology Policy Committee...