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The Wagner Law Group

The Wagner Law Group is a nationally recognized practice in the areas of ERISA and employee benefits, estate planning, employment, labor and human resources, investment management and real estate. 

 

Established in 1996, The Wagner Law Group has 28 attorneys engaged exclusively in employee benefits, estate planning and employment law. Six of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Boston 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110

 

Washington, D.C.

Tel: (202) 969-2800

  Fax: (202) 969-2568

800 Connecticut Ave., N.W.

Suite 810

Washington, D.C. 20006

 


Palm Beach Gardens 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

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Tel: (813) 603-2959

Fax: (813) 603-2961

101 East Kennedy Boulevard

Suite 2140
Tampa, FL  33602 

 

San Francisco

Tel: (415) 625-0002

Fax: (415) 358-8300

300 Montgomery Street

Suite 600

San Francisco, CA 94104

 

St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
100 South 4th Street, Suite 550
St. Louis, MO  63102 

 

 

www.wagnerlawgroup.com

 

 

 

March 16, 2017

 

 Health and Welfare Law Alert

 

 

 

     House Committees Release Proposals to

"Repeal and Replace" ACA

 

 

 

Two House of Representatives Committees have each released separate budget proposals that, after review and mark-up, will form the American Health Care Act ("AHCA"), the first in a series of legislation that is intended to replace the Affordable Care Act (the "ACA").  The two House Committee bills repeal many of the taxes imposed under the ACA and significantly change the ACA's revisions to the Medicaid program and its funding.  Below are highlights from the legislation that impact employer-sponsored group health plans:


Employer and Individual Mandate Penalties.  The AHCA essentially repeals the ACA's Employer Shared Responsibility Penalty (i.e., the "Employer Mandate" Penalty) and the Individual Shared Responsibility Penalty (i.e., the "Individual Mandate Penalty") by reducing the respective penalties to $0, retroactively to January 1, 2016. 

 
Tax Credits.  The AHCA would replace the ACA's income-based group health premium tax subsidies with advanceable, refundable tax credits to purchase either health insurance coverage offered through a state's health insurance marketplace or unsubsidized COBRA coverage under an insured employer's group health policy.  The credit increases from $2,000 to $4,000 based on age and phases out after the taxpayer's adjusted gross income exceeds $75,000 ($150,000 for joint filings). Coverage purchased with the credits must meet criteria that differ from the ACA requirements.


Employer Reporting.  The AHCA does not modify the ACA-imposed employer reporting requirements under Internal Revenue Code Sections 6055 and 6056.  This means, as of now, employers must continue with their efforts to satisfy their ACA reporting obligations (i.e., Forms 1094/B-C and 1095/B-C).


Limits on Health Flexible Spending Account ("Health FSA").  The AHCA removes the ACA's annual cap on employee pre-tax contributions to Health FSAs (currently $2,600 for 2017).  The AHCA also re-authorizes pre-tax reimbursements for certain medical expenses (e.g., over-the-counter medications).  The proposed effective date for these modifications is January 1, 2018.


Health Savings Accounts ("HSAs").  The AHCA modifies the tax rules related to HSA contributions and reimbursements as follows:

 

  • Increases the annual contribution limit to equal the IRS's HDHP annual out-of-pocket limits (for 2017, $6,550 for self-only coverage and $13,100 for family coverage).  The ACA currently limits annual HSA pre-tax contributions to $3,400 for self-only coverage and $6,750 for family coverage.
  • Authorizes HSA-eligible spouses who are over age 55 to make an additional $1,000 "catch up" contribution to the same HSA.  Current law requires qualifying, HSA-eligible spouses to each make catch up contributions to a separate HSA.
  • Reduces the ACA's tax on impermissible HSA distributions to 10%.   

The proposed effective date for these changes is January 1, 2018.


ACA Provisions Unaffected by AHCA.  The AHCA does not affect the following ACA provisions that impact the coverage provided by group health plans:

  • Prohibition on annual and lifetime dollar limits on essential health benefits.
  • Prohibition on pre-existing condition exclusions.
  • Prohibition on "excessive" waiting periods.
  • Requirement to cover in-network, preventive services at no cost.
  • Requirement to offer coverage to dependent children to age 26.
  • Limits on the maximum out-of-pocket expenses for in-network services.
  • Claims and appeal procedures.
  • Retroactive rescissions of coverage.
  • Minimum coverage and nondiscrimination requirements applicable to insured group health plans.

Note:  The AHCA only addresses ACA items that are considered "budget related" and, therefore, cannot be filibustered.  Other parts of the agenda to amend and replace the ACA will involve future non-budget item legislation, which will need 60 votes to survive a filibuster in the Senate. 

 

 

 

 

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This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.