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FACT SHEET: July 2019 Affordable Care Act Updates

As your ministry partner, GuideStone® monitors and advocates on your behalf in the church benefit plan regulatory environment. We want to update you on recent legal and regulatory activity related to the Affordable Care Act (ACA), church plans and group health plans.

Texas v. Azar

GuideStone is closely monitoring Texas v. Azar, the legal challenge to the ACA brought by the attorney generals of 18 states. This lawsuit challenges the constitutionality of the entire ACA on the basis that the remainder of the law is inseverable from the individual mandate. Since Congress zeroed out the individual mandate penalty in 2017, the legality of the entire ACA has now been brought into question. The Fifth Circuit Court of Appeals is currently hearing arguments related to this case and, regardless of the outcome in the Fifth Circuit, the case could likely find its way to the Supreme Court of the United States.

The Cadillac Tax

Implementation of the commonly called Cadillac Tax — the ACA’s High-Cost Plan Tax (HCPT) that taxes employers based on the value of health plans they provide — was previously delayed until the 2022 plan year. The Kaiser Family Foundation recently reported one in five employers may have a plan impacted by this tax. Several efforts are underway in Congress to either further delay the tax or completely repeal the Cadillac Tax. In fact, on July 17, 2019, the House of Representatives voted to repeal the Cadillac Tax, and the Senate is expected to follow suit. The repeal appears to have wide bipartisan support.

Surprise Medical Bills

Patients are hit with surprise medical bills when they receive services from an in-network facility, but, unbeknownst to the patient, one of the providers that works at the facility is out of the network. For example, a patient receives treatment at an in-network emergency room from an out-of-network physician. The House and Senate each are currently working on their own versions of a bill that would prohibit out-of-network physicians working at in-network facilities from balance billing a patient for charges not covered by their health plan or insurer. This issue is important to voters, and bipartisan support appears high.

GuideStone will continue to follow these and other important issues and will keep your ministry informed as changes occur.

If you’re looking for an ACA refresher, visit GuideStone’s Health Care Reform Education and Advocacy web page. This is your one-stop shop for ACA information and resources as they relate to your ministry.

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Lee Hyatt is manager of compliance for Life and Health lines for GuideStone®.

Lee Hyatt
Manager Compliance
Life and Health Lines

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