- The Department of Health and Human Services announced on Tuesday that insurance plans that do not cover both inpatient and physician services will be considered non-compliant under the Affordable Care Act.
- Under the ACA, self-insured employers are exempt from the rule requiring health plans that cover individuals and small groups to offer 10 essential benefits, including hospitalization, if they cover at least 60% of potential health costs. As a result, some employers began creating "skinny" plans that did not cover inpatient services.
- Under the new regulation, employers who had already started enrolling employees or who had signed a binding agreement with a benefits manager before November 4 will be given a temporary waiver, but any plans that begin after March 1, 2015 will be subject to the new rule. Those given the waiver will eventually have to redesign their plans to comply, and those employees that are offered a "skinny" plan will be eligible for federal premium subsidies.
"The earlier version of the calculator didn't live up to the spirit and letter of the ACA," said Federation of American Hospitals CEO Chip Kahn. "I think this [change] sets the calculator right."
The American Hospital Association also stood behind the new standards, although it admits that the practice was likely not common. Still, this protects not just consumers but also hospitals that may get hung with the bill if a patient is unable to pay.