Feds Target Health Law Loophole That Allows Large Employers To Offer Plans That Don’t Cover Hospitalization

Kaiser Health News: Obama Administration Closing Health Law Loophole For Plans Without Hospitalization
Moving to close what many see as a major loophole in Affordable Care Act rules, the Obama administration will ban large-employer medical plans from qualifying under the law if they don’t offer hospitalization coverage. The administration intends to disallow plans that “fail to provide substantial coverage for in-patient hospitalization services or for physician services,” the Treasury Department said in a notice Tuesday morning. It will issue final regulations banning such insurance next year, it said. (Hancock, 11/4)

USA Today: Feds To Require Big Companies To Cover Hospitalization
The Obama administration plans to close a loophole in the Affordable Care Act that allows large companies to refuse to cover in-patient hospital stays in any of their health insurance plans, according to an official involved in the internal discussions. The official requested anonymity until the announcement is made because "the guidance that will be issued is not finalized." (O'Donnell, 11/3)

Earlier, related KHN coverage:
Administration Signals Doubts About Calculator Permitting Plans Without Hospital Benefits (Hancock, 10/16).
Debate Grows Over Employer Plans With No Hospital Benefits (Hancock, 9/26).
Flaw In Federal Software Lets Employers Offer Plans Without Hospital Benefits, Consultants Say (Hancock, 9/12).

The Wall Street Journal's Washington Wire: Obamacare Premium Changes Coming Soon—But Not by Election Day
Just after the election, insurers will send letters to millions of consumers spelling out changes in premiums for coverage under the health care law. Why not before? Under the health law, the federal government is responsible for approving premiums for health plans in 36 states where it is running some or all of the online insurance exchanges through the HealthCare.gov website. The Department of Health and Human Services told insurers in early September they should notify consumers who hold policies with them of their new premiums for 2015 only after HHS approved the rates. HHS can’t reject the new rates, only criticize them. (Radnofsky, 11/3)

Fox News: Some Obamacare Patients With High Deductibles Turning To Community Care Centers
When Obamacare patients learn their deductible is so high they’re unlikely to get any reimbursement, they often wind up in places like the Denton, Texas Community Care Center. (Angle, 11/4)

The New York Times: A Builder Swears He’ll Stay At 49 Employees To Avoid The Mandate. Unless He Grows.
Todd Hawkins is a Virginia home builder who insists that the big plans he has for his business are not so big that they will put him in the path of the Affordable Care Act. That, anyway, is what he told You’re the Boss readers when he commented on a recent post about determining whether a company is subject to the law’s employer mandate. “I can promise we won’t go over 49 employees, so A.C.A. will affect employment, at least by one company,” he wrote. “Mine.” But Mr. Hawkins told a different story when I contacted him a few days later to talk about his comment. “Next year,” he said, if he and his partner’s new idea works out, “that’s when we’ll run into the A.C.A.” He has 21 employees now. (Mandelbaum, 11/3)

The Associated Press: Government Argues In favor Of Federal Insurance Exchanges
The Obama administration is defending its health care law in court, arguing that the text of the law and Congress' intent allow Americans to receive insurance subsidies regardless of whether they're enrolled through insurance markets run by the states or by the federal government. In a federal appeals court filing, the Justice Department on Monday disputed opponents' contention that the law limits tax credits for low- and moderate-income consumers only to those who live in states that have set up their own insurance markets, or exchanges. (11/3)