The final rule raises the essential community provider threshold from 20 to 35 percent and uses wait time standards to evaluate qualified health plans for network adequacy.

The legislation delays looming Medicare payment cuts and creates an expedited pathway for debt limit relief; Senate Democrats this week are expected to release legislative text for a $2 trillion debt limit increase — sufficient to last through the 2022 midterm election.

Consumers now can preview health plans and prices on healthcare.gov ahead of open enrollment, which runs Nov. 1, 2020, through Jan. 15, 2021.

The rule, released by the Department of Health and Human Service and the Department of Treasury, extends open enrollment, adds a new special enrollment period, expands navigator responsibilities, and modifies Section 1332 innovation waivers.

The departments of the Treasury and Health and Human Services proposed extending open enrollment in the Affordable Care Act marketplaces, adding a new special enrollment period, expanding navigator responsibilities, and modifying Section 1332 innovation waivers.

The lawsuit, brought by individual plaintiffs and 18 Republican-led states, argued the ACA’s individual mandate was unconstitutional and that the entire ACA had to be dismantled as a result. The court's decision was made on procedural grounds and did not rule on the underlying merits of the case.

HHS will interpret and enforce the Affordable Care Act's prohibition on discrimination "on the basis of sex" to include sexual orientation and gender identity. The change comes in response to a Trump administration rule in June 2020 that removed protections for transgender and LGBTQ individuals.

In a set of letters, America’s Essential Hospitals urges the administration and congressional leaders to address pressing facility needs of essential hospitals and the health care safety net.

The Centers for Medicare & Medicaid Services is extending until Aug. 15 the special enrollment period for 36 states using the federal health insurance marketplace, giving consumers more time to view new options under the American Rescue Plan, including lower premiums and plan upgrades.

In an annual report to Congress, the Medicaid and CHIP Payment and Access Commission finds an increase from 2018 to 2019 in the number of uninsured and in charity care and bad debt. The report includes state-specific projections of the Medicaid disproportionate share hospital allotment.

In response to an executive order, a new issue brief reviews four policy areas under Section 1115 demonstrations and their impact on Medicaid coverage and access to care. The brief notes all examined areas create barriers to enrollment and reduce coverage, leading to adverse health effects.

A federal court vacated several policies in the Trump Administration’s 2019 health insurance marketplace rule for violating federal law, including provisions related to review of network adequacy, standardized options, income verification requirements, and reducing medical loss ratio rebates.

The special enrollment period, intended to ensure access to health coverage amid the the COVID-19 pandemic, will continue through May 15. The enrollment period applies to consumers in the 36 states that use the federal marketplace platform.

President Biden released an executive order to strengthen Medicaid and the Affordable Care Act. The order calls for a special enrollment period on the federally facilitated exchange for uninsured or underinsured individuals — particularly those hardest hit by the COVID-19 pandemic.

The proposed rule builds on a CMS final rule on interoperability and patient access; it would leverage application programming interfaces to improve patients’ access to their electronic health information and reduce burden on providers related to prior authorization.

A new final rule from the Health Resources and Services Administration provides details on the long awaited administrative dispute resolution process, including the composition of a dispute resolution panel, types of claims covered entities and manufacturers can bring before the panel, and more.

The Health Resources and Services Administration finalized a rule creating a 340B Drug Pricing Program administrative dispute resolution process for covered entities and drug manufacturers; the rule marks a long-delayed implementation of an Affordable Care Act requirement.

Responding to concerns raised by the association and lawmakers, the Department of Health and Human Services has altered detrimental reporting requirements for the Provider Relief Fund, including one regarding lost revenue.

The House-passed $2.2 trillion COVID-19 relief package would increase Medicaid disproportionate share hospital allotments and the Provider Relief Fund. Meanwhile, Congress now has until Dec. 11 to pass its annual spending bills or agree to another short-term CR.

HHS finalized a rule overhauling the ACA to remove some nondiscrimination protections for transgender individuals and requirements for treating people with limited English proficiency. In a statement, the association said the decision puts the health and safety of vulnerable populations at risk.

The Department of Health and Human Services finalized a rule overhauling parts of the Affordable Care Act to remove nondiscrimination protections for transgender individuals and certain language access requirements for providing health care services to people with limited English proficiency.

CMS issued the 2021 final notice of benefit and payment parameters rule and letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS provides detailed options for issuers to adopt value-based designs for marketplace plans.

In its March report to Congress, the Medicaid and CHIP Payment and Access Commission included chapters analyzing Medicaid disproportionate share hospital payments, state readiness to report on core quality measure sets, and Section 1115 waiver evaluations.

The Supreme Court announced it will review the court decision finding the Affordable Care Act’s individual mandate unconstitutional. The case, now expected to be heard this fall with a decision likely in 2021, will determine the fate of the law.

CMS issued guidance outlining how states can receive a block grant or per-capita cap in exchange for additional administrative flexibility. Through a Section 1115 demonstration waiver, these new financing arrangements would apply to coverage of optional Medicaid patient populations.

In an amicus brief, America's Essential Hospitals joined other national hospital associations in calling for an expedited Supreme Court review of a case that will determine the future of the Affordable Care Act. The court on Tuesday denied the expedited schedule.

A U.S. Court of Appeals panel upheld a ruling on the constitutionality of the individual mandate but returned the case to a lower court to decide whether that nullifies the entire law.

The package, expected to become law, would delay a $4 billion cut to Medicaid disproportionate share hospital payments through May 22, 2020. It does not include proposals to reduce surprise medical bills or prescription drug prices.

The court struck down parts of the law that explicitly prohibit discrimination based on gender identity and termination of pregnancy.

America’s Essential Hospitals expressed concern that changes to nondiscrimination protections will decrease access and worsen outcomes for vulnerable patients, including transgender individuals and individuals with limited English proficiency.

The agreement would stop a $125 billion budget cut and increase defense and nondefense discretionary spending while raising the debt limit for two years.

The tools include a checklist of required waiver elements and model templates to help states better understand their options and the waiver approval process.

A House panel marked up legislation to eliminate $16 billion in Medicaid disproportionate share hospital cuts, mitigate surprise bills, and fund expiring health care programs.

As Congress returns from the July Fourth recess, lawmakers focus on legislation to reduce surprise medical bills and prescription drug costs, as well as extend short-term funding for community behavioral health clinics.

A proposed rule from the Department of Health and Human Services would overhaul parts of Section 1557 of the Affordable Care Act, removing some nondiscrimination protections for transgender individuals and requirements for covered entities treating people with limited English proficiency.

The rule would eliminate protection from discrimination in health care settings based on gender identity and roll back requirements to notify individuals with limited English proficiency of antidiscrimination policies and access to translation services.

A bipartisan group of 300 House lawmakers sent a letter to leadership calling for a two-year delay of Medicaid disproportionate share hospital cuts. The House will vote on a legislative package to expedite the availability of generic drugs and protect parts of the Affordable Care Act.

The House this week will take up legislation to protect people with pre-existing conditions and help generic drug and biosimilar manufacturers bring their products to market. A House letter calling for a delay of Medicaid DSH payment cuts has 286 bipartisan signatures; the deadline to sign is May 8.

In a new request for information, the agency seeks ideas for innovative programs and waiver concepts states could consider in developing Section 1332 waivers. The request follows October 2018 guidance aimed at increasing state flexibility.

CMS finalized the Notice of Benefit and Payment Parameters for the Affordable Care Act’s health insurance marketplace and the annual letter to issuers offering plans on the federally facilitated marketplaces for plan years beginning on or after Jan. 1, 2020.

Hearings focused on rising drug costs and pricing transparency. Sen. Elizabeth Warren (D-MA) reintroduced a measure to bolster consumer protections under the Affordable Care Act. Both chambers will return to legislative business on April 29.

America’s Essential Hospitals, in coalition with other national hospital associations, has filed an amicus brief urging the Fifth Circuit to uphold the Affordable Care Act and overturn a Texas district court’s decision declaring the individual mandate and, in turn, the entire law unconstitutional.

The guidance comes in response to a recent federal court decision striking down a regulation expanding the availability of association health plans.

The legislation allows states to establish Medicaid health homes to coordinate complex care for children and provides $20 million in additional funding for the "Money Follows the Person" demonstration program, among other provisions.

The United States District Court for the District of Columbia ruled that expanding the availability of association health plans illegally circumvents the Affordable Care Act and violates the intent of federal insurance laws.

The House also will mark up a dozen bills aimed at lowering health care and prescription drug costs. House and Senate committees move forward on work to address surprise billing.

Affordable Care Act–mandated reporting requirements for tax-exempt hospitals remain in effect despite ongoing lawsuits and a Senate Finance Committee inquiry.

Long-expected "Medicare-for-all" bill formally introduced; Congressional hearings continue to focus on rising health care costs and prescription drug prices.

As the president prepares to deliver his State of the Union address this week, Congressional committees remain focused on health care costs and threats to the Affordable Care Act.

Congressional leaders and the White House reached a deal to fully reopen the federal government until Feb. 15; congressional hearings this week focus on prescription drug prices and protections for individuals with pre-existing conditions.

Medicaid and CHIP Payment and Access Commission members unanimously approved three recommendations to mitigate the impending Affordable Care Act–mandated Medicaid disproportionate share hospital allotment reductions.

Proposed provisions aim to further the Trump administration’s goals to lower premiums, increase market stability, reduce regulatory burden, and protect taxpayers.

As the partial government shutdown continues, the House this week will consider the Pandemic and All-Hazards Preparedness and Advancing Innovations Act and a bill to extend funding for the "Money Follows the Person" demonstration program.

House and Senate Democratic leaders vowed to pursue legislation to intervene after a judge ruled the Affordable Care Act unconstitutional; negotiations continue on a spending package to fund portions of the federal government before current funding expires on Dec. 21.

The guidance allows states additional flexibility to waive certain provisions of the Affordable Care Act while preserving access to affordable, comprehensive coverage.

The Senate is expected to vote this week on a bipartisan legislative package to combat the opioid crisis. The House considers legislation to roll back Affordable Care Act provisions.

The new guidance outlines the types of rules association health plans must follow under the Employee Retirement Income Security Act and reiterates that states and the Department of Labor have a joint responsibility to regulate such plans.

Under the final rule , short-term, limited-duration insurance plans can be issued for up to 12 months, with a maximum duration of 36 months after renewals and extensions.

The waivers allow each state to create a reinsurance program to lower premiums in the individual market; the waivers will take effect in 2019 and are approved through 2023.

A Government Accountability Office witness and several 340B Drug Pricing Program stakeholders testified last week at a House committee hearing; another House committee marked up several consumer-driven health care bills.

The Centers for Medicare & Medicaid Services noted that the provisions aim to increase flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce regulatory burden in the individual and small group marketplaces.

Negotiations on the bill have stalled amid disagreements on certain provisions, such as including language barring abortion access as part of a package to stabilize the Affordable Care Act's insurance marketplace.

This year's report includes the commission’s statutorily required annual analysis of Medicaid disproportionate share hospital payments, as well as chapters on Medicaid managed care and telehealth.

House Republicans this week hope to bring to the floor a bill to fund the government through the remainder of the fiscal year; America's Essential Hospitals CEO asked to testify during Senate committee hearing on 340B Drug Pricing Program.

Congress this week is focused on negotiating legislation to stabilize the Affordable Care Act insurance marketplace and efforts to fight the opioid crisis.

The proposal extends to one year the maximum length of short-term, limited duration plans — up from three months, as mandated by the Affordable Care Act.

The association encouraged the Centers for Medicare & Medicaid Services to ensure that state plans cover essential health benefits and include sufficient access to essential community providers.

The House passed the Tax Cuts and Jobs Act; the Senate version of the tax reform bill includes a repeal of the Affordable Care Act's individual mandate.

The Finance Committee's "chairman's mark" is similar to a House bill, but forgoes many House provisions of particular concern to essential hospitals.

The bill delays disproportionate share hospital payment cuts for two years; House Republicans consider repealing the individual mandate through tax reform.

The move jeopardizes coverage for millions of working Americans, could substantially raise premiums for those who remain in marketplace plans, and could increase uncompensated care costs at essential hospitals.

The Congressional Budget Office estimates premiums will increase 20 percent by 2018 and the uninsured population will increase by 1 million; 19 states and the District of Columbia filed a lawsuit arguing that withholding the payments violates current law.

The federal fiscal year came to a close Sept. 30, ending a nearly yearlong congressional effort to repeal and replace the Affordable Care Act and bringing tax reform efforts and other health care priorities to the forefront in Congress.

Reductions to Medicaid disproportionate share hospital (DSH) payments, as mandated by the Affordable Care Act, went into effect on Oct. 1. A total of $2 billion will be cut from Medicaid DSH funding in fiscal year 2018 alone.

Tuesday's decision effectively ends Congress’ current push to repeal and replace the Affordable Care Act; a letter calling for the delay of Medicaid DSH cuts has garnered nearly 200 signatures in the House.

America's Essential Hospitals continues to advance our opposition to the Senate's Graham-Cassidy-Heller-Johnson proposal.

The bill would replace Medicaid expansion funding and private insurance subsidies with $1.2 trillion in block grants to states; the Congressional Budget Office is expected to release a score early next week.

Congress aims to pass legislation by Sept. 30 to stabilize the Affordable Care Act (ACA) insurance markets and reauthorize several health care programs; three senators plan to unveil new ACA repeal legislation.

Substantial cuts to Medicaid disproportionate share hospital payments are set to begin on Oct. 1; strong and immediate input from essential hospitals is vital to successfully secure another delay.

After Affordable Care Act repeal efforts collapsed in the Senate, the administration began considering options on cost-sharing reduction payments, but some lawmakers remain focused on repeal.

Expanded Medicaid access under the Affordable Care Act might have helped patients seek treatment for behavioral health issues, which disproportionately affect low-income populations.

The Senate approved a motion to proceed, which is needed to open floor debate of a repeal bill; it remains unclear how the Senate will proceed.

Senate Majority Leader McConnell said he would bring up a repeal-only bill that includes a two-year transition period for replacing the Affordable Care Act, but three Republican senators oppose the plan.

Senate Republican leadership continues negotiations with Republican holdouts; a vote on the bill is expected before the month-long August recess.

Researchers from George Washington University and The Commonwealth Fund found the Better Care Reconciliation Act of 2017 could cause an estimated 1.45 million jobs to disappear by 2026.

Negotiations continue; areas of contention include the Medicaid per-capita cap growth rate and the phase out of Medicaid expansion enhanced funding.

A revised draft of the Senate bill was released to address some Republicans' concerns, but it made no meaningful changes to the bill’s Medicaid provisions.

The brief projects Medicaid disproportionate share hospital payment reductions under the Affordable Care Act and the House-passed American Health Care Act.

Senate Republican leaders aim to submit a draft bill to the Congressional Budget Office early this week and vote on the bill before the July Fourth recess.

CMS aims to eliminate or change outdated, costly, or inconsistent regulations for marketplaces established under the Affordable Care Act.

Senate Republican leadership recently indicated the possibility of a vote by the end of July, before the month-long August recess.

The plan would reduce funding for social and entitlement programs for low-income Americans by $1.7 trillion, including a $610 billion cut to Medicaid.

The new checklist tool helps states compile the necessary documents to apply to waive ACA provisions and pursue alternative reforms.

America’s Essential Hospitals provides an overview of community benefit requirements, which hospitals must comply, and the penalties for failure to comply.

Senate Republicans stay focused on a strategy to repeal and replace the ACA; committees hold hearings on public health, Medicare, and chronic conditions.

A 13-member Senate working group made up of conservative and moderate Republicans now begins to craft its own version of the legislation.

Three new amendments garnered enough Republican support to pass the bill in a 217-213 vote; CBO has not scored the bill since the amendments were added.

Rep. MacArthur (R-NJ) proposed an amendment to the AHCA that would have allowed states to opt out of several important insurance regulations.

A vote on the bipartisan bill could come Wednesday in the House, followed by Senate consideration before continuing resolution appropriations expire Friday.

Lawmakers face an extensive agenda of legislative priorities, including health care and tax reform, and most urgent, a continuing resolution to prevent a government shutdown.

When lawmakers return, they could attempt to make additional changes to pass the American Health Care Act, legislation to repeal and replace the ACA.

Talks of a deal to resurrect the American Health Care Act — legislation to repeal and replace the ACA that was pulled in March — are underway.

House GOP leadership pulled the bill due to inadequate support; the association now resumes its focus on other hospital-related issues, including DSH cuts.

The American Health Care Act's Medicaid cuts would fall heavily on low-income states that expanded Medicaid under the Affordable Care Act.

Samuel Ross, CEO of Bon Secours Baltimore Health System, testified at an event held by House Democrats on the Republican-proposed bill to repeal the ACA.

The replacement plan would make steep cuts to Medicaid and leave an estimated 24 million more people uninsured, compared with current law under the ACA.

The letter affirms their desire to improve the Medicaid program and the vulnerable people it serves and to ensure the program provides value to taxpayers.

MACPAC's March report includes analysis on Medicaid DSH and impacts of the ACA on hospitals, as well as recommendations for the future of CHIP.

The American Health Care Act moves next to the House Committee on the Budget, which is scheduled to mark up the legislation on Thursday.

The letter encourages states to pursue Section 1332 State Innovation Waivers, especially those including high-risk pool/state-operated reinsurance programs.

The committees on Energy & Commerce and Ways & Means passed ACA repeal and replacement bills that could affect coverage and essential hospital funding.

The House committees on Energy and Commerce and Ways and Means this week released their long-awaited legislation to repeal and replace the ACA.

The American Health Care Act offers some relief for the safety net, but the association remains deeply concerned about substantial changes to Medicaid.

America’s Essential Hospitals expressed concerns about proposed changes that could harm the integrity of qualified health plan networks.

Draft GOP text for legislation to repeal and replace the ACA leaks; a Senate committee is poised to vote on the administration's CMS administrator nominee.

Whether you join us or support the fight from home, urge lawmakers to ensure continued coverage access and stable, equitable, sustainable Medicaid funding.

The House plan to repeal and replace the Affordable Care Act would rescind Medicaid disproportionate share hospital cuts and impose per-capita caps on Medicaid funding.

A leaked House GOP plan to repeal & replace the ACA raises concerns for essential hospitals. A Senate committee considered nominee Seema Verma to lead CMS.

On February 16, a policy brief by House Republicans on how they would repeal and replace the Affordable Care Act (ACA) was leaked in Washington. Learn more about what was included.

Former Rep. Tom Price was confirmed as secretary of HHS; the Senate Committee on Finance will consider the nomination of Seema Verma as CMS administrator.

A House subcommittee marked up two bills focused on income eligibility for Medicaid. The association weighed in on a hearing about the individual mandate.

The Feb. 7 letter offers recommendations on proposed executive orders, regulations, and legislation that could affect essential hospitals, patients.

No agreements have been reached about a repeal/replacement plan for the ACA and it appears Republicans in both chambers are far from making final decisions.

The second confirmation hearing was held for Rep. Price as HHS secretary and a House subcommittee held a hearing on the individual mandate's effectiveness.

A memo instructs all executive departments and agencies to temporarily halt pending regulations until incoming department or agency heads can review them.

With House and Senate passage of budget resolutions, efforts to repeal the Affordable Care Act now move to committees and toward a Jan. 27 deadline for repeal legislation.

Debate and amendment votes in the Senate are expected though the weekend. The Senate measure then will go to the House for consideration.

Hawaii is the first state to receive approval for a Section 1332 waiver, and will be allowed to close its Small Business Health Options Program for five years.

Essential hospitals can expect the new Congress' Republican leaders to follow through quickly with their pledge to repeal the Affordable Care Act.

Essential hospitals should be equipped with key information to understand this procedural tool that likely will be used early next year to begin the process of dismantling the Affordable Care Act (ACA).

America's Essential Hospitals is taking part in the Provider and Hospital Week of Action to promote open enrollment for insurance marketplaces under the ACA.

The notice contains state-specific FMAPs, used to determine the amount of federal matching funds for state Medicaid programs; and enhanced FMAPs, used to calculate federal funding for the Children’s Health Insurance Program.

The impending full control of government by Republicans is expected to kick start discussions about repealing the Affordable Care Act and passing entitlement reform.

CMS will use social video platform Twitch, improve the HealthCare.gov mobile interface, and use #HealthyAdulting to encourage young adults to sign up.

While details are still being finalized, a continuing resolution to fund the government through early December likely will include funding to combat Zika.

HRSA is proposing that a decision-making body within the Department of Health and Human Services be responsible for reviewing claims and resolving deputes.

By forming strategic partnerships and using social media, CMS aims to “reach young adults where they are” to facilitate engagement during open enrollment.

The plan would convert Medicaid to a program managed entirely by states through block grants or per-capita allotments from the federal government.

HHS finalizes 2017 Notice of Payment and Benefit Parameters rule and letter to issuers offering qualified health plans on the federally facilitated marketplace.

Obama touts ACA successes in final address, calls for ongoing support of Medicare, Social Security. House Speaker Ryan prepares ACA replacement plan as GOP continues repeal efforts; Califf wins Senate HELP vote.

House returns from recess for largely symbolic vote on Senate-passed reconciliation bill that would repeal many ACA provisions, including Medicaid expansion; Senate remains out.

Guidance builds on 2012 final regulations that outline the process for submission and review of section 1332 waivers, which may begin as early as Jan. 1, 2017.

Proposals would make required and recommended changes to how qualified health plans operate in Affordable Care Act marketplaces.

Congressional staff continue negotiating omnibus appropriations package, which is expected to go to a vote by Dec. 11; Sen. Wyden asks HHS for update on progress of state 1332 waivers.

Letter from Senate Finance Committee leaders asks America's Essential Hospitals, other stakeholders, for comment on Medicaid transparency, quality, accountability

In the Loop, a joint project of Community Catalyst and the National Health Law Program, helps enrollment assisters share experiences and answer questions.

Model law would update requirements for insurance carriers in the health insurance marketplaces, particularly regarding provider directories, mental health services, telehealth, and nondiscrimination.

Senate plans to expand House reconciliation bill with full ACA repeal; Rep. Brady named Ways and Means chair; Republicans establish Medicaid task force.

Open enrollment for ACA marketplaces will last from Nov. 1, 2015, to Jan. 31, 2016, with coverage taking effect as soon as Jan. 1. Previously announced HHS enrollment goals include improving consumer experience, retaining and adding customers.

U.S. District Court says 2014 HRSA interpretive rule is contrary to plain language of ACA provision that excludes certain hospitals from 340B discounts on orphan drugs.

Congress will vote to pass legislation to avoid a government shutdown. Meanwhile, House committees are also working to pass budget reconciliation measures that would defund Planned Parenthood and make major changes to the Affordable Care Act.

The hospital-related NOTICE Act was sent to the president last week. An ACA repeal vote remains likely for fall along with the potential for a government shutdown.

Plans must be budget-neutral and cover as many people as traditional ACA reforms. With these waivers, states may forgo certain ACA provisions including the marketplaces and individual mandate.

The Senate fails to repeal the ACA but will keep trying. Committees discuss HHS priorities and health care bills, including a bundle of hospital-related bills.

GOP will weigh procedural tactics to repeal the ACA or propose tax reform; House vote on Cures bill expected.

The association will use the information gathered to advocate to policymakers the need to continue to support essential hospitals’ mission and service to their communities. This survey focuses on the first quarter of calendar year 2015. We will use aggregate information only.

Republicans will also continue to develop a strategy for undoing the ACA in light of the Supreme Court's ruling upholding the law last week.

The Supreme Court ruled in King v. Burwell that the Affordable Care Act makes federal subsidies available to individuals in states that use the federally facilitated marketplace, not just those with a state-based marketplace.

Six justices ruled in favor of the Obama administration, arguing that the overall structure and purpose of the ACA supports the interpretation that Congress intended subsidies to be available in both federally facilitated and state-based marketplaces.

CBO also found that if a full ACA repeal took effect on Jan. 1, 2016, the federal deficit would increase by $137 billion between 2016 and 2025.

The House will vote to repeal two major ACA provisions this week - medical device tax and the IPAB - and consider four Medicare Advantage bills. Health committees are reviewing mental health and HIT.

America's Essential Hospitals is conducting this member survey to capture the impact of the ACA coverage expansion on essential hospitals.

The survey focuses on uncompensated care and utilization during the last two quarters of CYs 2013 and 2014. It aims to capture the impact of ACA coverage expansion on essential hospitals.

Congress will attempt to pass SGR and budget legislation by Friday. The SGR package includes a one-year delay of Medicaid DSH cuts. House Committees will hold hearings on 340B, heroin and prescription drug abuse, and Medicare Fraud. The Senate HELP Committee will hold a hearing on patient research.

Ruling against subsidies could send ACA into "death spiral," according to RAND report.

Congress must pass a homeland security spending bill this week, and health insurance marketplaces are under scrutiny as oral arguments in the King v. Burwell Supreme Court case begin.

Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans

Plus, more than 3.3 million people who submitted marketplace applications are eligible for Medicaid or CHIP.

Also on tap is a Senate vote on homeland security funding that would bar legal status for undocumented immigrants and President Obama's 2016 budget

Association filed Jan. 28 amicus brief in Supreme Court case supporting insurance subsidies through federally facilitated health insurance marketplace.

In a new policy brief, America's Essential Hospitals describes how billions of dollars in reductions to Medicaid and Medicare funding threaten care at essential hospitals.

Obama delivers annual address; House considers an abortion ban, natural gas permits, and SGR; and Senate considers the Keystone Pipeline and definition of full time.

Congress convenes with a new Republican majority in the Senate. The House will vote on the ACA 40-hour work week, veterans legislation and the Keystone pipeline. The Senate will elect committee chairs.

Final regulations are issued regarding the required community health needs assessment for charitable hospitals and the consequences for failing to satisfy the requirements.

The association extended the survey deadline to continue to gather information on members' uncompensated care post-ACA.

The association launched this survey Nov. 10 to capture the impact of the ACA coverage expansion on essential hospitals.

New association policy brief describes how cost-sharing assistance by hospitals helps vulnerable patients afford health insurance marketplace coverage and access vital health care services

The survey aims to capture the impact of ACA coverage expansion and add to association advocacy efforts with timely information on members' uncompensated care.

Oral arguments for this case are scheduled to begin Dec. 17.

Though the payment bump has reportedly increased access to care in some states, it appears unlikely that this ACA provision will be extended beyond 2014.

What impact has section 1202 of the Affordable Care Act, also know as the primary care bump, had on your hospital?

Congress meets this week to extend federal funding through Dec. 11. Other legislative considerations include medical device tax, VA authorities, and the Emergency Medical Services for Children Program. Committees will address CHIP, Ebola, and the ACA.

This week, Congress will likely consider a CR, allowing non-ACA-compliant group health insurance plans through 2018, extending the Emergency Medical Services for Children Program, and several health-related items.

The full U.S. Court of Appeals for the District of Columbia will rehear Halbig v. Burwell, one of the two cases with conflicting results on whether ACA subsidies are available in the federally facilitated marketplace.

Generally, if consumers do nothing, they will be auto-enrolled in the same plan with the same premium tax-credit and other financial assistance as they had in the 2014 plan year.

Under consideration will be a federal funding extension and a House bill to grandfather non-ACA-compliant group health plans

Pennsylvania will expand Medicaid through a private option, requiring some enrollees to pay premiums.

The final rule updates Medicare payment policies, rates for inpatient stays at general acute care hospitals, and provisions related to quality improvement programs.

The House and Senate head into August recess after voting to clear a VA assistance bill, sending it to the president on Friday. The Senate couldn't pass border emergency supplemental legislation, while the House passed a less expensive version. CMS faced tough criticism from Republicans about HealthCare.gov contractors.

The U.S. Court of Appeals for the DC Circuit has ruled that people who purchase health insurance through the federally facilitated marketplace are ineligible for ACA subsidies. The 4th Circuit Court of Appeals in Virginia released a conflicting opinion hours later.

New interpretive rule will address the 340B orphan drug exclusion.

House GOP will move forward with a lawsuit against President Obama on the delay of the employer mandate without congressional approval. Energy and Commerce is marking up a variety of bills and holding hearings on the health insurance marketplaces and anthrax.

CMS announced a second batch of prospective recipients for Health Care Innovation Awards (round 2). The 27 new recipients include four members of America’s Essential Hospitals. Awards will be used to reduce costs and improve care delivery models for Medicare, Medicaid, and CHIP patients.

White House Council of Economic Advisers released a report describing opportunities missed by states that have not expanded Medicaid under the Affordable Care Act.

CMS outlines three methods for reviewing enrollee coverage eligibility for insurance purchased through the federally facilitated marketplace.

HHS report announces that 87 percent of individuals who purchased health insurance from the federally facilitated marketplace during initial open enrollment have received premium assistance through federal tax credits. The report also shows that 64 percent of individuals enroll in plans with the lowest premiums, despite higher cost-sharing rates.

HRSA announced that it plans to stand by its interpretation of the 340B orphan drug rule and will continue to publish updated orphan drug designation lists to assist organizations with compliance with the policy.

The association submitted comments to the Departments of Labor, Health and Human Services, and the Treasury regarding their request for information on provider nondiscrimination.

A recent study found that planned reductions in Medicaid DSH payments and ongoing inflation in health care costs will cause debilitating gaps in funding for essential hospitals. Expected system costs to states that do not expand Medicaid will be exacerbated by continued uncompensated care costs and no additional Medicaid funds to offset them.

Congress continues to address delays in care at VA medical centers. The Ways and Means Committee explores income verification for tax credit eligibility under the ACA, and the Energy and Commerce Health Subcommittee looks at incentives to develop new drugs and devices as well as health care access under the ACA.

The district court held that the rule was outside the scope of the agency’s rulemaking authority. Because the court vacated the final rule, newly designated 340B entities will not be able to purchase orphan drugs at discounted prices, regardless of whether the drugs are used for their designated purpose or other purposes.

America's Essential Hospitals describes how provider-supplemented premium assistance for enrollees in the health insurance marketplaces strengthens the marketplaces and furthers the goals of the Affordable Care Act.

CMS issued a final rule Friday, May 16, on 2015 standards for health insurance marketplaces and the insurance market. Among other provisions, CMS finalized measures for a quality rating system that would require health insurance issuers operating through the marketplaces to collect, validate, and report data on quality metrics for qualified health plans.

Experts from American Muslim Health Professionals, Million Hearts, and CMS will update health professionals serving minority and undeserved populations on the Affordable Care Act's expansion of health insurance coverage.

On April 30, CMS issued the IPPS proposed rule for fiscal year 2015. The rule updates Medicare payment policies, rates for inpatient stays at general acute care hospitals, and provisions related to quality improvement programs. CMS will accept comments on the proposed rule through June 30.

CMS released the FY 2015 proposed IPPS rule April 30. The proposed rule updates Medicare payment policies and rates for inpatient stays at general acute care hospitals, as well as provisions regarding quality improvement programs.

Congress will begin the appropriations process, but not much is expected to be accomplished since it is an election year. Senate Democrats will bring up a bill to increase the minimum wage but expect Republican resistance. The House will reconsider a bill regarding exemption of expatriate health plans under the ACA.

CBO estimated 2016 marketplace premiums will be 15 percent less than they were estimated to be in 2009. This should mean the ACA will cost $104 billion less to the federal government over the next decade than previously projected.

In a major victory for essential hospitals, a House committee late last night posted physician payment legislation that includes an additional year delay in Medicaid disproportionate share hospital (DSH) cuts and requires an annual DSH report sought by America’s Essential Hospitals. The changes come in a House Rules Committee bill to extend the current patch

Health care leaders will discuss efforts to enroll patients in health insurance coverage before March 31. Association President & CEO Bruce Siegel, MD, MPH, along with Vice President Joe Biden, U.S. Department of Health and Human Services Secretary Kathleen Sebelius, and other hospital association leaders will participate in the call.

House and Senate differ on offsets for SGR repeal and replace; ACA alternative details under wraps

Health and Human Services Secretary Kathleen Sebelius will testify on the president's budget before two congressional panels this week. Meanwhile, the House will consider a bill to repeal the sustainable growth rate (SGR) physician payment formula. Republicans are expected to tie SGR fix to repeal of the Affordable Care Act’s individual insurance mandate.

This week the longest serving member of Congress, Rep. John Dingell, announced he will retire. Dingell served for 29 terms and through 11 different presidents. The House Energy and Commerce Committee will look at the changes CMS is making to Medicare Part D, and House Majority Leader Eric Cantor announced that the chamber would vote on the ACA's 30-hour work week definition.

Nearly 3.3 million people have selected plans through the marketplaces since they opened Oct. 1, 2013. This number represents 45 percent of the 7.3 million people who were eligible to enroll in a marketplace plan. In addition, 3.2 million people who submitted applications through the marketplaces were determined to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

Republican House leaders are working on a proposal to replace the Affordable Care Act (ACA). On Wednesday, the House Committee on Oversight and Government Reform will hold a hearing on the risk corridors provision in the ACA. Last week, House Energy and Commerce Ranking Member and Former Chair Henry Waxman (D-CA) announced he would retire at the end of his term this fall.

The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act would repeal the Affordable Care Act and replace it with market-based reforms. The plan would keep some ACA provisions. The proposal would end the individual mandate and offer tax credits for individuals unable to afford coverage.

Association seeks feedback from member hospitals on proposed procedures charitable hospitals must use to disclose and correct failures that are not willful or egregious. The procedures would allow hospitals to meet requirements under section 501(r) of the Internal Revenue Code, an Affordable Care Act provision that imposes additional requirements on charitable hospitals.

President Obama highlighted early ACA successes, CBO said SGR bills would cost $150.4 billion over 10 years

On Jan. 24, the Centers for Medicare & Medicaid Services (CMS) released new resources for implementing hospital presumptive eligibility (PE), including frequently asked questions (FAQs). In the FAQs, CMS clarified that hospitals “may implement PE with the support of third party contractors.”

A Jan.23 Gallup survey found that the percentage of uninsured adults nationally dropped 1.2 percentage points in January, from 17.3 percent in December to 16.1 percent in January. Gallup said the percentage of uninsured adults for January is “slightly lower than what Gallup has measured in any month since December 2012.”

Data has been released for the reporting period of April 2012 through March 2013

Bill would fund the government through fiscal year 2014

Bill includes provisions to fund the ACA, House held healthcare.gov hearings

Jan. 13 letter urges Congress to oppose Senate proposal to cut Medicare funding to pay for an extension of unemployment benefits

Brief reviews regulations that update current rules to allow Medicaid hospitals to make presumptive eligibility determinations

Association, two other national organizations file amicus brief in support of HRSA interpretation of law

Budget bill eliminates FY 2014 Medicaid DSH cuts, delays FY 2015 cuts

On November 27, the Centers for Medicare & Medicaid Services (CMS) issued the Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2014. Included in the rule are provisions related to the following: payment for hospital outpatient visits data collection in off-campus, provider-based departments Hospital Outpatient Quality Reporting (OQR) Program Hospital Value-Based Purchasing

America’s Essential Hospitals submitted comments Nov. 25 on the Basic Health Program proposed rule.

The Affordable Care Act establishes state-based and regional health insurance exchanges

Medicare DSH payments compensate hospitals for costs associated with low-income patient care

Hospitals that treat a large share of low-income patients receive add-on payments to the amount designated by IPPS

Eligibility notices, benefits in alternative benefit plans, appeals process among rule's provisions

Section 1115 projects give states additional authority to design, improve Medicaid and CHIP programs

Measures are intended for voluntary use by state Medicaid agencies

Rule implements proposed provisions in the Affordable Care Act

Decision suggests hospitals may help patients with financial assistance for plan premiums

House passed “Keep Your Health Plan Act,” Senate considered similar bills

Report includes options for reducing federal budget deficits for fiscal years 2014 to 2023

846,184 people completed applications through the marketplaces, 106,185 people selected marketplace plans.

Coverage renewed for between Jan. 1 and Oct. 1, 2014 will not be considered out of compliance

HHS encouraged issuers to reject premium payments from third parties

Premium tax credits are available to help people with low and moderate incomes afford the cost of health insurance

Federal anti-kickback statute, which only applies to federal health care programs, will not apply to QHPs.

Senate Democrats pressured Obama administration to fix healthcare.gov, SGR agreement gained support

Congress holds healthcare.gov hearings, committee met on budget agreement

The rule finalizes a number of provisions regarding health insurance marketplaces

In the Loop is a private, secure community for people working to help health insurance enrollment

Analysis finds program is likely to grow in states expanding their Medicaid program

Lawmakers negotiated potential plans to raise the debt limit

Analysis evaluated individual plan premiums in the 36 states with a federally facilitated marketplace

Congressional leaders stalled on debt limit agreement

Essential hospitals to play important role with experience caring for the uninsured

"Navigators" will raise awareness about plan availability and help individuals understand options

CR was set to expire on Sept. 30

Proposed rule establishes framework for several program elements

Siegel noted : some plan networks are only covering selected services, offering low rates for essential hospitals

Siegel, Gremminger highlighted the importance of delaying, reconsidering scheduled Medicaid DSH cuts

Rule implements the Affordable Care Act's Medicaid DSH cuts for fiscal years 2014 and 2015

Model combines federal oversight with state say over plan certification, outreach, and enrollment

House abandoned plans to vote on a bill to extend the continuing resolution

Limited knowledge of most effective messages, organizations at local level could pose challenges

Approach gives states most control over governance and requirements for qualified plans

Bill would halt subsidies until applicant coverage requirements, household income can be verified

Committee to review groups’ activities, budget, employees and training, and other issues

Fluctuating income can cause churn between Medicaid and marketplace coverage

Lawmakers to return to challenge of extending government funding past Sept. 30

Despite standards, inclusion of essential hospitals and other providers not certain

Letter urges HHS to place a special emphasis on robust essential community provider participation

Get Covered America aims to raise awareness about plan choices under Affordable Care Act

Senate Conservatives Fund announced plans to actively campaign against Senate Minority Leader

Plans must meet standards for quality measures, improvement strategies, consumer information

Letter suggests security could be compromised by missed IT system deadlines

Effort will seek to increase understanding of low-income and minority populations’ experiences with exchanges

Document, released as frequently asked questions, indicates exchanges will use tax filings and Social Security data

Four cost-sharing levels - bronze, silver, gold, and platinum - available to consumers

House votes to bar IRS from implementing Affordable Care Act and collecting taxes to fund the law

Information gathered will inform rulemaking for civil rights provision of the Affordable Care Act

Qualified health plans must offer coverage in 10 care categories, including ambulatory and emergency

Households with incomes between 100 and 400 percent of poverty line may qualify for tax credits

Certain providers may receive drug discounts for uses outside indication associated with orphan designation

Analysis from the Kaiser Family Foundation Commission on Medicaid and the Uninsured found that 6.4 million people will miss out on insurance coverage if the 21 states not intending to expand their Medicaid program and the six undecided states do not implement the Medicaid expansion.

Money to 32 centers nationwide will be used to train more than 300 primary care residents

Series will examine structure, essential benefits, plan types, and other aspects of marketplaces

Senate to consider changing existing rule requiring a filibuster-proof 60 votes for executive nominations

In letter, senators demand assurance that exchanges will be self-sustaining

Money distributed among six states: Colorado, Nevada, New Mexico, Vermont, Virginia, and West Virginia

Guidance addresses administration decision to delay the Affordable Care Act’s employer mandate

Health Affairs article questions availability of certain services to existing Medicaid enrollees

Urges CMS to incentivize states to target DSH at hospitals with high levels of uncompensated care and Medicaid patients

Finds nearly 80 percent of money spent on information technology systems and consulting

Administration responds to employer concerns about ability to comply with the requirement's complexities

Part of ACA, Children’s Health Insurance Reauthorization Act money for enrollment, renewal outreach

Rule states mandate for Medicaid coverage in 10 categories of essential health benefits

Comments express support for CHNAs, but ask IRS to grant dual-status organizations additional flexibility

Those without required minimum coverage to face penalties when filing federal income taxes

Regulation finalizes provisions on how eligibility will be determined and hardship exemption certificates granted

Found that HHS awarded about $3.8 billion in exchange and rate review grants to states by late March 2013

Change underscores member hospitals' importance to vulnerable patients, entire communities

States that opt out could lose $8.4 billion in federal funding, Health Affairs study finds

Definition in proposed regulation too narrow, essential hospitals say

Law mandates access to affordable insurance coverage by Jan. 1, 2014

Rule proposes implementation of the Affordable Care Act's Medicaid DSH cuts

Letter offers issuers operational and technical guidance on how to successfully participate

Association summary of rules, guidance

Includes important changes to Medicaid and Medicare of interest to association members

Agency also releases FAQ on state-supplied premium assistance option

Lawmakers turn back governor's plan to accept expansion for three years

Rule finalizes HHS proposal to make advance payments that total the value of cost-sharing reductions

Also releases report that details how rule affects mental health, substance abuse disorder benefits

Iowa, New Hampshire, Illinois, Arkansas among states pursing partnerships with federal government

Document addresses questions about federal medical assistance percentages

Administration official announced that the president would not include Medicaid cuts in 2014 budget

Report concludes that slowing Medicaid enrollment in 2012 reflected economic recovery

$1.5 billion in grants to 11 states aim to support affordable health insurance marketplaces

Commissioners vote unanimously to recommend 1 percent increases for fiscal year 2014