ACA update for employers

What You Need to Know

On Friday, December 14, 2018 a judge in the Northern District of Texas issued an opinion that the individual mandate in the Affordable Care Act (ACA) is unconstitutional and that, as a result, the entire ACA is invalid. The decision is not an injunction that halts the enforcement of the law. ACA remains in place and will be enforced during the appeals process. Employers should continue to comply with all ACA requirements.

ACA update for employers

Background

Texas vs. Azar was filed by 20 Republican state attorneys general and governors who argue that since the individual mandate was zeroed out by the Tax Cuts and Jobs Act of 2017 (TCJA), the rest of the ACA is invalid. The individual mandate requires taxpayers to obtain health coverage for themselves and their dependents or pay a penalty. The TCJA reduced the individual mandate penalty amount to $0 beginning January 1, 2019.

Ruling

In 2012, the U.S. Supreme Court upheld the constitutionality of the individual mandate based on Congress’s taxing power. With the elimination of the tax penalty by the TCJA, the court in the Northern District of Texas found in December 2018 that the individual mandate no longer constitutes an exercise of Congress’s tax power, and is, therefore, unconstitutional. Then, finding that the individual mandate is essential to the ACA as a whole, the court struck down the entire ACA.

Employer Implications

Nothing is changing for now. ACA remains in place and will be enforced. Employers should continue to comply with all ACA requirements. Keep in mind that some states have their own individual health coverage mandates.

If the district court’s ruling is upheld by the appellate courts, ACA provisions such as the following would be invalid:

  • Employer shared responsibility
  • Prohibitions on preexisting condition exclusions
  • Dependent coverage until age 26
  • Preventive health benefits without copays
  • Prohibitions on annual and lifetime maximums

Check out a more detailed summary of potential implications in this blog by Robert ProjanskyPaul M. Hamburger  and Damian A. Myers.

Next Steps

In a ruling issued Sunday, December 30, the judge confirmed that the ACA remains fully in effect while on appeal “because many everyday Americans would otherwise face great uncertainty.” On Thursday, January 3, the notice of appeal to the Fifth Circuit was filed. Legal experts say it’s likely the case will be ultimately decided by the Supreme Court. Employers need to stay the course for now.


Jenny Lucey, CEBS
Manager, Reference/Research Services at the International Foundation

Employee Benefits Survey 2018

The latest from Word on Benefits:

Jenny Gartman, CEBS

Manager, Reference/Research Services at the International Foundation

Favorite Foundation member service: Personalized Research Service

Benefits topics that interest her most: mental health, work/life benefits, retirement readiness of different generations

Personal Insight: Jenny makes sure the International Foundations members are informed of the very latest by keeping her fingertips on the pulse of the benefits industryfrom just released guidance to emerging trends. Outside of the office, Jenny keeps busy with family playtime, knitting and exercising.

 

 

Recommended Posts

FAQs on Workplace Emergency Savings Accounts Under SECURE 2.0  

Jenny Gartman, CEBS
 

The U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) has issued FAQs on optional pension-linked emergency savings accounts (PLESAs) as part of the implementation of the SECURE 2.0 Act of 2022 (ERISA section 801). SECURE 2.0 authorized 401(k), 403(b) and governmental […]

Foundation Survey Results–Focus on Mental Health Initiatives in Apprenticeship Programs

Justin Held, CEBS
 

The International Foundation just released Top Trends in Apprenticeship Programs—2024 Survey Results, the 8th iteration of their apprenticeship program benchmarking survey. In addition to focusing on trends, such as individual and program challenges, life skills, and partnerships, this iteration takes a deep […]