PPACA and Governments

PPACA and the Federal Government

PPACA Administration

• Federal Coordinating Council for Comparative Effectiveness Research (list of members). Authorized by the American Recovery and Reinvestment Act (ARRA), this new Council will help coordinate research and guide investments in comparative effectiveness research funded by the Recovery Act.  The council’s first report to the President and Congress was made in June, 2009.

• Independent Payment Advisory Board.  IPAB (or the Board) is charged with developing proposals to “reduce the per capita rate of growth in Medicare spending.” The Secretary of Health and Human Services (the Secretary) is directed to implement the Board’s proposals automatically unless Congress affirmatively acts to alter the Board’s proposals or to discontinue the automatic implementation of such proposals.

PPACA Financing

Part of PPACA’s costs are financed through higher taxes and the balance through Medicare savings.

• Excise Tax on Indoor Tanning Services. A 10-percent excise tax on indoor UV tanning services went into effect on July 1, 2010.  The tax doesn’t apply to phototherapy services performed by a licensed medical professional on his or her premises. There’s also an exception for certain physical fitness facilities that offer tanning as an incidental service to members without a separately identifiable fee. For more information on the tax and how it will be administered, see IRS news release, video, questions and answers and legal guidance.

• Changes to Flexible Spending Arrangements. Effective Jan. 1, 2011, the cost of an over-the-counter medicine or drug cannot be reimbursed from Flexible Spending Arrangements or health reimbursement arrangements unless a prescription is obtained. The change does not affect insulin, even if purchased without a prescription, or other health care expenses such as medical devices, eye glasses, contact lenses, co-pays and deductibles. The new standard applies only to purchases made on or after Jan. 1, 2011, so claims for medicines or drugs purchased without a prescription in 2010 can still be reimbursed in 2011, if allowed by the employer’s plan. A similar rule goes into effect on Jan. 1, 2011 for Health Savings Accounts (HSAs), and Archer Medical Savings Accounts (Archer MSAs). For more information, see IRS news release IR-2010-95, Notice 2010-59, Revenue Ruling 2010-23 and questions and answers.

• Tax Timeline (NAHU) gives an overview of the taxes created by the health care legislation and when they go into effect (member-only link).
• ObamaCare Watch, Taxes has news related to PPACA taxes.
• Research and Analysis: Taxes
  • AMA, Taxes and Credits in the Health System Reform Law
  • IRS, Affordable Care Act Tax Provisions provides a description of each provision and links to further resources detailing each.
  • New taxes under PPACA (Kiplinger)
  • Obamacare and Taxes: The Final Tab (Americans for Tax Reform)
• Research and Analysis: Medicare Savings
  
  • Congressional Research Service, Medicare Provisions in PPACA: Summary and Timeline.

PPACA and Medicare

PPACA and Medicaid

PPACA and The States