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From Health Law Daily, September 12, 2013

PPACA amended, delayed 19 times since 2010

By Paul Clark

Implementation of portions of the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) have been delayed 19 times since it was enacted in March 2010, according to a report prepared by the Congressional Research Service for Sen. Tom Coburn (R-OK). Congress has passed 14 laws amending or delaying portions of the law. The Obama administration, through regulatory changes, blog posts, or communication by a government official to a member of Congress, has delayed portions of the law five times.

Legislative delays. The CRS report focuses on legislation that amended or made changes to new programs created under PPACA, and not changes to programs that existed before PPACA was enacted, and then were amended by both PPACA and subsequent legislation. Eleven different laws amended or changed new programs put in place by PPACA. Three other appropriations acts rescinded funding for various programs instituted under PPACA.

Obama administration delays. In February 2013, in a series of FAQs posted on the website of the Department of Labor, the Obama administration delayed for one year a requirement that placed limits on the amount of annual cost-sharing that could be required by a group health plan.

In March 2013, via a letter from HHS Secretary Kathleen Sebelius to Sen. Maria Cantwell (D-Wash.), the Obama administration announced that it was delaying implementation until 2015 of the basic health plan option that would offer health insurance coverage for certain low-income families that are not eligible for Medicaid.

Also in March, the administration proposed delaying until 2015 a requirement that federally facilitated small business health options programs (SHOPs) help small employers offer a choice of qualified health plans (QHP) to their employees. Instead, SHOPs are only required to offer one QHP option to small employers in 2014. This proposal was finalized in June.

Finally, in July, the administration announced on the Treasury Department website that it was delaying until 2015 the mandate that employers with more than 50 employees offer health insurance to their employees or pay a penalty. The administration followed this announcement with the publication of a Final rule on health exchange eligibility and enrollment which delayed until 2015 (1) the requirement that state-based insurance exchanges or marketplaces verify applicants’ information regarding employer coverage; (2) required audits by exchanges of the income reported by exchange applicants who might be eligible for refundable premium tax credits; and (3) the requirement that state Medicaid agencies provide notices electronically to beneficiaries.

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