Articles Tagged with Affordable Care Act

On April 8, 2020 Kantor & Kantor Partner Elizabeth Hopkins and Karen L. Handorf of Cohen Milstein, filed a friend-of-the court brief in the Supreme Court for Phyllis Borzi and Dan Maguire, two former, high-ranking Department of Labor officials.

The brief supports a number of States that successfully challenged a newly-enacted federal regulation, which runs contrary to the requirement in the Affordable Care Act (ACA) that women in healthcare plans be provided free access to preventive health services.

Under the challenged regulation, virtually any employer may simply disregard the ACA requirement that healthcare plans provide cost-free contraception for women enrolled in such plans, and thereby prevent enrolled women from receiving this congressionally-mandated preventive health service.

Before the enactment of the Affordable Care Act, also called ACA or Obamacare, under the guise of making health insurance more affordable, health insurers whittled away at the health services covered by individual and small group health plans. Slowly but steadily, health plans covered fewer and fewer services. Individual and small group health plans were a vulnerable target for health insurers. The purchasers of these plans do not have the same bargaining power a large employer does, and often were given insurance with substantially less favorable terms than large group policies. ACA was enacted in part to ensure that all individual and small group plans provide meaningful health insurance coverage.

To accomplish this goal, ACA requires all non-grandfathered health plans in the individual and small group markets to cover ten Essential Health Benefits. The Essential Health Benefits are:

  1. Ambulatory patient services – Medical treatment one receives without being admitted to a hospital. An example would be a check-up at a doctor’s office, or minor surgical procedures that do not require an overnight hospital stay. The size of a plan’s network may vary, but it must be “sufficient” to meet ACA guidelines
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