PPACA Tax Overview BenefitMall Reference Guide - (Page 12)
SECTION 5.0
MEDICAID & MEDICARE
CHANGES & THE IMPACT
ON EMPLOYERS
Section 5.0 highlights several key changes to the Medicaid and Medicare Programs that will impact employers,
including the Medicaid expansion, emphasis on prevention and related services, changes to Medicare
Part D Program.
PART A: The Expanding Medicaid Program
5.1
How did PPACA initially attempt to
expand the Medicaid program?
In keeping with its stated goal of providing health
care coverage to all Americans, PPACA contains
several provisions designed to significantly expand
the number of persons covered under state Medicaid
programs.25
The federal government initially
attempted to expand the number of individuals with
health care coverage by establishing one national
standard for Medicaid participation.
Beginning in 2014, states that choose to expand
their eligibility criteria will allow individuals with
modified adjusted gross incomes below 133% of the
federal poverty level (FPL) to participate in a state
Medicaid program. Also, children currently covered
by state Children’s Health Insurance Programs
(CHIP) in households with modified adjusted gross
incomes (MAGI) between 100% and 133% of the FPL
would be transitioned to Medicaid coverage. Under
the expanded eligibility requirements, there would
be no assets test or resource test. It was originally
estimated that this expansion, on a nationwide basis,
would cover 21 million or one-half of the targeted
uninsured that would have been covered by PPACA.
How did the U.S. Supreme Court ruling
impact this expansion goal?
The Medicaid expansion requirements were
challenged by the Attorneys General of 26 states
who argued the provisions were overly coercive
and effectively threatened states with the loss of
all Medicaid federal funding if a state refused to
implement the expanded eligibility criteria. The U.S.
Supreme Court agreed with this argument, and
ordered the provisions be narrowed.
5.2
5.3
What practical impact will the Court’s
decision have?
Due to the Supreme Court decision, the number
of persons that will be covered by state Medicaid
programs will be less than originally anticipated.
Large numbers of currently uninsured individuals
reside in states such as Florida and Texas that
have decided not to expand their Medicaid eligibility
requirements due to budget constraints. In 2014,
many residents of states that refuse to adopt the
expanded criteria and who would have been covered
will now be moving into the state health insurance
exchanges, becoming eligible for federal subsidies.
This will significantly increase the number of people
covered by federal subsidized health insurance, and
effectively shift some of the coverage costs away from
states and back to the federal government.
12 Published by BenefitMall®
Table of Contents for the Digital Edition of PPACA Tax Overview BenefitMall Reference Guide
PPACA Tax Overview BenefitMall Reference Guide
Table of Contents
Individual Mandate & Tax Implications
Premium Subsidies
Employer Requirements & Tax Implications
PART A: Small Employer Tax Credits
PART B: Large Employer Tax Penalties
PART C: Employer W-2 Reporting Requirements
PART D: Employer Deductions for Retiree Drug Coverage
Additional PPACA Tax Provisions Impacting Employers & Employees
PART A: The Unearned Income Medicare Contribution Tax
PART B: Excise Tax on Comprehensive, High-Cost Health Insurance Plans
PART C: Assessing the Impact of PPACA on HSAs, MSAs, FSAs, & HRAs
Medicaid & Medicare Changes & the Impact on Employers
PART A: The Expanding Medicaid Program
PART B: Emphasis on Prevention & Related Services
PART C: Medicare Part D Updates
PART D: Putting the Coverage Puzzle Together
PPACA Tax Overview BenefitMall Reference Guide
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