Congress Advancing Budget Deal With ACA Preventive Care FAQ | Mercer US

Congress Advancing Budget Deal With ACA Preventive Care FAQ

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Congress Advancing Budget Deal With ACA Preventive Care FAQ
Calendar29 October 2015

The two-year budget and debt-ceiling agreement approved in the House yesterday, and now heading for likely Senate approval within days, would repeal the ACA’s auto-enrollment mandate for employer health plans and prevent a major spike in 2016 Medicare Part B premiums for certain beneficiaries.  

Under the never-implemented auto-enrollment provision, certain employers with more than 200 full-time employees must automatically enroll new full-time employees in health coverage and continue already-enrolled employees' coverage. Regulators have said that employers do not have to comply with this mandate until regulations are issued, but the matter is now set to become moot with expected Senate approval and president’s signing of the Bipartisan Budget Act of 2015 before next Tuesday’s deadline for suspending the country’s debt limit.

Many Medicare beneficiaries facing a $54 jump in their monthly Part B premiums next year would only see an estimated $18 increase under the agreement. The deal would set the standard Part B 2016 monthly premium rate for the recipients facing the increase at $120, with an additional $3 surcharge.

New agency FAQs give more guidance for health plans on cost-free coverage of various preventive services and address issues related to wellness rewards and disclosures about mental health claims. The information includes details on how the preventive-coverage mandate applies to lactation support and equipment, obesity management services, colonoscopy-associated costs, as well as genetic counseling and BRCA testing for women.

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