health care | Fraser Blog

Medicare Part D Notice Deadline Approaching

Group health plans offering prescription drug coverage are required to disclose to all Part D-eligible individuals who are enrolled in or were seeking to enroll in the group health plan coverage whether such coverage was “actuarially equivalent,” I.e., creditable. (Coverage is creditable if its actuarial value equals or exceeds the actuarial value of standard prescription drug coverage under Part D.) This notice is required to be provided to all Part D eligible persons, including active employees, retirees, spouses, dependents and COBRA qualified beneficiaries.

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Health Care Mandate – UNCONSTITUTIONAL!

This afternoon, a three judge panel of the 11^th Circuit Court of Appeals ruled 2-1 that the so-called “individual mandate” (the Obama health care reform law’s requirement that virtually all Americans purchase health insurance or face penalties) is unconstitutional. The decision in Florida et al v. Dept. of Health & Human Services et al, a suit brought by 26 states, marks the first time that a judge appointed by a democrat has voted to strike down the mandate. The panel ruled that the individual mandate portion of the law exceeds Congress’ power under the commerce clause by “mandating that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die.” However, the appellate court did not go as far as the district court that originally heard the case, which found the entire health care overhaul to be unconstitutional.

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Obama Administration Claims First Victory in Health Care Overhaul Litigation

A three-judge panel from the United States Court of Appeals for the 6^th Circuit has ruled that the Obama administration’s plan to require citizens to purchase health insurance did not violate the Constitution. This is the first such opinion and is considered a win for the Obama administration.

The Thomas More Law Center, based in Ann Arbor, had sued on behalf of itself and its members claiming that the requirement in the 2010 health care law for individuals to either purchase health insurance or to pay a penalty was unconstitutional. The judge in the Eastern District of Michigan disagreed, holding that the statute was constitutional. The plaintiffs appealed the decision to the Court of Appeals, which upheld the lower court’s decision. There are currently two other similar lawsuits pending in other parts of the country.

Plaintiffs argued that Congress lacked authority to require citizens to purchase health insurance and that the penalty for not purchasing health insurance constituted an unconstitutional tax. But on appeal, the Court found that Congress could rationally believe that requiring the purchase of health insurance was an economic activity that had substantial effects on interstate commerce, and that the provision requiring either purchase or a penalty was essential to the larger approach to reforming the health care and health insurance markets.

Combined with the other two opinions pending from the 4^th Circuit and the 11^th Circuit, it is widely expected that the Supreme Court will take up one or more of the decisions for review, potentially as early as the Supreme Court’s next term which commences in October. Accordingly, the 6^th Circuit’s opinion is not likely to be the final say in the matter.

As the constitutionality of the health care law effects every person in the United States, the arguments by the litigants and ultimately the decision of the Supreme Court have an important impact on the lives of Americans. If you have any questions about this article, or legal concerns about any health care issue at all, please see our Health Care web page for contact information of our Department’s attorneys.

To learn more, contact our Health Care Department Chair Jonathan Raven at jraven@fraserlawfirm.com or 517.377.0816. Jonathan has guided business and health care leaders in strategically planning, implementing, and adapting to often unpredictable and rapidly changing environments.

Proposed Michigan Law: Governmental Employers & Health Plan Contribution Increases

Currently, there is legislation pending (Michigan Senate Bill No. 7) which would require public employers to contribute no more than 80% toward the cost of health insurance for their employees. If this becomes law, numerous public employees will be required to begin contributing at least 20% toward their health insurance costs. This legislation is written with an effective date of January 1, 2013.

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