ACA Title 1, Sec. 1560. Rules of construction: “Good” – helps establish clarity in Law’s impact in four collateral areas.Lawmakers clarify here that no part of the ACA negates any of the antitrust laws, counters the ERISA exemption of the Hawaii Prepaid Health Care Act, prevent any institution of high education from offering student health insurance plans or modify the requirements on state agencies responsible for Medicaid and CHIP Programs. This is a typical kind of legislative provision to help resolve unforeseen construction or applicability issues.

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ACA Title 1, Sec. 1559. Oversight: “Good” – General authorization of Inspector General’s role in ACA. This provision recognizes that the Inspector General of the DHHS has administrative oversight over the Department’s role in the administration and implementation of the Law. This is a general intention statement on the part of the Congress related to the function of oversight of departmental activities. Standard item in most domestic legislation.

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ACA Title 1, Sec 1558. Protections for employees: “Good” – Provides general protection to employees. This provision provides general protection to employees that utilize either premium credits or subsidies under the ACA. This statutory provision prohibits employers from discharging an employee because of their use of these features of the ACA. Seems like a way to prevent an employer from firing employees that utilize the credits or subsidies included in the Act. Would be better balanced if it also protected employers from employees that make intentional or unintentional misstatements about their coverage.

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ACA Title 1, Sec 1557. Nondiscrimination: “Good” – a general prohibition against discrimination. This provision prohibits discriminatory actions under any aspect of the ACA and links to complaint and accountability provisions of civil rights, age, and disabilities discrimination laws. “Good” because it uses the existing federal administrative machinery to provide a recourse in the event of discriminatory practices rather than set up a whole new administrative structure for addressing discrimination issues under the Law.

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ACA Title 1, Sec. 1556. Equity for certain eligible survivors. “Good” – Provides continuity of coverage for those with “black lung” conditions associated with coal mining. This provision allows those grand fathered with “black lung” coverage to be included under the applicable provisions of the ACA. This appears to be a continuity of coverage provision extending the ability of those with “black lung” conditions to be covered under health plans authorized by the Law. Good for resolving issues of coverage for this special group. From a government efficiency standpoint it would seem to be advantageous to eliminate all separate aspects of “Black Lung Benefits” and incorporate them under the provisions of the ACA.

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ACA Title 1, Sec. 1555. Freedom not to participate in federal health insurance programs: “Good” – prevents coercion of health plan providers. This section provides a basic statement that prohibits any penalty or fine to any entity that offers health insurance and chooses not to participate in any federal health insurance program. However, one could argue that given the extensive involvement of federal health insurance programs in the financing of health care in the U.S. that not participating represents a “death wish” on the part of any health plan. Perhaps a somewhat perfunctory qualification.

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ACA Title 1, Sec. 1554. Access to therapies: “Good” – although somewhat inoperable platitudes. This section contains the following platitudes about the Secretary of HHS not publishing any regulations implementing the Law that….

(1) creates any unreasonable barriers to the ability of individuals to obtain appropriate medical care;
(2) impedes timely access to health care services;
(3) interferes with communications regarding a full range of treatment options between the patient and the provider;
(4) restricts the ability of health care providers to provide full disclosure of all relevant information to patients making health care decisions;
(5) violates the principles of informed consent and the ethical standards of health care professionals; or
(6) limits the availability of health care.

Nice intention but how is anyone going to adjudicate these platitudes? What thresholds are assumed and how will regulators know when they have exceeded the threshold?

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ACA Title 1, Sec. 1553. Prohibition against discrimination on assisted suicide: “Good” – Prevents punishment of those who refuse to assist in suicide or abortion. This provision is a basic protection for health care providers and health facilities to minimize their legal and civil liability if they refuse to cooperate with any effort that is designed to take human life. This is a basic level of protection at the federal level, but may not offer any protection against applicable state laws and regulations. This provision is good but in my opinion would be better if it established a clear legal protection for acts of conscience regarding euthanasia, mercy killings, infanticide and abortion.

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ACA Title 1, Sec 1552. Transparency in government: “Good” – but essentially meaningless. This section requires the Secretary to publish on the department’s website a list of all the authorities provided to the Secretary by this Law. Perhaps a symbolic gesture because of the complexity and number of legislative initiatives (450+) contained in the Law.

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ACA Title 1, Sec. 1515. Offering of exchange-participating qualified health plans through cafeteria plans: “Ugly” – Why exclude them? This provision does not make sense to me. It prohibits employers from offering “certain” exchange-participating qualified health plans from being offered through a Section 125 Cafeteria plan. I don’t understand why. Wouldn’t you want qualified health plans to be offered to employees through the tax advantaged form of a Section 125 cafeteria plan? Doesn’t make sense. I vote to get rid of this feature – if you want market competition enhanced across the board why not dump this limitation. Let qualified health plans compete in Section 125 offerings.

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