Illinois Recognizes Same Sex Marriage

Illinois became the 15th state to legalize same sex unions when Governor Pat Quinn signed the Religious Freedom and Equality Act into law on Nov 20. The bill takes effect in June of 2014.

Before the new law takes effect, Illinois employers will want to examine their benefit packages to ensure that same-sex unions receive equal treatment when compared to opposite-sex marriages.  Benefits affected include but are not limited to health, retirement, and payroll and leave policies.

Federal agencies recently issued guidance recognizing state sanctioned same-sex marriages for federal tax purposes in the wake of a federal court ruling that found the Defense of Marriage Act unconstitutional.  Guidance on this issue can be found on the IRS website.

Latest on Marketplace Enrollment

While problems continue to plague the Health Insurance Marketplace website, there are signs of improvements over the past few weeks. Insurers are reporting an uptick in enrollment through the federal Marketplace, and new websites are making it easier for consumers to understand their options. For example, allows consumers to quickly compare plans by age and zip code. While the information presented is “unofficial,” it does give consumers an idea of what they may want to buy before entering the more complex federal website.

In the meantime, Governor Scott Walker recently asked the Wisconsin legislature to delay in changes to Wisconsin’s Medicaid program that would have removed an estimated 77,000 from the Medicaid roles effective January 1, 2014. The changes are now expected to take effect on April 1 if the Governor’s proposal is approved as is by the legislature. The Governor also asked for an extension of the state’s high risk pool (HIRSP), although HIRSP enrollees that sign up for the three month extension would be subject to a new deductible when moving to new coverage by April 1.

Flurry of Federal Activity

A bevy of new bills and regulations have been introduced recently affecting employee benefits:

  • The Self-Insurance Protection Act would prevent regulators from applying insurance-like standards to employer stop loss policies, which most if not all small and mid-size businesses purchase when making the decision to self-fund their health benefits. The legislation intends to protect employers and Taft-Hartley plans against regulations (i.e. reserve requirements, taxes) that would make it considerably more difficult for them to offer self-funded benefits to workers.
  • A bipartisan bill authored by Rep. Dan Lipinksi (D-Illinois) and Rep. Pat Tiberi (R-Ohio) would repeal the $63 per enrollee reinsurance fee imposed by the Affordable Care Act on self-funded employers and other health plans.
  • Two committee bills would change the way Medicare reimburses physicians, strengthening quality measures and promoting alternative payment models such as bundled payments.

On the regulatory side, federal agencies recently released a final rule implementing the Mental Health Parity and Addiction Equity Act of 2008 that generally requires group health plans to equalize financial requirements (deductibles, copays, etc.) between mental health benefits and other health benefits.

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Melissa Duffy

Melissa Duffy

Guest Blogger, Health Policy Consultant

Melissa Duffy has spent the last three decades working to improve health care and health care policy for the “buy-side” of health care. She launched her career and found her passion for health improvement in her time as the lead health policy advisor in the Wisconsin Senate, where she helped shape meaningful legislation to improve accountability and expand health coverage options available to consumers and employers. Her mission on behalf of health care purchasers led her from the legislature to the startup of several nonprofit cooperatives designed to empower individuals and employers when it comes to quality, affordability, and fairness. Along the way, Melissa served as the Executive Director for one start-up, Chief Strategy Officer for another, and a consultant to other organizations trying to improve health care. Today, Melissa advises Common Ground Healthcare Cooperative and The Alliance on government affairs, healthcare policy, communications, and business strategy.

Read more blog posts by Melissa