Ohio Demands Obamacare Exemption in 6th Circuit

     CINCINNATI (CN) — Ohio attempted to convince a Sixth Circuit panel on Tuesday that nonfederal government entities are exempt from the federal health care law’s reinsurance requirements.
     The state — along with several public universities and other government entities — appealed a district court decision that refused to require the U.S. government to refund contributions made since 2014.
     The “Transitional Reinsurance Program” was designed as a way to stabilize prices in the insurance market following the passage of the Patient Protection and Affordable Care Act, and concludes at the end of 2016.
     Employers who take part in group health plans are required to make contributions in an effort to offset the premiums of high-risk enrollees.
     Ohio and other plaintiffs sued the U.S. government, the Department of Health and Human Services, and its secretary, Sylvia Matthews Burwell.
     The lawsuit claimed state and local government agencies were exempt from the reinsurance program, and sought reimbursement for previous contributions.
     U.S. District Judge Algenon Marbley dismissed the suit in January, ruling that “‘non-federal governmental plans’ … constitute a subset of ‘group health plans’ … with respect to the Transitional Reinsurance Program.”
     Attorney Fred Nelson argued on behalf of the plaintiffs, and said that the definition of “group health plan” used by the Act is taken from ERISA, and does not include nonfederal government health plans.
     Nelson called the omission “deliberate,” and asserted a lack of “legislative history that the government intended state entities to make these payments.”
     U.S. Circuit Judge Karen Nelson Moore asked the attorney about the consequences of overturning the lower court’s decision; specifically if there would be “massive implications” for the rest of the ACA.
     “Not at all,” Nelson replied.
     Alisa Klein, attorney for the United States, countered this claim during her argument.
     “There would be enormous implications” if the three-judge panel reversed the lower court ruling, she said.
     She argued the federal government took care to prevent state and local governments from opting out of the ‘big ticket items’ in the Act, including the reinsurance program.”
     Klein also pointed out that while the Act does cross-reference the definition of a group health plan from ERISA, it relies primarily on the definition found in the Public Health Services Act.
     According to Klein, this definition specifically mentions “non-federal government health plan,” which is taken to mean state and local plans.
     Judge Moore asked for clarification on the definitions several times, and at one point called the cross-references “confusing.”
     “Plain language does not always mean easy to discern,” Klein answered. “It does not need to be ‘blinking lights clear’ from one provision.”
     Chief Judge R. Guy Cole Jr. and Senior Judge Martha Craig Daughtrey rounded out the panel.
     No timetable has been set for the court’s decision.

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