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ACA Repeal and Replace Bill

Posted by Barbara J. Zabawa | Mar 06, 2017 | 0 Comments

Here is a copy of the ACA Repeal and Replace Bill proposed by the House Republicans.  It removes the individual mandate and replaces it with a continuous coverage incentive.  That is, if an individual cannot demonstrate that they did not have a gap in health insurance coverage for more than 63 continuous days in a year, an insurer can charge that individual 30% more in premium.  The Bill also creates a "Patient and State Stability Fund," which allocates money to states to be used for a variety of purposes spelled out in the Bill.  Many of the purposes are to help stabilize the individual health insurance market.   Other purposes include promoting participation in the individual and small group market and promoting access to preventive services.  The Bill allows insurers to vary premiums by age by 5:1 (or more if the State so provides) instead of 3:1 under the ACA, makes significant changes to Medicaid (such as setting target expenditures in Medicaid) and removes funding from the Prevention and Public Health Fund. The Bill also prohibits federal funding to for one year to health centers that conduct abortions except in the case of rape, incest or endangers the life of the mother.  The Bill DOES NOT impact the ACA nondiscrimination rules as applied to workplace wellness programs or the nondiscrimination provision relating to provider license types.  As these proposed changes become more clear, the Center for Health and Wellness Law, LLC will provide updates.

About the Author

Barbara J. Zabawa

Attorney Barbara J. Zabawa started the Center for Health & Wellness Law, LLC after she recognized a need for legal services that shared a mission with providers to improve patient outcomes and population health, encourage wellness, protect patient interests in choice of provider and treatment options, provide holistic care, and expand information access. Attorney Zabawa has 20+ years of experience in the health care field, first receiving her Master's in Public Health from the University of Michigan before attending law school at UW Madison, where she graduated with honors in 2001. From 2003-2005, Ms. Zabawa clerked for the Honorable Barbara B. Crabb in the United States District Court for the Western District of Wisconsin and worked on a variety of matters, including employment, patent infringement, civil rights, and contract matters. She also served as a Skadden Fellow representing health care consumers on both the national and local level by helping consumers navigate private insurance coverage issues and advocating for their interests as a Funded Consumer Advocate at the National Association of Insurance Commissioners (NAIC). Attorney Zabawa has worked for a large health insurance company providing advice on the Affordable Care Act as well as HIPAA Privacy and Security compliance. In addition, she was in private practice at a large regional law firm for seven years, where she was a shareholder, led her firm's health care team and served as its HIPAA Privacy Officer. While in private practice, she handled a variety of health law matters, such as compliance with fraud and abuse laws, professional scope of practice matters, state licensing issues, HIPAA privacy and security compliance, Medicare and Medicaid reimbursement and conditions of participation compliance, Accountable Care Organization and other joint venture agreements, employment agreements, as well as business litigation. Attorney Zabawa is the author of the forthcoming book "Rule the Rules of Workplace Wellness Programs." She is a frequent speaker and writer both nationally and regionally on workplace wellness program compliance, the Affordable Care Act, fraud and abuse issues and HIPAA compliance. She has published several law review articles in the practice of health law and has been interviewed by TV, radio and print media regarding wellness, health reform, and HIPAA. She is a Board Member for Rogers Memorial Hospital Foundation, Board President for the Wisconsin Alliance for Women's Health, Board Member for Health Promotion Advocates, and currently serves on the Oversight Advisory Council for the Wisconsin Partnership Program and the State Bar Health Law Section Board. Education JD - University of Wisconsin Law School, cum laudeMPH - University of Michigan School of Public HealthBA - Lawrence University Admitted to Practice: • New York• Wisconsin• Federal District Court of the Western District of Wisconsin• Federal District Court of the Eastern District of Wisconsin• Court of Appeals for the Seventh Circuit• United States Supreme Court

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