Appeals Court Deals Major Blow to Implementation of Affordable Care Act

Today's post is shared by WSJ Law Blog and comes from blogs.wsj.com

A federal appeals court on Tuesday dealt a serious blow to the Obama administration’s implementation of its signature health-care law, striking down subsidies available to some consumers who purchase health coverage on insurance exchanges set up by the federal government.

WSJ’s Brent Kendall has more on the breaking legal development out of Washington:

The U.S. Court of Appeals for the District of Columbia Circuit, on a 2-1 vote, invalidated an Internal Revenue Service regulation that implemented a key piece of the 2010 Affordable Care Act. The regulation said subsidies for health insurance were available to qualifying middle- and low-income consumers whether they bought coverage on a state exchange or one run by the federal government.

The ruling potentially could cripple the Affordable Care Act by making subsidies unavailable in as many as 36 states where the federal government has run some or all of the insurance exchanges.

The court sided with challengers, four individuals and three employers, who argued the health law allowed subsidies only for insurance purchases made through state exchanges. The issue became an important one after the law was enacted because more than two-thirds of the states chose not to set up their own exchanges, relying on federally run exchanges instead.

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Obama administration to begin processing Social Security payments to same-sex couples

Same sex marriages are now going to be recognized as beneficiaries for Social Security purposes. Today's post is shared from Jurist.org

The Obama administration announced [press release] Monday that the Social Security Administration will begin processing payments to surviving spouses of same-sex married couples
In n a brief statement, Press Officer LaVenia LaVelle said, "I am pleased to announce that, effective today, Social Security is processing some widow's and widower's claims by surviving members of same-sex marriages and paying benefits where they are due. In addition, we are able to pay some one-time lump sum death benefit claims to surviving same-sex spouses.

As I stated shortly after the Supreme Court decision on Section 3 of the Defense of Marriage Act, our goal is to treat all Americans with dignity and respect." Widow's benefits are payable to the surviving spouses who were married at the time of their spouse's death, as well as those who were legally married for at least 10 years, but later divorced. The maximum amount a widow over 60 years old may receive is the amount the deceased spouse was receiving or would have received at the time of death. Because the SSA regulations specifically yield to the definition of "marriage" used by the state in which a couple lives, the SSA has lagged behind other federal departments in providing for same-sex couples.
Other federal agencies have taken similar steps to ensure the inclusion of same-sex couples in administrative processes. Earlier this month the US Department of Education [official website] announced [JURIST report] that for the purposes of applying for and receiving federal student financial aid, the federal government will now recognize all legal same-sex marriages.On the same day as the Department of Education's announcement, the US Customs and Border Protection said [Time report] it will expand the definition of "members of a family residing in a household" to include same-sex couples and other domestic relationships so as to facilitate the declarations process.
While the Windsor decision did not create a constitutional right to same-sex marriage, it does entitle couples in lawfully recognized same-sex marriages to certain federal benefits. In September the US Department of Labor [official website] issued guidance explaining [JURIST report] that all legally married same-sex spouses in the US can participate in employee benefit plans overseen by the Employee Benefits Security Administration [official website]. Earlier in September the US Department of Justice [official website] announced [JURIST report] that it will no longer enforce a federal law that denies same-sex spouses veterans benefits. In August the US Treasury Department [official website] announced that it, along with the Internal Revenue Service (IRS) [official website], will recognize marriages [JURIST report] of all same-sex couples for federal tax purposes.

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Victims of Misclassification

Misclassification is a major issue for workers' compensation programs. Misclassified workers are those who should be considered employes but have been denied employment status. This post is shared by from the nytimes.com

.LAST month, a Michigan construction worker named Matt Anderson testified in a Senate hearing about being a victim of employee misclassification. Mr. Anderson said that his employer forced him, after six years as an employee, to switch to “independent contractor” status. Though the move stripped Mr. Anderson of basic employee rights and protections, he went along with the change, he said, because “my fellow workers and I had families to support and we saw how bad the economy was.”

Today, millions of American workers in a wide variety of sectors, from construction and trucking to I.T. and professional services, are victims of misclassification, a tactic employers use to avoid paying taxes and providing benefits that are guaranteed to employees, such as workers’ compensation, overtime pay, minimum wage and unemployment insurance.

In 2000, a United States Department of Labor study estimated that up to 30 percent of employers misclassify workers. This year, the Treasury Department’s inspector general concluded that the problem had worsened. Fifteen states have now teamed up with the Department of Labor and the Internal Revenue Service to reduce misclassification through information sharing and joint...


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Obamacare Will Be Collecting Workers' Compensation Medical Records

The implementation of Affordable Care Act data collection regulations will include the collection of medical information concerning work related accidents and injuries.  The coalition of this information will broadly advance the concept of universal medical care and impose yet another route for the Centers for Medicare and Medicare to strengthen enforcement under the Medicare Secondary Payer Act.

The largest and most expansive database of personalized medical information is being established under the umbrella of an newly created unit under the authority granted to the Internal Revenue Service, The Federal Data Services Hub. Personal medical records, including electronic medical records, will be incorporated into the program. 

"On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act 
(P.L. 111-148). On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 
(P.L. 111-152) was signed into law. The two laws are collectively referred to as the Affordable 
Care Act. The Affordable Care Act creates new competitive private health insurance markets –
called Exchanges – that will give millions of Americans and small businesses access to 
affordable coverage and the same insurance choices members of Congress will have. Exchanges 
will help individuals and small employers shop for, select, and enroll in high quality, affordable 
private health plans that fit their needs at competitive prices. The IT systems will support a 
simple and seamless identification of people who qualify for coverage through the Exchange, tax 
credits, cost-sharing reductions, Medicaid, and CHIP programs. By providing a place for onestop shopping, Exchanges will make purchasing health insurance easier and more understandable 
and will put greater control and more choice in the hands of individuals and small businesses."

Read more about "Federalization" and workers' compensation:

US Dept of Labor Moves Aggressively on Misclassification of Employees

The misclassification of workers by employers directly impacts the calculation of workers' compensation benefits. The US Department of Labor today has moved aggressively to co-ordinate actives with the US IRS to co-ordinate enforcement and education.

Generally, employees classified as independent contrators are not entitled to workers' compensation benefits Employers sometime commit fraud and designate employees as independent contractors and avoid paying both taxes and benefits such as workers' compensation.

11 state agency leaders also sign, agree to memorandums of understanding

Secretary of Labor Hilda L. Solis today hosted a ceremony at U.S. Department of Labor headquarters in Washington to sign a memorandum of understanding with the Internal Revenue Service that will improve departmental efforts to end the business practice of misclassifying employees in order to avoid providing employment protections. In addition, labor commissioners and other agency leaders representing seven states signed memorandums of understanding with the department's Wage and Hour Division and, in some cases, its Employee Benefits Security Administration, Occupational Safety and Health Administration, Office of Federal Contract Compliance Programs and Office of the Solicitor. The signatory states are Connecticut, Maryland, Massachusetts, Minnesota, Missouri, Utah and Washington. Secretary Solis also announced agreements for the Wage and Hour Division to enter into memorandums of understanding with the state labor agencies of Hawaii, Illinois and Montana, as well as with New York's attorney general.

The memorandums of understanding will enable the U.S. Department of Labor to share information and coordinate law enforcement with the IRS and participating states in order to level the playing field for law-abiding employers and ensure that employees receive the protections to which they are entitled under federal and state law.

"We're here today to sign a series of agreements that together send a coordinated message: We're standing united to end the practice of misclassifying employees," said Secretary Solis. "We are taking important steps toward making sure that the American dream is still available for all employees and responsible employers alike."

"This agreement takes the partnership between the IRS and Department of Labor to a new level," said IRS Commissioner Doug Shulman. "In this new phase of our relationship, we will work together more efficiently to address worker misclassification issues, and better serve the needs of small businesses and employees."

Business models that attempt to change, obscure or eliminate the employment relationship are not inherently illegal, unless they are used to evade compliance with federal labor laws — for example, if an employee is misclassified as an independent contractor and subsequently denied rights and benefits to which he or she is entitled under the law. In addition, misclassification can create economic pressure for law-abiding business owners.

These memorandums of understanding arose as part of the department's Misclassification Initiative, which was launched under the auspices of Vice President Biden's Middle Class Task Force with the goal of preventing, detecting and remedying employee misclassification.

For over 3 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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