Tax Reform Bill Repeal Beginning in 2019

December 20, 2017

Tax Reform Bill Includes Repeal of Individual Mandate Beginning in 2019

On Dec. 20, Congress passed the Tax Cuts and Jobs Act, which makes significant changes to individual and corporate provisions of the U.S. tax code, including a reduction in the corporate tax rate to 21%, down from 35%, beginning in 2018. The bill includes permanent effective repeal of the Affordable Care Act (ACA) individual mandate, requiring individuals to purchase and maintain health coverage, by zeroing out the penalty beginning in 2019. For 2018, most individuals are still required to maintain coverage or pay a penalty when they file their 2018 federal income tax return.

The bill was negotiated by a conference committee comprised of representatives from both the Senate and House after each chamber passed their own versions of tax reform. The final bill was passed 51-48 by the Senate and 224-201 by the House before being sent to the President. President Trump is expected to sign the bill into law soon.

The bill also changes how certain tax thresholds will be indexed for inflation. Affected provisions, including the ACA “Cadillac” Tax (scheduled to take effect in 2020), will now be indexed to the Chained Consumer Price Index (CPI) instead of the regular CPI (the previous metric). That change makes it likely that more employer-sponsored plans would trigger the Cadillac tax sooner.

Judicial challenge: Expanded exemption for covering contraceptive services  
As we shared in our Oct. 13 alert, the Administration expanded the ACA contraceptive coverage exemption through the Interim Final Rules (IFRs) released by the Department of Health and Human Services on Oct. 6. On Dec. 15, a Pennsylvania federal court temporarily blocked the IFRs, ruling that the language of the ACA does not allow for such exemptions.

Since the preliminary injunction was issued by a federal court, the new IFRs cannot be enforced in any state unless or until it is removed. The injunction maintains the status quo. It does not impact exemptions or accommodations to the contraceptive coverage requirement granted prior to Oct. 6, 2017. Employers who may have been newly eligible for an exemption under the IFRs can only seek the exemption if they qualify under the previous contraceptive coverage mandate rules and follow the accommodation process. The Administration is expected to appeal this decision.

Staying informed
To stay up to date on the evolving state of health care reform, visit www.InformedonReform.com, including the new Repeal and Replace Update webpage.

Jo Anne is back!

What Exactly Is Stress?

Stress is unavoidably unavoidable. Even the most Zen yogis experience stress in their lives, and for everyday people, stress is something with which we have to learn to live. Just because we can’t always escape stressful situations or stressful times doesn’t mean there isn’t anything we can do to manage stress when it comes.

We sat down with Dr. Di Thompson, medical director of behavioral health and integrative services at Penrose-St. Francis and South State Operations in Colorado Springs, Colo., to talk about stress and what we can do to manage it.

What exactly is stress?

Everyone experiences stress differently, and stress can present itself in a number of different ways for different people. But, by definition, stress is a state of mental or emotional strain resulting from adverse or demanding circumstances. Simply put, stress is our body’s reaction to something that’s happened.

We often correlate stress with bad or negative experiences or events in our lives. But, did you know stress can also happen during fun events, too? We experience stress when we ride a roller coaster, enter into a new relationship, start a new job and numerous other experiences throughout our lives; and this stress can actually be beneficial and help us function better.

The more common form of stress presents as our body’s reaction to something negative or overwhelming in life, and should be paid closer attention to when it comes to coping with it.

How can we decrease our stress levels?

Little things throughout the day can help significantly lower stress levels when they start to rise. This can include practicing your favorite hobby, exercising, disconnecting with technology or taking some time to practice mindfulness. Even if you only have a couple of minutes each day, writing down three positive affirmations each morning or telling yourself five reasons you’re amazing before going to sleep can improve your overall outlook on a situation.

We also live in the real world, and some of our stressors are inescapable. If you’re dealing with a difficult work situation or something you can’t remove yourself from, try and focus on ways to improve your own self-care and not necessarily try to fix the external situation. You’d be surprised how much it helps.

How does stress physically impact our lives?

Extreme stress can cause people to feel just as bad physically as it does mentally, so it’s equally important to recognize the physical signs of stress.

Many of us often feel sick to our stomach when we’re especially stressed – and there’s good reason for it. One of the hormones in our body that affects stress is serotonin, and apart from the brain, our stomach holds the most amount of serotonin in our bodies. When stress increases, so does our serotonin.

Other physical symptoms of stress can include headaches, insomnia, gastrointestinal distress, palpitations and even shakiness.

So, when is too much stress too much?

Stress can be too much to handle when someone is feeling so overwhelmed that it’s beginning to impact his or her daily life. When this happens, identifying where the stress is coming from can help you examine the situation and determine what can be done to make that particular situation less stressful.

Sometimes it helps to think about and identify stressors in particular buckets. What is your stress caused by? Family? Money? Work? Loss? Physical? The first step to alleviating stress is identifying it, after which you can figure out how to combat it.

When stress becomes too much, simply talking to someone about your situation can go a long way. Whether that’s talking with friends and family or seeking professional help, other people’s insights and perspectives can help you gain perspective on what’s most important in your life.

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Author: Dr. Di Thompson

Dr. Di Thompson is the medical director, behavioral health and integrative services at Penrose-St. Francis and South State Operations. She is a psychiatric oncologist and women’s health specialist. Since completing her residency at the University of Pittsburgh Medical Center, she has specialized in treating cancer patients and women with a focus on midlife and menopause issues. In addition to her role as a psychiatrist, she is a certified a menopause practitioner and hypnotherapist. Prior to moving to Colorado in 2012, she and her husband resided in Honolulu where she was the medical director for Women’s Health and the Program Director for the Cancer Center at Queen’s Medical Center. Her prior positions included medical director of psychiatric oncology at the Winship Cancer Center in Atlanta and medical director of behavioral health for the Pittsburgh Cancer Center and Magee Women’s Hospital in Pittsburgh. She is well published, has spoken at many medical conferences and has appeared on both local and national television discussing topics related to cancer and quality of life. Outside of work, she enjoys running, skiing, hiking and biking.

Medical Plan Increase 29% for Colorado

With all the uncertainty in the public policy, many of us did not know what to expect in this Open Enrollment Period. Now, as we approach the midway point, we have reason to be optimistic. Medical plan selections reached 43,881 in November, a rate that is 29% ahead of the rate in November 2016. You can find more detail in today’s media release.

Kevin Patterson, CEO

In the News Families relying on the Children’s Health Insurance Program, Child Health Plan Plus (CHP+) in Colorado, began receiving notices this week that the program will not continue beyond January 31, 2018, unless Congress reauthorizes funding. The program serves more than 75,000 children and 800 pregnant women in our state. We continue to coordinate with the department of Health Care Policy and Financing to move those families to private insurance through Connect for Health Colorado. Although they should continue to use their CHP+ benefits through January, we encourage participants in CHP+ to start researching the options available to them and we have posted information on our site to assist that effort.