Circuit Split Leaves Nebraska and Iowa in Limbo on ACA Contraceptive Mandate

On September 17, 2015, the United States Court of Appeals for the Eighth Circuit (8th Circuit) ruled against the United States Department of Health and Human Services (HHS) in two cases regarding the contraceptive mandate found within the Patient Protection and Affordable Care Act (ACA). The 8th Circuit determined that nonprofit religious organizations do not have to provide contraceptive coverage or participate in the accommodation process designed to alleviate concerns for religious objectors under the ACA. For those residing in the court’s jurisdiction, which includes Nebraska and Iowa, this ruling interjects ambiguity because this is the only circuit court to rule against HHS on this issue.

The two cases, Dordt Coll. v. Burwell, No. 14-2726 (8th Cir. 2015) and Sharpe Holdings, Inc. v. HHS, No. 14-1507 (8th Cir. 2015), pertained to religious organizations that fell outside of the religious employer exemption, instead falling in another category. This category, designed by HHS, provides for the nonprofit entity by granting a religious accommodation. The religious accommodation allows nonprofit organizations to notify HHS of their objections, which also requires the nonprofit provide updates and further information about the objection. Once notified, HHS would begin a procedure that would ultimately require another party to provide contraceptive benefits to the beneficiary of the nonprofit’s health plan. The 8th Circuit determined the nonprofit organization is neither required to notify HHS or provide contraceptives to the health plan beneficiaries.

This poses a problem for those within the 8th Circuit’s jurisdiction because it is the lone circuit to rule against HHS on this issue and it is expected that the United States Supreme Court will take up this issue in the fall term. In the meantime, those in Nebraska, Iowa, and similar 8th Circuit jurisdictions are subject to an ambiguous and evolving standard. For those employers in the 8th Circuit’s jurisdiction considering applying this ruling, counsel should be contacted prior to moving forward.

© 2015 Houghton Vandenack Williams
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How Does the Affordable Care Act (Obamacare) Affect My Business?


How the Affordable Care Act will affect your business depends, in part, on the size of your business. If you are a business that has 50+ employees then you have certain requirements regarding proving health insurance or paying a penalty. If you are an employer who has less than 50 employees, there are some tax credit opportunities available to you if you do provide health insurance to your employees.

© 2014 Parsonage Vandenack Williams LLC

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How the ACA Will Affect Medical Practices in 2013

The Affordable Care Act will bring several major tax consequences for medical practices in the new year. Physicians need to be aware of important changes to health care law taking effect in 2013. These changes will affect both patients and providers. A few of these key changes are as follows.

Patients with flexible spending accounts may find their usefulness limited. In January, a new cap comes into effect, limiting FSA spending to $2,500 per year. Furthermore, the threshold for unreimbursed medical expenses will increase from 7.5% of adjusted gross income to 10%. This burden will be waived for patients 65 and older until 2016. High income earners will see a 0.9% Medicare tax hike, as well as a 3.8% medicare tax assessment on unearned income.

Primary care physicians will see an increase in Medicaid payments. For 2013 and 2014, the new rate is 100% of the Medicare payment rate. Finally, new excise taxes will be imposed on certain medical devices. Given the significant number of changes in 2013, good planning will save taxes.

© 2013 Parsonage Vandenack Williams LLC

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