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GR: Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (PPACA) is extensive, with many moving pieces, and the public opinion of the bill is highly polarized. Therefore, it’s critical that fire department leaders fully understand the facts and avoid sharing misinformation. This page contains resources and information to help you understand this complex law and its impact on fire departments. In 2013, the IAFC created the PPACA Task Force which consists of fourteen members and focuses on analyzing the impact of the PPACA on the fire service. The Task Force has focused on the PPACA's impact on the three general issues of the volunteer fire service, emergency medical services, and the cost of employer provided health insurance.

The IAFC will continue to share the latest news and analysis on the PPACA, please check back regularly for more information.

PPACA News, White Papers, and Information Briefs

PPACA News Alert: U.S. Supreme Court Upholds PPACA -- What Does It Mean for the Fire Service? (pdf) - June 2015

PPACA White Paper: Re-Examining the Affordable Care Act (pdf) - May 2015

PPACA Information Brief: ACA 101 (pdf) - December 2014 

The Volunteer Fire Service

House Passes Volunteer Exemption Bill
Mar. 17, 2015 - The House of Representatives voted to pass H.R. 1191 in a unanimous 415-0 vote. The legislation is now in the Senate where it is awaiting action. 

Legislation Introduced to Codify IRS Protection of Volunteers
Mar. 2, 2015 - Rep. Lou Barletta (R-PA) and Senators Pat Toomey (R-PA) and Mark Warner (D-VA) introduced the Protecting Volunteer Firefighters and Emergency Responders Act (H.R. 1191 / S. 420). This legislation would codify the IRS' 2014 decision to exempt volunteer fire departments from the PPACA's requirement for certain employers to offer health insurance to full-time employees. 

IAFC Webinar on PPACA Final Rule
Feb. 13, 2014 - The IAFC held a webinar to analyze the impact of the IRS' final rule on the Employer Shared Responsibility Provision

IRS Releases PPACA Final Rule (pdf)
Feb. 12, 2014 - The IRS released their final rule on the Employer Shared Responsibility Provision. See Page 8550 for the exemption of volunteers in governmental and non-profit organizations

IAFC President on FOX
Dec. 22, 2013 - IAFC President Chief William Metcalf was interviewed on Fox and Friends about the need to exempt volunteers from the PPACA 

IAFC Comments on PPACA (pdf)
Sept. 10, 2013 - The IAFC filed formal comments to the IRS on the concerns of volunteer and combination fire departments with respect to the PPACA


Emergency Medical Services

The EMS Section and the PPACA Task Force are currently researching innovative EMS delivery programs across the country. If your department is using, or previously used, an innovative EMS delivery model, take this survey and let us know about it.

U.S. Supreme Court Upholds PPACA - What Does It Mean for the Fire Service?
June 20, 2015 - Chief Porter Welch, J.D., walks readers through the latest U.S. Supreme Court ruling on the PPACA and what it means for the fire service and future of EMS

Your Ambulance Reimbursement is Going to Change!
May 1, 2015 - Chief Mike Metro, PPACA Task Force Chair, discusses changes that the PPACA will likely bring to EMS reimbursements 

PPACA Will Transform EMS
Apr. 4, 2013 - Chief Gary Ludwig, past EMS Section Chair, discusses the potential impacts that the PPACA may have on the field of EMS

What is Community Paramedicine?
Mar. 21, 2013 - Learn more about community paramedicine and how the PPACA may lead to a growth in this emerging field

Changing EMS Reimbursements
Jun. 14, 2012 - Chief Pete Lawrence, discusses how the PPACA may impact the reimbursements fire departments receive for EMS care


Employer Provided Benefits

IAFC Submits Cadillac Tax Comments (pdf)
Apr. 3, 2015 - The IAFC submitted a number of comments to the Internal Revenue Service on ways to improve the Cadillac Tax. The IAFC's comments addressed a variety of issues, including the need to allow all firefighters to recieve a higher threshold for being "high risk professionals." 

The IAFC's PPACA Factsheet (pdf) provides a general overview of how the PPACA Employer Shared Responsibility Provision will apply to fire departments.

Challenges of Budgeting for Health Insurance
Sept. 15, 2013 - This On Scene article discusses the challenges of budgeting for health insurance costs and the impact the that the PPACA may have on pricing

Interview with Chief Gary Morris
Aug. 15, 2013 - Chief Gary Morris discusses the challenges that the PPACA may pose in budgeting for health insurance and providing health insurance to a fire department's employees

National Resources

The Official Federal Health Care Reform website

The National Association of Counties Health Reform Implementation website

National Association of Counties – Health Reform Implementation FAQs. 2013

Congressional Research Service – Potential Employer Penalties Under the Patient Protection and Affordable Care Act. 2013.

Department of Health and Human Services - Preventative Services Covered Under the Affordable Care Act. 2012.

Department of Labor - Technical Release No. 2013-02: Guidance on the Notice to Employees of Coverage Options under Fair Labor Standards Act §18B and Updated Model Election Notice under the Consolidated Omnibus Budget Reconciliation Act of 1985 - 2013

Internal Revenue Service - Final Rules for Employer Shared Responsibility Provision

Internal Revenue Service – Internal Revenue Manual, Part 6.550.1.1.6 - 2009

Internal Revenue Service – Issues for Firefighters. 2013

Internal Revenue Service – Publication 15-A: Employer’s Supplemental Tax Guide. 2013