Monday, March 11, 2013

13 people injured in shooting on D.C. street corner overnight'

By Peter Hermann and Matt Zapotosky, Updated: Monday, March 11, 5:32 PM

A drive-by shooting early Monday on a D.C. street corner that has been repeatedly touched by violence left 13 people wounded, one of them seriously, police said.

Video: The Metropolitan Police Department has released surveillance video capturing an early morning drive-by shooting in Northwest D.C. on camera. Thirteen people were injured when gunmen opened fire in front of a crowd outside an apartment building.

The shooting took place on North Capitol Street at New York Avenue in front of Tyler House, a crime-plagued subsidized apartment complex that police said is one reason the neighborhood has struggled with gun violence even as redevelopment in nearby “NoMa,” or north of Massachusetts Avenue, has redefined the area.

Those wounded in the shooting — the youngest of whom was 17 — were struck mostly in the arms and legs, D.C. Police Chief Cathy L. Lanier said. Assistant Police Chief Peter Newsham said the seriously injured victim was hit in the back. None of the injuries are considered life-threatening.

“Everybody was screaming,” said Jonique Douglas, 21, who had just come out of the Fur Nightclub around the corner and was standing in front of Tyler House when the shots rang out.

“They shooting like directly at us,” she said, adding that she and others began kicking and punching Tyler House’s locked door, where Douglas said she used to live, to get to safety. “It coulda been a bloody mess.”

But she said there was no one to let them in. Douglas said people in the group began to fall over one another as bullets struck some and grazed others. She said her 17-year-old brother was hit in the hand by a bullet.

The shooting occurred across New York Avenue from Big Ben Liquor Store, on the northern edge of the District’s up-and-coming NoMa district.

Gunmen in two cars fired into a crowd 
outside an apartment building early 
Monday. (Courtesy of WJLA)
Cranes loom overhead, marking new construction that is rapidly filling the empty lots that once dotted the area. New condos, stores and office complexes are rising among apartment complexes that for decades have housed lower-income city residents.

The development activity comes despite sporadic bursts of violence in the neighborhood, including shootings on consecutive weekends in October that wounded a total of seven people outside Big Ben.

DC. Police chief Cathy L. Lanier said detectives had not determined a motive in the more recent shooting, but she pointed at the Fur Nightclub, about a block away from Tyler House, which she said has been a constant source of complaints.

D.C. Police Chief Cathy Lanier discusses 
the shootings during a press conference 
Monday morning. (Courtesy of WJLA)
Lanier has temporarily shut down more than two dozen bars, nightclubs or other liquor establishments since 2011, invoking her emergency power in cases she deems necessary to ensure public safety. In most cases, the 72-hour closures come after violence that can be directly attributed to disputes that start inside the establishments.

Lanier and other police officials said people coming out of the mega club Fur, which can hold 1,200 customers, often gather in front of Tyler House.

Commander Andy Solberg said that in the early hours of the morning, when the clubs in the neighborhood close, “a whole lot of people with cash in their pockets come out onto the street, and the guys from Tyler House are waiting for them. That’s when you get the holdups and that’s the source of the shootings in the neighborhood.”

 Twitter reaction to Monday's violence
Twitter reaction to Monday's violence
2:09 PM ET

Residents responded on Twitter to Monday’s shootings that left several injured along North Capitol Street.

Solberg added that discussions have been under way for some time with the District government about finding a permanent solution in which Tyler House would either be rehabbed, torn down or sold. “You won’t get the violence down as much as you’d like until you do something about Tyler House,” he said.

Police said the gunfire early Monday may have come from one or both of the cars that sped south along the 1200 block of North Capitol St. NW. It was not immediately clear how many shots were fired or from what type of weapons.

Lanier said detectives believe that one of the vehicles involved in the shooting may have been a dark-colored car, and another a may have been a light gray or silver sedan. Police had initially said one of the cars might have been a BMW, but said neither car in the video appears to be that model.

Police said one person was seriously injured by a bullet wound to the lower back, but the rest were all shot in their legs, arms, feet, hands and buttocks, or were grazed, and the injuries did not appear to be serious. The youngest victim was 17, police said.

Thirteen people on a sidewalk outside Tyler House were injured in a drive-by shooting on North Capitol Street about 2:10 a.m. Monday

At the time of the Big Ben shootings in October, police said they may have stemmed from a dispute between residents from north of New York Avenue, around 1st and O streets NW, and people living at Tyler House to the south. No arrests have been made. No one died in those shootings, but a 14-year-old boy who was shot in the abdomen was seriously injured.

Police spent hours at the intersection early Monday, collecting evidence from the latest violence such as spent shell casings.

Tonya Brigdes, 36, said she has seen crime ebb and flow in the nearly 17 years she has lived in Tyler House. When she first moved there in 1996 the building seemed safe, but by the mid to late 2000s, violence seemed to tick up, she said.

Monday’s shooting, Brigdes said, was a startling reminder of how bad the area can be.

“I’m saving up my money -- because I got a baby on the way -- so I can get out of here,” said Brigdes, who is nine months pregnant.

The trouble, Brigdes said, comes mainly from the youths who hang out regularly in front of the apartment at all hours of the night, undeterred by security guards who try to shoo them away. She said the apartment even removed furniture from the lobby in an effort to discourage people from hanging out there, but it has not seemed to work.

“When they had furniture there, there was too many guests coming in here, sitting down,” Brigdes said.

Brigdes said apartment officials have been discussing renovations for years, but none have come to pass. She had hoped that officials would also implement a screening process would accompany the renovations to weed out criminals.

“It’s a nice, lovely building,” she said. “It’s just the people that reside in the building.”

Brigdes said that while some new businesses have moved into the area, vestiges of old D.C. hinder their impact. Fur Nightclub, she said, is especially problematic, often drawing feuding youths from different neighborhoods. She said she wonders whether that might have played a role in Monday’s shooting.

The shooting surprised Gerry Payne, 43, who said he has lived in a townhouse that sits diagonally across an intersection from Tyler House for 40 years. That 13 people were wounded, he said, was startling in its own right. But that it happened in this neighborhood, where development seems to have pushed out violence in recent years, was perhaps even more noteworthy.

“You probably couldn’t walk through this neighborhood 10 years ago without someone trying to rob you or something like that,” Payne said. “But the neighborhood has changed tremendously -- for the better. You can walk down the street to the stores now and everything is right there.”

Even Tyler House itself, Payne said, seems to have undergone some renovations. He said he does not let his own children hang out in front of it. But he said he also does not feel it is dragging down an otherwise up and coming area.

“It is what it is,” Payne said.”The building is going under reconstruction right now. After everything is said and done, I think it will be more safe than it is now.”

Payne said he did not hear or see the shooting and only learned what happened this morning when a friend called to make sure he was OK.

“Just to shoot into a crowd, that’s crazy,” he said.

Police are urging anyone with information about Monday’s shooting to call 202-727-9099.

Marc Fisher contributed to this article.

States balk at $15B Obama healthcare 'tax'
By Ben Goad - 03/08/13 12:34 PM ET

A newly unveiled component of President Obama’s healthcare law forcing insurers to pay annual fees is sowing angst in state capitols, where officials view the provision as a $15 billion tax that could disrupt Medicaid programs and other services.

The health insurance providers fee, included in the healthcare reform law over the objections of congressional Republicans, is designed to raise tens of billions of dollars in the coming years.

In Wisconsin alone, the fee would hit the state’s coffers to the tune of $23 million in 2014, and will likely total more than that in subsequent years, said J.P. Wieske, legislative liaison and public information officer for the state’s Commissioner of Insurance.
The blow to Wisconsin’s private insurance market would be far higher – $3 billion over the next 10 years, Wieske said.

The proposed regulation’s details were published this week, and prompted harsh criticism from the health insurance industry, which warns that the fees would ultimately raise the price of healthcare. The Obama administration has countered that the insurer fee is just one of many provisions, which, taken together, would drive costs down.

But in states that participate in Medicaid managed care plans, the fee would be painful. One study commissioned by the Medicaid Health Plans of America found that states would be on the hook for $15 billion over the next ten years.

“That’s dangerous,” said Bruce Greenstein, Louisiana’s health secretary. “I have deep concerns.”

Greenstein said the fee is tantamount to discrimination, since some plans – including those offered by certain nonprofit healthcare providers – are exempt from the fee.

Administration officials did not imemditaely respond to requests for comment on the concern from states.

Nationwide, fees assessed on non-exempt insurers would total $8 billion next year and rise thereafter, eclipsing $14 billion in 2018, according to the Internal Revenue Service, which drafted the proposed rule. The fees would vary in size, depending on a firm’s net premiums, and would come due by Sept. 30 every year.

In Wisconsin, some smaller private insurers were considering changing their business model to nonprofit status because of the added costs, Wieske said.

For states offering Medicaid managed care, however, that is not an option.

Ultimately, the fee will raise the costs of Medicaid programs, which are funded by a combination of federal and state money, said Joe Moser, executive director for Medicaid Health Plans of America (MHPA).

The trade group opposes the fee in general and is pressing for its repeal. Short of that, Moser said, MHPA would support changes that exempt Medicaid. from the provision.

During consideration of the Affordable Care Act, congressional Republicans fought unsuccessfully to scrap the fees. Another attempt to do away with them is now under way in the House, where Reps. Charles Boustany Jr. (R-La.) and Jim Matheson (D-Utah) are pressing a bill to repeal the provision.

Even if the House were to pass the bill, it would have a tough road forward in the Senate and would likely face a veto from Obama.

Opponents, meanwhile, are trying to build their case against the fee. Already, the fee is a top issue for health insurers who contract with states, said Jonathan Dinesman, vice president of government relations for Centene Corporation, a managed care company based in St. Louis.

“This fee will discourage states from enrolling more people,” he said. “It contradicts the objectives of the ACA.”

Dinesman said Centene was still analyzing the language of the proposed rule. Beyond legislation to block or repeal the fee, opponents can submit public comments on the proposal for the next three months and otherwise seek to influence its language during the rulemaking process.

“Everything’s on the table,” he said.

This story was updated at 12:15 p.m.

PPACA's Health Insurance Tax (HIT) -- an NFIB Research CribSheet

Beginning in 2014, the Patient Protection and Affordable Care Act (PPACA) imposes a health insurance tax (HIT) on the fully-insured market that serves most small business employers and those who purchase policies individually.

Learn the essential facts about the HIT Tax in this NFIB Research CribSheet.

The latest topics include:

PPACA: A Healthcare Law Guide for Employees (# 12-17)

Small Business Tax Rates and Tax Complexity (# 12-16)

PPACA: Medicare Wage/Salary & Investment Taxes (# 12-15)

Healthcare Solutions: Interstate Insurance Markets (# 12-14)

Healthcare Solutions: Portability (# 12-13)

Healthcare Solutions: Tax Parity for Insurance (# 12-12)

Healthcare Solutions: Defined Contribution Plans (# 12-11)

Healthcare Solutions: Malpractice Reform (# 12-10)

Fiscal Cliff 2013 (before the deal) (# 12-9)

PPACA Timeline (# 12-8)

PPACA: Employer Mandate Penalty Calculations (# 12-7)

NFIB Healthcare Solutions (#12-6)

IRS Form 1099 Reporting Requirements (#12-5)

PPACA: Problems for Small Business (#12-4)

PPACA: Health Insurance Tax (HIT) (#12-3)

PPACA: The Individual Mandate Tax (#12-2)

EPA Lead Renovation, Repair and Painting (LRRP) Program(#12-1)

PPACA: Small Business Health Insurance Tax Credit (#11-2)

PPACA: Employer Mandate Penalties (# 11-1)

All PPACA CribSheets (includes #12-4, #12-17, #12-8, #12-2, #11-1, #12-7, #12-3, #12-15, #11-2)

All Healthcare-Solutions CribSheets (includes #12-6, #12-10, #12-11, #12-12, #12-13, #12-14)

A gun for every home? Maine town to vote on mandatory firearm ownership

Glenn Adams / AP, file
Michael Hein of Augusta, Maine, holds a sign in front of the Maine State House during a Gun Appreciation Day rally on Jan. 19. In a smaller Maine town, a more powerful gesture in favor of guns has taken shape in a proposal to require firearm ownership.
By Sarah Mahoney, Reuters
Residents of a Maine town are expected to vote Monday on whether each household should be required to own a firearm, a decision that has thrust the tiny town of Byron into the heated national debate on gun control.

The vote is scheduled to take place on Monday evening in a potentially rancorous annual town meeting for the western Maine town's 140 residents and will be largely symbolic.

The town's head selectman says the vast majority of households in Byron already have at least one gun, and a requirement to possess guns and ammunition would be unenforceable because Maine law bars municipalities from legislating on firearms.

"It was never my intention to force anyone to own a gun who doesn't want to. My purpose was to make a statement in support of the Second Amendment (to the U.S. Constitution)," said Head Selectman Anne Simmons-Edmund, who proposed the ordinance.

The December shooting rampage that left 26 people dead at a Connecticut elementary school has reignited the national debate over guns. In response, some states have been prompted to tighten gun laws, while other states have sought to keep federal gun measures from being applied within their borders.
Byron is not the only town to mull such a measure. Last week, selectmen in the Maine town of Sabbatus, about 60 miles from Byron, voted against putting a similar proposal before town residents.
In Georgia, a city leader in Nelson has proposed an ordinance calling on every head of household to have a gun as a way to keep down crime in the city of 1,300 residents, which employs only a single police officer.
The Nelson city council is expected to vote on the gun ownership ordinance on April 1.
In Byron, Simmons-Edmund, who is also a police officer in nearby Dixfield, said the measure reflects community concern about the remote area's rising crime rates, which she said have nearly tripled in the last year.

Not all in the town were supportive of the move.

"It gives new meaning to the term 'March Madness,'" said Byron resident Philip Paquette, who has spent the past three decades as a Merchant Marine. "She is infringing on the rights of townspeople. I'm a hunter and own guns, and I have a right to. People also have a right not to own guns."

Simmons-Edmund says she got the idea after a suggestion from her father and fellow Byron resident Bruce Simmons.

"Five days ago, I would have predicted this article would pass," Simmons-Edmund said. "But we've gotten so much media attention, nothing would surprise me. This town has never been so closely scrutinized. It's up to the residents to decide now. And if they shoot it down, I am totally fine with it."


NRA executive accuses Obama of gun 'charade'

Obama unveils sweeping gun control proposals

'Total lockdown': Vatican preps security for papal conclave

Joe Raedle / Getty Images
Canadian Cardinal Marc Ouellet makes his way to Vatican City on Monday. Security is tight ahead of the papal conclave, which is due to begin Tuesday.

By Alastair Jamieson, Staff writer, NBC News

ROME — Jamming devices to halt communication were installed at the Vatican on Monday, as part of a security lockdown ahead of the papal conclave.
The behind-the-scenes ballot process is supposed to remain a secret, but modern technology left Roman Catholic Church officials taking no chances.

Staff working alongside the cardinals voting inside the Sistine Chapel must swear an oath of secrecy.

"I expect they’ll be on a total lockdown," NBC News' Vatican analyst George Weigel said. "Security is tight. It’s got to be."

Jamming devices will be used at the Sistine Chapel inside the Vatican and the nearby guest residences at Santa Marta where cardinals will sleep during the conclave, officials told reporters on Friday.

After a weekend celebrating mass at their assigned parishes across Rome, all 115 cardinals are preparing to file into the Sistine Chapel tomorrow to begin the selection of the next pope. NBC's Lester Holt reports.

The move will ensure cardinals cannot communicate with the outside world or use social media. It will also prevent hidden microphones from picking up the discussions.
Any cardinals or Vatican workers –- such as those serving food in Santa Marta – breaching the code face excommunication from the church.

"Even who said, 'pass the salt' is a secret,"wrote Sister Mary Ann Walsh, media relations director for the United States Conference of Catholic Bishops in a blog post. "In this electronic age, I worry some cardinals may go into iPad and Twitter withdrawal."

To prevent any contact with the outside world, cardinals will also be taken the 750 yards from Santa Marta to the Sistine Chapel by bus.

"The Vatican highly prizes the traditional Conclave secrecy — even more so after the leaks scandal that have plagued it in the past months," said Alessandro Speciale, Vatican correspondent for Religion News Service. "Most of the jamming measures were already in use in 2005, but of course, back then there were no smartphones and iPads. While cardinals will probably take their commitment to secrecy seriously, some of them are avid [Tweeters] and bloggers, and they might risk going into internet withdrawal if the conclave drags on too long."

Weigel added: "It would be difficult for anyone to use a cellphone, even out of sight. With 115 cardinals in the Sistine Chapel, space is tight and it would be obvious if anyone was checking their phone."

Slideshow: Pope Benedict XVI's departure


'Grave indicator': Penguins' survival at stake as Antarctic ice disappears

NBC News Correspondent Kerry Sanders recently returned from Antarctica, where he chronicled the dramatic changes in the world's last wilderness. Below is his main report; you also can click on the map above for more dispatches from across the breathtaking seventh continent.

By Kerry Sanders, Correspondent, NBC News

ANTARCTIC PENINSULA — There are serious changes taking place here at the bottom of the world.

Increasingly, experts say, the ice is disappearing at a disturbing rate in the Antarctic Peninsula and that in turn impacts the future -- and perhaps the very existence — of at least half of the world’s 18 penguin species, who depend on ice and frigid waters that support krill, the penguin diet mainstay.

"When cheetahs or lions get hunted, or elephants decline, there’s a big uproar. And I think, because you see penguins in large numbers [in some places] people are ignoring the larger rate of their decline," said Oxford University penguinologist Tom Hart. "The general public doesn't realize the penguins are declining so fast."

But it’s not just the penguins we have to worry about, Hart says, it’s the health of the planet itself.

"The last wilderness on Earth is impacted by us now," he said, describing the region’s decline as a "grave indicator" of what’s to come.

Marine biologist Fabrice Genevois speaks with NBC's Kerry Sanders about Gentoo penguins and their extraordinary way of swimming which at times can appear as if they are "flying."

Life’s cycle disrupted for Antarctica’s penguins

It’s the end of the breeding cycle for most penguins here as summer comes to a close. The Gentoos,Adelies and Chinstraps are nudging their newborns from the rocks of Antarctica’s peninsula toward the waters of the Southern Ocean.

Experts say about 50 percent of the eggs will produce a penguin chick that makes it to sea. And about half of those will survive the hungry predators below, as they plunge into the frigid waters for their first swim. Leopard seals are lurking -- and for the newborns, avoiding their mortal enemy is not easy. Many will die. Those that do survive are subject to climate change that is threatening their food supply.

Hart has spent nearly a decade studying the creatures that have captured the world’s imagination for centuries. Each year, for three to four months, he positions himself along the Antarctic coast to observe, measure and chart penguin colonies. Some colonies have been followed since polar explorer Sir Ernest Shackleton and his men headed here some 100 years ago.

Modern-day expeditions to Antarctica are a more pampered escape than the harrowing ordeals they once were, but a couple men remember the heroes of previous expeditions a little better than most. NBC's Kerry Sanders reports.

"When you look at all penguins they are largely in trouble," said Hart. "We're so concerned because we're seeing massive changes to their populations. They’re probably not going to go extinct anytime soon, but the environment is changing very fast.

Chinstraps populations seem to have declined up to 50 percent in the last 30 years," he added.

Hart, like most experts, is cautious to speak in absolutes because the harsh environment here makes it difficult to get a clear picture of what’s happening. Experts use time-lapse cameras and sit at computers, laboriously counting penguins one by one to compare colony sizes from year to year.

To keep track of the penguin population in the extreme conditions of Antarctica, scientists turn to time-lapse photography as an important tool for research. This video shows years of the animals' migration patterns.

Krill decline quickly as sea ice disappears

Ice is the source of all life in Antarctica. It may seem at odds to think that ice gives life, but when you connect the dots, it’s a straight line to a penguin’s belly.

Algae live on top of the ice and underneath it too, providing a grazing ground for the krill that amass beneath -- the way a raccoon chooses to hide in a garbage can.

Krill mostly stay put under the frozen Southern Ocean. But as the ice sheet disappears due to climate change, that habitat shrinks and moves further south.

"The West Antarctic Peninsula has increased three degrees since 1951,” Hart said. "We’ve seen a large reduction in sea ice over the same period."

Although the climate has always undergone oscillations in temperature, Hart says the recent changes are happening much faster than normal.

NBC's Kerry Sanders takes a look at some of the unusual and fascinating wildlife that inhabits Earth's coldest continent.

Logically, less ice has resulted in less krill, say marine biologists. And since krill is the main diet for penguins, seals and whales, less food has in turn meant fewer births. That theory is widely accepted by scientists like French marine biologist Fabrice Genevois.
He says it’s mostly Americans, who have confused politics with science by questioning global climate change.

"We have all the information now, that's clear enough,” said Genevois. "There's no argument any more. You have to be either a liar or be crazy not to understand what we are doing to change the climate. We are responsible, that's for sure."

Add to that equation: Fishing. Less ice has opened areas to more fishing boats that in turn have targeted krill as a profitable catch.

There’s a 620,000 ton catch limit for krill in Antarctica, which is only about 1 percent of the total estimated mass in the region.

NBC's Kerry Sanders pays a visit to Antarctica, one of the world's last wilderness areas, to see the penguins that are being threatened by the increasingly rapid melting of the ice that dominates the landscape.

But it’s the location of the krill fisheries — all aggregated in the Antarctic Peninsula near the South Shetland Islands — that is the main cause of concern.

The boats increasingly drop their nets in the same waters where penguins search for food. The nets are not catching penguins indiscriminately but they are competing for the krill that the wildlife eats to survive.

Where do those captured krill end up? In part, they’re used as fish food at salmon farms, desirable because krill help color salmon “pink” which increases sales at the supermarket.

Click here and here for more on managing the krill catch.

Slideshow: Antarctica: Journey to the bottom of the Earth

See photos from NBC's Kerry Sanders' voyage to Antarctica.

Canary in a coal mine

The entire population of Emperor penguins, Chinstraps and Adelies live in Antarctica — if the ice continues to retreat those species are at risk. Meanwhile, the potential for disease outbreaks increases.

"As regions of Antarctica warm it has much more potential as a petri dish," said Hart, citing disease from the north, in particular avian disease, as being a main concern.
The penguins, marine biologists say, are giving us a warning. 

"We don't need to necessarily fear change," said marine biologist Maria Clauss, who works with tour company Quark Expeditions. But the penguin’s decline "will change the world as we know it," she said. "And we should not kid ourselves."

Karzai accuses U.S. and Taliban of conspiring to keep troops in Afghanistan

Erin A. Kirk-Cuomo / Dept. of Defense via AFP - Getty Images
U.S. Secretary of Defense Chuck Hagel speaks with Afghan president Hamid Karzai during a private meeting in Kabul.
By Mirwais Harooni and Phil Stewart, Reuters

KABUL —Afghan President Hamid Karzai ratcheted up his criticism of the United States on Sunday, marring a debut visit by the new U.S. defense secretary, Chuck Hagel, and highlighting tensions that could undermine Washington's strategy to wind down the unpopular war.
A day after two Taliban bombings killed 17 people, Karzai accused the United States and the Taliban of colluding to convince Afghans that foreign forces were needed beyond 2014, when NATO is set to wrap up its combat mission and most troops withdraw.
"Those bombs that went off in Kabul and Khost were not a show of force to America. They were in service of America. It was in the service of the 2014 slogan to warn us if they (Americans) are not here then Taliban will come," Karzai said in a speech.

"In fact those bombs, set off yesterday in the name of the Taliban, were in the service of Americans to keep foreigners longer in Afghanistan."

It was one of several inflammatory comments by Karzai and his government on Sunday and follow weeks of efforts by the Afghan leader to curtail U.S. military activity in Afghanistan, including a call to kick American special forces out of an important province. U.S. commanders see special operations forces as key to the end-phase of the conflict.

U.S. Secretary of Defense Chuck Hagel responds to Afghan President Hamid Karzai's statements in which Karzai accused the U.S. and Taliban with working together.

Hours after Karzai's speech, Hagel said he spoke "clearly and directly" about the comments during his first meeting with the Afghan leader since becoming U.S. defense secretary on February 27.

Hagel appeared at pains to be respectful of Karzai and avoid sharp criticism, but he told reporters that any collusion between the U.S. and the Taliban "wouldn't make a lot of sense."

The U.S. and NATO commander in Afghanistan, General Joseph Dunford, was more categorical.

"We have fought too hard over the past 12 years, we have shed too much blood over the past 12 years, we have done too much to help the Afghan security forces grow over the last 12 years to ever think that violence or instability would be to our advantage," Dunford told reporters travelling with Hagel.

Of Karzai's remarks, he added: "I'll let others judge whether that's particularly helpful or not at the political level."

Still, politics will be key over the next several months, as the United States and NATO allies work to carry out their strategy of pulling out their troops and decide how large a residual force to leave behind after 2014.

NATO defense chiefs meeting in Brussels last month discussed keeping a combined U.S. and allied force of 8,000-12,000 in Afghanistan, focusing on training Afghan troops and countering the remnants of al Qaeda, the Pentagon has said.

Any deal for a follow-on force, which Washington says must include immunity for U.S. troops, would need Karzai's blessing.

Abusing students? Taliban talks?Karzai has a history of making incendiary statements that exasperate Washington but the nature and awkward timing of his latest remarks about the United States were exceptional.

He also alleged on Sunday that the Taliban and the United States had been holding talks in the Gulf Arab state of Qatar on a "daily basis," further fuelling his suggestion that Washington and the militants were working at common purposes.

"I told the president that it was not true," Hagel said. "The fact is any prospect for peace or political settlements - that has to be led by the Afghans."

The Taliban spokesman in Afghanistan, Zabihullah Mujahid, denied that negotiations with the United States had resumed.

Karzai's government also alleged that U.S.-led forces and Afghans working with them were abusing and arresting university students. Karzai issued an executive order banning foreign troops from entering all education institutions.

Hagel and Karzai were meant to have appeared together at a joint news conference on Sunday evening. But, in a reminder of the threats posed by the resilient insurgency, U.S. officials said it was canceled because of security concerns.

Hagel was about a kilometer away and within earshot of a Saturday morning suicide attack outside the defense ministry that killed nine people. He was meant to have met his Afghan counterpart there this weekend but the venue was later changed.

Hagel's visit coincided with the passing of a deadline imposed by Karzai for U.S. special forces to leave Wardak province accusing them of overseeing torture and killings.

U.S. forces have denied involvement in any abuses.

Hagel has sounded hopeful that a deal could be reached on their continued deployment but acknowledged no breakthroughs were made in his talks with Karzai.

It was unclear how Hagel's trip would be viewed by U.S. Republicans who bitterly fought his nomination to become defense chief, portraying him as soft on Iran and questioning his judgment.

Hagel at times appeared sympathetic to the stresses of political life that Karzai must endure.

"I know these are difficult issues for President Karzai and the Afghan people. And I was once a politician," Hagel said. "So I can understand the kind of pressures - especially leaders of countries - are always under."

Additional reporting by Hamid Shalizi

2 US service members killed at special operations base in Afghanistan
By Jamieson Lesko and Jim Miklaszewski, NBC News

KABUL, Afghanistan -- Two U.S. service members were killed and at least eight others injured Monday in a possible insider attack at a special forces site in Afghanistan, U.S. and Afghan officials said.

At least two American service members were killed this morning when a man dressed in Afghan police clothing entered a meeting and opened fire on coalition and Afghan forces. NBC's Mike Taibbi reports.
The shooting occurred at a U.S. special operations outpost in Wardak province in eastern Afghanistan, U.S. officials said. The shooter, who was dressed in an Afghan military or police uniform, was shot and killed.
"We have two confirmed dead, but the toll could rise,” one U.S. official said. 
A senior official in the Afghan Defense Ministry said that at least three Afghans were also killed.
The Taliban claimed responsibility for the attack in a text message sent by Taliban spokesman Zabihullah Mujahid. The group has falsely claimed responsibility for attacks in the past.

The shooting occurred during a group meeting or briefing, a spokesman for NATO's International Security Assistance Force said.
Monday’s incident marks the first time Americans have been killed by enemy contact in Afghanistan since Jan. 7, according to U.S. officials.
The attack took place as a deadline expired for U.S. special forces to leave Wardak, after Afghan President Hamid Karzai accused them and Afghans working for them of overseeing torture and killings in the area. 
It was not immediately clear if the attack was directed at U.S. special forces. 
U.S. Secretary of Defense Chuck Hagel, who left Afghanistan early on Monday after a three-day visit, raised the sensitive issue of Wardak when he met Karzai. 
U.S. forces have denied involvement in any abuses in Wardak.
Other issues besides Wardak have pointed to a particularly strained relationship between Kabul and Washington of late.

Slideshow: Afghanistan: Nation at a crossroads

Rahmat Gul / AP

More than ten years after the beginning of the war, Afghanistan faces external pressure to reform as well as ongoing internal conflicts.
On Sunday, Karzai said in a speech that the U.S. was colluding with the Taliban to keep foreign forces in Afghanistan beyond next year's planned withdrawal, and he went so far as to accuse the two sides of holding daily meetings.

A planned joint press conference with Hagel and Karzai was canceled shortly after Karzai's comments. "Security concerns" were cited as the reason.

The commander of coalition forces, U.S. General Joseph Dunford, and a Taliban spokesman rejected all of Karzai’s assertions unequivocally.
By Sunday night, Dunford was compelled to say the U.S. did "not have a broken relationship” with Karzai or a lack of trust. Hagel told reporters that as a former politician himself he “can understand the kind of pressures national leaders are always under,” and that the two countries will be able to move forward together.

Reuters contributed to this report.

Paul Ryan Reveals His Plan to Balance the Budget in 10 Years Includes Repealing Obamacare

9:19 am ETMarch 10, 2013

This week, Rep. Paul Ryan (R-WI) is expected to lay out a plan to balance the budget in 10 years. On Fox News Sunday, Ryan explained, “The reason we do a balanced budget is not to simply make the numbers add up. It leads to a healthy, growing economy that creates jobs.”

The congressman says Republicans don’t want to reopen the fight over the fiscal cliff and are also proposing pro-growth tax reform. “No more crony politics, stop picking winners and losers, pro-growth tax reform — those things are still achievable and we achieve them in this budget.”

Instead of absolute spending cuts, Ryan is proposing cuts in the rate of growth. He said his plan promotes Medicare reform which includes the repeal of Obamacare. Chris Wallace pointedly asked, “Are you saying that as a part of your budget […] you assume the repeal of Obamacare?”

“Yes,” Ryan simply answered.

“Well, that’s not going to happen,” Wallace said.

“We believe it should. That’s the point. This is what budgeting is all about,” said Ryan. He went to say that they’d replace it with patient-centered health care instead of a “rationing board” system like Obamacare.

Will Republicans in Congress and the president reach a compromise? President Obama had lunch with Republicans including Ryan on Thursday and will go to Capitol Hill next week to meet with Senate Republicans for the first time in almost three years. Ryan blamed the stalemate on President Obama, slamming his plan for raising taxes as one that aims to fuel more spending rather than reducing the deficit. “Tax reform to us is an economic growth generating exercise. Tax reform to the president so far seems to be a spending growth exercise.”

Wallace asked Ryan if he has plans on seeking House speakership or possibly the presidency. Ryan didn’t rule it out but said that until he figures out how to close the budget gap, he won’t be thinking about running for president just yet.

Despite having a positive experience as the GOP vice presidential candidate, he said, “I’ve always believed a better place for me is in policy leadership, like being a chairman. […] I shouldn’t be clouding my judgment today by thinking about some political thing four years from now.”

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Affordable Care Act Tax Provisions

Effect of Sequestration on Small Business Health Care Tax Credit

Pursuant to the requirements of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended, certain automatic cuts took place as of March 1, 2013. These required cuts include a reduction to the refundable portion of the Small Business Health Care Tax Credit for certain small tax-exempt employers under Internal Revenue Code section 45R. As a result, the refundable portion of your claim will be reduced by 8.7 percent. The sequestration reduction rate will be applied until the end of the fiscal year (Sept. 30, 2013) or intervening Congressional action, at which time the sequestration rate is subject to change.


The Health Care Law generally has no new impacts to the Form 1040 series for the 2012 returns that individuals may be currently filing. However, if you received a health insurance premium rebate during 2012, check under Medical Loss Ratio to see if you are one of the few people who needs to include it on your 2012 return. If you do not have a tax filing requirement, you do not need to file a 2012 federal tax return to establish future eligibility or qualify for future financial assistance to purchase health care coverage through an exchange. To find out if you have to file a federal tax return for other reasons, use the IRS Interactive Tax Assistant.

If you are seeking information about how to obtain health care coverage or financial assistance to purchase health care coverage for you and your family, visit the Health and Human Services website,

InformaciĆ³n en EspaƱol: Disposiciones del Acta del Cuidado de Salud de Bajo Precio

The Affordable Care Act was enacted on March 23, 2010. It contains some tax provisions that are in effect and more that will be implemented during the next several years. The following is a list of provisions for which the IRS has issued proposed and/or final guidance; additional information will be added to this page as it becomes available.

IRC §7216, Disclosure or Use of Information by Tax Return Preparers

Final Treasury Regulations on rules and consent requirements relating to the disclosure or use of tax return information by tax return preparers became effective Dec. 28, 2012. For additional information about how these apply to services and education related to the Affordable Care Act, please see ourquestions and answers

Medical Loss Ratio (MLR)

Beginning in 2011, insurance companies are required to spend a specified percentage of premium dollars on medical care and quality improvement activities, meeting a medical loss ratio (MLR) standard. Insurance companies that are not meeting the MLR standard will be required to provide rebates to their consumers beginning in 2012. For information on the federal tax consequences to an insurance company that pays a MLR rebate and an individual policyholder who receives a MLR rebate, as well as information on the federal tax consequences to employees if a MLR rebate stems from a group health insurance policy, see our frequently asked questions.

Reporting Employer Provided Health Coverage in Form W-2

The Affordable Care Act requires employers to report the cost of coverage under an employer-sponsored group health plan on an employee’s Form W-2, Wage and Tax Statement, in Box 12, using Code DD. Many employers are eligible for transition relief for tax-year 2012 and beyond, until the IRS issues final guidance for this reporting requirement.

The amount reported does not affect tax liability, as the value of the employer excludible contribution to health coverage continues to be excludible from an employee's income, and it is not taxable. This reporting is for informational purposes only, to show employees the value of their health care benefits.

More information about the reporting can be found on Form W-2 Reporting of Employer-Sponsored Health Coverage.

Net Investment Income Tax

A new Net Investment Income Tax goes into effect starting in 2013. The 3.8 percent Net Investment Income Tax applies to individuals, estates and trusts that have certain investment income above certain threshold amounts. The IRS and the Treasury Department have issued proposed regulationson the Net Investment Income Tax. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Net Investment Income Tax, see our questions and answers.

Additional Medicare Tax

A new Additional Medicare Tax goes into effect starting in 2013. The 0.9 percent Additional Medicare Tax applies to an individual’s wages, Railroad Retirement Tax Act compensation, and self-employment income that exceeds a threshold amount based on the individual’s filing status. The threshold amounts are $250,000 for married taxpayers who file jointly, $125,000 for married taxpayers who file separately, and $200,000 for all other taxpayers. An employer is responsible for withholding the Additional Medicare Tax from wages or compensation it pays to an employee in excess of $200,000 in a calendar year. The IRS and the Treasury Department have issued proposed regulations on the Additional Medicare Tax. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Additional Medicare Tax, see our questions and answers.

Minimum Value

On April 26, 2012, the Department of the Treasury and IRS issued Notice 2012-31, which provides information and requested public comment on an approach to determining whether an eligible employer-sponsored health plan provides minimum value. Starting in 2014, whether such a plan provides minimum value will be relevant to eligibility for the premium tax credit and application of the employer shared responsibility payment. 

Information Reporting on Health Insurance Coverage

On April 26, 2012, the Department of the Treasury and IRS issued Notices 2012-32 and 2012-33, which invited comments to help inform the development of guidance on annual information reporting related to health insurance coverage. The information reporting is to be provided by health insurance issuers, certain employers that sponsor self-insured plans, government agencies and certain other parties that provide health insurance coverage.

Disclosure of Return Information

On April 27, 2012, the Department of the Treasury and the IRS issued proposed regulations with rules for disclosure of return information to be used to carry out eligibility determinations for advance payments of the premium tax credit, Medicaid and other health insurance affordability programs. The proposed regulations solicit public comments.

Small Business Health Care Tax Credit

This new credit helps small businesses and small tax-exempt organizations afford the cost of covering their employees and is specifically targeted for those with low- and moderate-income workers. The credit is designed to encourage small employers to offer health insurance coverage for the first time or maintain coverage they already have. In general, the credit is available to small employers that pay at least half the cost of single coverage for their employees. Learn more by browsing our page on the Small Business Health Care Tax Credit for Small Employers and our news release.

Health Flexible Spending Arrangements

Effective Jan. 1, 2011, the cost of an over-the-counter medicine or drug cannot be reimbursed from Flexible Spending Arrangements (FSAs) or health reimbursement arrangements unless a prescription is obtained. The change does not affect insulin, even if purchased without a prescription, or other health care expenses such as medical devices, eye glasses, contact lenses, co-pays and deductibles. This standard applies only to purchases made on or after Jan. 1, 2011. A similar rule went into effect on Jan. 1, 2011, for Health Savings Accounts (HSAs), and Archer Medical Savings Accounts (Archer MSAs). Employers and employees should take these changes into account as they make health benefit decisions. For more information, see news release IR-2010-95, Notice 2010-59, Revenue Ruling 2010-23 and our questions and answers. FSA and HRA participants can continue using debit cards to buy prescribed over-the-counter medicines, if requirements are met. For more information, see news release IR-2010-128 and Notice 2011-5.

In addition, starting in 2013, there are new rules about the amount that can be contributed to an FSA. Notice 2012-40 provides information about these rules and flexibility for employers applying the new rules and requests comments about other possible administrative changes to the rules on FSA contributions. The notice provides instructions on how to submit comments.

Medical Device Excise Tax

On Dec. 5, 2012, the IRS and the Treasury Department issued final regulations on the new 2.3-percent medical device excise tax (IRC §4191) that manufacturers and importers will pay on their sales of certain medical devices starting in 2013. On Dec. 5, 2012, the IRS and the Treasury Department also issued Notice 2012-77, which provides interim guidance on certain issues related to the medical device excise tax. Additional information is available on the Medical Device Excise Tax page and Medical Device Excise Tax FAQs on

Health Insurance Premium Tax Credit

Starting in 2014, individuals and families can take a new premium tax credit to help them afford health insurance coverage purchased through an Affordable Insurance Exchange. Exchanges will operate in every state and the District of Columbia. The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit. The credit also can be paid in advance to a taxpayer’s insurance company to help cover the cost of premiums. On May 18, 2012, the Treasury Department and the IRS issued final regulations which provide guidance for individuals who enroll in qualified health plans through Exchanges and claim the premium tax credit, and for Exchanges that make qualified health plans available to individuals and employers. Additionally, on Jan. 30, 2013, the Treasury Department and IRS released final regulations on the premium tax credit affordability test for related individuals.

The portion of the law that will allow eligible individuals to use tax credits to purchase health coverage through an Exchange is not effective until 2014.

Exchanges will offer individuals a choice of health plans that meet certain benefit and cost standards. The Department of Health and Human Services (HHS) administers the requirements for the Exchanges and the health plans they offer. Additional information about the Exchange can be found at and in IRS REG-131491-10 issued on Aug. 12, 2011.

Individual Shared Responsibility Provision

Starting in 2014, the Individual Shared Responsibility provision calls for each individual to either have minimum essential health coverage (minimum essential coverage) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return. On Jan. 30, 2013, the Treasury Department and the IRS issued proposed regulations on the Individual Shared Responsibility provision. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Individual Shared Responsibility provision and the proposed regulations, see our questions and answers. Additional information on exemptions and minimum essential coverage is available in proposed regulations issued by the U.S. Department of Health & Human Services.

Health Coverage for Older Children

Health coverage for an employee's children under 27 years of age is now generally tax-free to the employee. This expanded health care tax benefit applies to various work place and retiree health plans. These changes immediately allow employers with cafeteria plans –– plans that allow employees to choose from a menu of tax-free benefit options and cash or taxable benefits –– to permit employees to begin making pre-tax contributions to pay for this expanded benefit. This also applies to self-employed individuals who qualify for the self-employed health insurance deduction on their federal income tax return. Learn more by reading our news release or this notice.

Excise Tax on Indoor Tanning Services

A 10-percent excise tax on indoor UV tanning services went into effect on July 1, 2010. Payments are made along with Form 720, Quarterly Federal Excise Tax Return. The tax doesn't apply to phototherapy services performed by a licensed medical professional on his or her premises. There's also an exception for certain physical fitness facilities that offer tanning as an incidental service to members without a separately identifiable fee. For more information on the tax and how it is administered, see the Indoor Tanning Services Tax Center.

Adoption Credit

For tax years 2010 and 2011, the Affordable Care Act raised the maximum adoption credit per child and the credit was refundable. For more information related to the adoption credit for tax years 2010 and 2011, see our news release, tax tip, questions and answers, flyer, Notice 2010-66, Revenue Procedure 2010-31, Revenue Procedure 2010-35 and Revenue Procedure 2011-52.

For tax year 2012, the credit has reverted to being nonrefundable, with a maximum amount (dollar limitation) of $12,650 per child. If you adopted a child in 2012, see Tax Topic 607 for more information. 

Transitional Reinsurance Program

The ACA requires all health insurance issuers and self-insured group health plans to make contributions under the transitional Reinsurance Program to support payments to individual market issuers that cover high-cost individuals. For information on the tax treatment of contributions made under the Reinsurance Program, see our frequently asked questions.

Medicare Shared Savings Program

The Affordable Care Act establishes a Medicare shared savings program (MSSP) which encourages Accountable Care Organizations (ACOs) to facilitate cooperation among providers to improve the quality of care provided to Medicare beneficiaries and reduce unnecessary costs. More information can be found in Notice 2011-20, which solicited written comments regarding what additional guidance, if any, is needed for tax-exempt organizations participating in the MSSP through an ACO. This guidance also addresses the participation of tax-exempt organizations in non-MSSP activities through ACOs. Additional information on the MSSP is available on the Department of Health and Human Services website.

The Centers for Medicare and Medicaid Services has released final regulations describing the rules for the Shared Savings Program and accountable care organizations. Fact Sheet 2011-11 confirms that Notice 2011-20 continues to reflect IRS expectations regarding the Shared Savings Program and ACOs, and provides additional information for charitable organizations that may wish to participate.

Qualified Therapeutic Discovery Project Program

This program was designed to provide tax credits and grants to small firms that show significant potential to produce new and cost-saving therapies, support U.S. jobs and increase U.S. competitiveness. Applicants were required to have their research projects certified as eligible for the credit or grant. IRS guidance describes the application process.

Submission of certification applications began June 21, 2010, and applications had to be postmarked no later than July 21, 2010, to be considered for the program. Applications that were postmarked by July 21, 2010, were reviewed by both the Department of Health and Human Services (HHS) and the IRS. All applicants were notified by letter dated October 29, 2010, advising whether or not the application for certification was approved. For those applications that were approved, the letter also provided the amount of the grant to be awarded or the tax credit the applicant was eligible to take.

The IRS published the names of the applicants whose projects were approved as required by law. Listings of results are available by state.

Learn more by reading the IRS news release, the news release issued by the U.S. Department of the Treasury, the page on the HHS website and our questions and answers.

Group Health Plan Requirements

The Affordable Care Act establishes a number of new requirements for group health plans. Interim guidance on changes to the nondiscrimination requirements for group health plans can be found inNotice 2011-1, which provides that employers will not be subject to penalties until after additional guidance is issued. Additionally, TD 9575 and REG-4003810, issued by DOL, HHS and IRS, provide information on the summary of benefits and coverage and the uniform glossary. Notice 2012-59provides guidance to group health plans on the waiting periods they may apply before coverage starts. Other information on group health plan requirements is available on the websites of the Departments of Health and Human Services and Labor and in additional guidance.

Annual Fee on Health Insurance Providers

The Affordable Care Act created an annual fee on certain health insurance providers beginning in 2014. On March 1, 2013, the Treasury Department and IRS issued proposed regulations on this provision. Comments may be submitted electronically, by mail or hand delivered to the IRS.

Tax-Exempt 501(c)(29) Qualified Nonprofit Health Insurance Issuers

The Affordable Care Act requires the Department of Health and Human Services (HHS) to establish the Consumer Operated and Oriented Plan program (CO-OP program). It also provides for tax exemption for recipients of CO-OP program grants and loans that meet additional requirements under section 501(c)(29). IRS Notice 2011-23 outlined the requirements for tax exemption under section 501(c)(29) and solicited written comments regarding these requirements as well as the application process. Revenue Procedure 2012-11, issued in conjunction with temporary regulationsand a notice of proposed rulemaking, sets out the procedures for issuing determination letters and rulings on the exempt status of organizations applying for recognition of exemption under 501(c)(29).

An overview of the CO-OP program is available on the Department of Health and Human Services website.

Medicare Part D Coverage Gap “donut hole” Rebate

The Affordable Care Act provides a one-time $250 rebate in 2010 to assist Medicare Part D recipients who have reached their Medicare drug plan’s coverage gap. This payment is not taxable. This payment is not made by the IRS. More information can be found at

Additional Requirements for Tax-Exempt Hospitals

The Affordable Care Act added new requirements for charitable hospitals. (See Notice 2010-39 andNotice 2011-52.) On June 22, 2012, the IRS issued proposed regulations which provide information on the requirements for charitable hospitals relating to financial assistance and emergency medical care policies, charges for emergency or medically necessary care provided to individuals eligible for financial assistance, and billing and collections. Comments on the proposed regulations are requested by Sept. 24, 2012.

Form 990, Schedule H, for tax year 2010 was revised to include a new Part V, Section B, to gather information on hospitals' compliance with the new requirements and on related policies and practices. To give the hospital community time to familiarize itself with the types of information the IRS is requesting, Part V, Section B of Schedule H was made optional for the 2010 tax year (seeAnnouncement 2011-37).

The IRS considered public input and made revisions to Part V, Section B for tax year 2011 (see theForm 990, Schedule H and instructions). Hospitals are required to complete all parts and sections of Schedule H for tax year 2011, with the exception of lines 1-7 of Part V, Section B, which relate to community health needs assessments (see Notice 2012-4). These lines are optional for 2011. The IRS continues to welcome public input on the new requirements for charitable hospitals under the Affordable Care Act.

Annual Fee on Branded Prescription Pharmaceutical Manufacturers and Importers

The Affordable Care Act created an annual fee payable beginning in 2011 by certain manufacturers and importers of brand name pharmaceuticals. On Aug. 15, 2011, the IRS issued temporary regulations and a notice of proposed rulemaking on the branded prescription drug fee. The temporary regulations describe the rules related to the fee, including how it is computed and how it is paid.

On Nov. 4, 2011, the IRS issued Notice 2011-92 which provides additional guidance on the branded prescription drug fee for the 2012 fee year. On Nov. 29, 2012, the IRS issued Notice 2012-74providing similar guidance for the 2013 fee year. 

Modification of Section 833 Treatment of Certain Health Organizations

The Affordable Care Act amended section 833 of the Code, which provides special rules for the taxation of Blue Cross and Blue Shield organizations and certain other organizations that provide health insurance. IRS Notice 2010-79 provides transitional relief and interim guidance on the computation of an organization’s taxpayer’s Medical Loss Ratio for purposes of section 833, the consequences of nonapplication and changes in accounting method. Notice 2011-04 provides additional information and the procedures for qualifying organizations to obtain automatic consent to change its method of accounting for unearned premiums. Notice 2011-51 extends the transitional relief and interim guidance provided in Notice 2010-79 for another year to any taxable year beginning in 2010 and the first taxable year beginning after Dec. 31, 2010. Notice 2012-37 extends the transitional relief and interim guidance provided in Notice 2010-79 for another year to any taxable year beginning in 2012 and the first taxable year beginning after Dec. 31, 2012.

Limitation on Deduction for Compensation Paid by Certain Health Insurance Providers

The Affordable Care Act amended section 162(m) of the Code to limit the compensation deduction available to certain health insurance providers. The amendment goes into effect for taxable years beginning after Dec. 31, 2012, but may affect deferred compensation attributable to services performed in a taxable year beginning after Dec. 31, 2009. Initial guidance on the application of this provision can be found in Notice 2011-2, which also solicited comments on the application of the amended provision.

Employer Shared Responsibility Payment

Starting in 2014, certain employers must offer health coverage to their full-time employees or a shared responsibility payment may apply. On Dec. 28, 2012, the Treasury Department and the IRS issued proposed regulations on the Employer Shared Responsibility provisions. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Employer Shared Responsibility provisions and the proposed regulations, see our questions and answers. Other information, much of which has been incorporated into the proposed regulations, may be found in news releases IR-2011-92 and IR-2011-50 and Notices 2011-73, 2011-36, 2012-17and 2012-58. Additionally, Notice 2012-59 provides related guidance for group health plans on the waiting periods they may apply before starting coverage.

Patient-Centered Outcomes Research Institute

The Affordable Care Act establishes the Patient-Centered Outcomes Research Institute. Funded by the Patient-Centered Outcomes Research Trust Fund, the institute will assist patients, clinicians, purchasers and policy-makers in making informed health decisions by advancing clinical effectiveness research. The trust fund will be funded in part by fees paid by issuers of certain health insurance policies and sponsors of certain self-insured health plans.

The IRS and the Treasury Department have issued final regulations on this fee. 

Retiree Drug Subsidies

Under § 139A of the Internal Revenue Code, certain special subsidy payments for retiree drug coverage made under the Social Security Act are not included in the gross income of plan sponsors. Plan sponsors receive these retiree drug subsidy payments based on the allowable retiree costs for certain qualified retiree prescription drug plans. For taxable years beginning on or after Jan. 1, 2013, new statutory rules affect the ability of plan sponsors to deduct costs that are reimbursed through these subsidies. See our questions and answers for more information.
For More Information

For tips, fact sheets, questions and answers, videos and more, see our Affordable Care Act of 2010: News Releases, Multimedia and Legal Guidance page.

Page Last Reviewed or Updated: 2013-03-06