Obama Admin Seeks To Mollify Big Companies By Granting Waivers On Health Care

[Me.]

“As Obama administration officials put into place the first major wave of changes under the health care legislation, they have tried to defuse stiffening resistance — from companies like McDonald’s and some insurers — by granting dozens of waivers to maintain even minimal coverage far below the new law’s standards.

The waivers have been issued in the last several weeks as part of a broader strategic effort to stave off threats by some health insurers to abandon markets, drop out of the business altogether or refuse to sell certain policies.

Among those that administration officials hoped to mollify with waivers were some big insurers, some smaller employers and McDonald’s, which went so far as to warn that the regulations could force it to strip workers of existing coverage.

At a time when the midterm elections are looming and Republicans have been vocal in campaigning against the law, reaction to the rollout has been closely watched.”…cont…

http://www.nytimes.com/2010/10/07/business/07insure.html?_r=2&hp

[PoliticAverse]

1. I'm shocked, shocked the powerful don't have to follow the same rules as everyone else... n/t

[ProSense]

2. This is not what this is about.

These one-year waivers are being given to mini-health plans, including those offered by restaurants and teacher's unions, to give them time to comply with the law.

If Horrible Insurance Is Outlawed, Only Outlaws Will Have Horrible Insurance

[USArmyParatrooper]

3. +1

Nip it in the bud.

[Me.]

4. McDonald's Is Not Mini Anything

More time needed to comply is bogus especially as most of it doesn't kick in till 2014. The article calls it mollifying and that is exactly what it is.

[H2O Man]

6. I agree.

[ProSense]

7. Yes, it is, and

frankly, it sucks.

To call that "insurance" is to distort the definition, since these policies would do very little to help people with even moderately serious medical conditions. (You can blow through $10,000 in medical care with one emergency room visit.) And those are the people whom insurance is supposed to help, since they are the ones who face serious financial hardship or have serious trouble getting access to care. As Aaron Caroll, who now blogs at the Incidental Economist, wrote several months ago when the issue first came up, "There are a host of health insurance plans out there that are cheap. It’s just that the majority of those also are crappy. Sure, they’re great if you’re healthy. They only stink when you get sick; but that’s when you need them." (Actually, they're not even so great if you're healthy--but that's a story for another time.)

In the long run, McDonald's employees need policies that protect them in case of serious medical problems. And they need policies they can afford. They'll get those policies thanks to the Affordable Care Act--but not until 2014, because the administration and Congress couldn't come up with enough money to implement the full scheme sooner.

For now, some fast-food workers can take advantage of the law's early benefits, like the temporary insurance plans for people with pre-existing conditions that the administration and the states have been starting. But for the most part these people will have to wait.

They may get to keep their McDonald's brand insurance. But they still won't have insurance.

more

Think Progress

Bloomberg is reporting that “almost a million workers, one-third of them members of New York’s teachers union, were left out of a consumer protection in U.S. health law meant to cap insurance costs after the government exempted their employers.” “Thirty companies and organizations, including Jack in the Box Inc. and the United Federation of Teachers, won’t be required to raise the minimum annual benefit included in low-cost health plans covering seasonal, part-time or low-wage employees.”

The waivers are intended to prevent employers that offer so-called mini-med plans — subprime insurance that restricts the number of covered doctor visits or imposes a relatively low maximum on insurance payouts — from dropping coverage, but there is also very real concern that this approach would deprive too many workers of the law’s protections:

<...>

To be sure, HHS is in a rather tough spot. If companies respond to the new regulations by dropping insurance coverage, low-wage employees will have to either go uninsured until 2014 (when the exchanges kick in) or try to enroll in Medicaid or the new high-risk insurance pools, for which they may be ineligible and may have some trouble affording. As Aaron Carroll of the Incidental Economist explains it, Democrats are facing the three-legged-stool problem. You can’t give people access to affordable coverage without regulating the insurers, getting everyone into the risk pool through the mandate and providing subsidies for those who need them, but the law implements the regulation leg four years before the subsidy and mandate legs are even attached. And so what you’re seeing now is a stool that just can’t find its balance.

<...>

Basically, the HHS is writing the regulations ahead of the plan's full implementation, and giving waivers to allow time for compliance.

[zipplewrath]

5. Not exactly

These waivers are being given to keep people with some sort of coverage, no matter how meager, until 2014 when alot of these folks will be subject to the mandate, and offered subsidies. Whether that means that by 2014 the people covered by the mini-plans will have new insurance or not is still being hashed out. If they can figure out ways to create compliant plans that the companies will afford remains to be seen. If they can't the employees will then have to look to subsidies to purchase individual plans, or go without.

It's going to be a rough 4 years and some folks are gonna get screwed in the process. The administrations ability to protect everyone is going to be limited. Truth is, even after 2014 it will be easy to find "sob stories" about people who are now worse off.

[Better Believe It]

8. So what kind of waivers and exemptions will they get in 2014? Answer. Lots!

And what kind of government controls over premium costs will be in place?

The answer is .... None!

[zipplewrath]

9. Probably not

In 2014 the penalties go into place for companies that don't provide qualifying plans. The governments plan after that is to move these folks into individual plans, the exchanges, or medicaid. Well, there is the forth categor of "exempt". But I don't expect them to exemmpt the companies at that point. Just let them pay the fine, that is probably less than the cost of actually providing a qualifying plan.

[seafan]

10. There are several more notable facts in this article.

Again, we are confronted with the ongoing fallout from the administration's early decision to cut off at the knees all discussion of expanding Medicare to everyone.


This is what we will be fighting bitterly over for years into the future; just how much sheer profit off of Americans' illnesses that Big Health Insurance and Big Pharma can steal for themselves.

But for the lack of political will, people will continue to face hardship and suffering far into the foreseeable future.


And the real tragedy is that it did not have to be this way.



From the NY Times:


October 6, 2010

.....

These early exemptions offer the first signs of how the administration may tackle an even more difficult hurdle: the resistance from insurers and others against proposed regulations that will determine how much insurers spend on consumers’ health care versus administrative overhead, a major cornerstone of the law.

Several leading insurers, including WellPoint, Aetna and Cigna, have also objected to new rules requiring them to cover even those children who are seriously ill, warning that they will stop selling new policies in some states because the rules do not protect them from having to cover too many sick children.

“The hardest part of health reform is always going to be the transition,” said Peter T. Harbage, a former state health official who is a policy consultant in Sacramento. He predicts more insurers and employers will lean on the government to delay or weaken the new regulations. “I think this pressure just increases until we get to 2014,” he said, referring to the year that the law will fully go into effect.

How much the administration can, or should, compromise in ways that could dilute the effect of the new law in the next few years is a subject of much debate, depending on the politics from state to state or the economic dynamics in a particular market.

.....

According to the article, McDonald's, Aetna, Cigna have received waivers; HealthMarkets is planning to apply for them. Multiple states are also seeking to obtain waivers to protect small insurance carriers in their states, to protect against their pulling out coverage in these states.

The new standards may prove a challenge to the administration in its attempt to protect the limited-benefit plans. Under the legislation, insurers are required to spend at least 85 cents of every dollar in premiums on the welfare of their customers, and many of these plans spend far less.

.....

The struggle to stop insurers from dropping child-only coverage illustrates the limited power that the administration, and some states, may have to pressure companies to participate. While federal officials have tried to address the concerns by insurers that the rules allow parents to wait until their children are sick to sign up, some insurers have remained reluctant to commit to the market.

While states like California can force their hands by passing legislation requiring any insurer who plans to sell policies in the new exchanges to also sell child-only policies, other states have little recourse other than to try to persuade insurers to stay.

.....

And politics surrounding the health care law may intrude. In Minnesota, Gov. Tim Pawlenty, a Republican and a potential 2012 presidential candidate who has long opposed the law, has become the target of accusations that he is stonewalling discussions over certain types of coverage. (He has already refused federal money for rate reviews and to set up the 2014 exchanges.)

.....

Medicare For All was, is, and will continue to be the solution to this cl*$*@#$&*!.


But we are saddled with politicians who are paid handsomely NOT to notice it.

[Cal Carpenter]

11. Is this what people meant when they said the Dems would 'fix the bill'

and make it better?

yeah, better for the insurers and the corporations...not for the people.

This does not bode well.

[Fumesucker]

14. Yes..

SATSQ

[seafan]

18. The administration had it in its hands to fix this at the outset. They punted.

... and only after capitulating to all the backroom deals with Big Insurance, Big Pharma, Max Baucus, Kent Conrad and Ben Nelson.


But WAIT! Max Baucus snagged expanded Medicare for HIS constituents. For the rest of us--- we must not deserve it...


This administration deliberately forfeited an historic opportunity to expand health care to everyone through Medicare. There is absolutely no excuse for this unwillingness to fight for what is right for the people.

[Panaconda]

12. K&R n/t

[seafan]

13. Kick n/t

[Greyhound]

15. K&R. Another "Nobody could've predicted moment"?

Tick, tick, tick...

[dflprincess]

17. When they said they'd "fix it later"

this is not what I expected.

(Though, to tell the truth, I didn't expect them to fix anything).

[bvar22]

16. The real BOMB explodes in 2014.

Thats when MILLIONS of lower Middle Class (Working Class) Americans will be forced to buy Insurance they can't afford to use.
Good thing the Democrats delayed implementation until AFTER the 2012 elections,
because they will be unelectable for a generation.

[asdjrocky]

19. What more do we need people?

How often do they have to do stuff like this to us before we realize they are absolutely out for big money, and not for us?

The foreclosure bill is on the his desk. Will he sign it? At this point, all signs point to yes. No public option. no ending to DADT. Git-Mo? Forget about it.

And here's the problem with our elections, we either get sucks, or really sucks.

[nashville_brook]

20. wow that stinks.

[DirkGently]

21. Sounds like more fallout from the fallacy of crafting "reform" to appeal to corporate interests.