What's with all the health care waivers being granted

[cali]

Well over a thousand waivers have been issued. Here's one of the latest.

Nevada secures partial waiver from federal health care law

By Karoun Demirjian (contact)

Monday, May 16, 2011 | 5:08 p.m.

Nevada got a partial waiver from the health care law — a significant development that Democrats are dismissing as par for the course and Republicans are claiming as a political victory.

The Health and Human Services Department announced late Friday that Nevada had secured a statewide waiver from certain implementation requirements of the Obama administration’s health care law, because forcing them through, the department found, “may lead to the destabilization of the individual market.”

The announcement makes Nevada one of only three states to have compliance requirements under the health care bill waived.

Nevada’s Insurance Division had appealed to the feds to reduce the federal requirement that health plans serving people who buy insurance on their own must spend at least 80 percent of the money they collect on medical expenses. Under the national rule, companies that don’t spend that percentage of revenue on medical costs have to cut policyholders rebate checks starting this year.

Nevada asked that requirement be reduced to 72 percent for one year, arguing that top insurance providers would be so strapped to make the payments that they’d exit the state market.

<snip>

http://www.lasvegassun.com/news/2011/may/16/nevada-secures-partial-waiver-federal-health-care-/

[SeattleVet]

1. They are temporary, and apply to only one provision.

From the White House:

"To ensure that we protect the coverage that these workers have today until better options are available for them in 2014, the law allows HHS, in extreme cases, to issue temporary waivers from the phase out of annual limits. There are some important facts to remember about these temporary waivers:

- The waivers only apply to one provision of the law – the provisions phasing out annual limits. Insurance companies and employers that receive waivers must comply with all other parts of the Affordable Care Act.

- The waivers last one year. Insurance companies must reapply for the waivers each year between now and 2014 when annual limits on coverage will be completely prohibited and individuals will have more affordable and better private insurance choices in the competitive Exchange markets.

- All employers and insurers that offer mini-med plans may apply for a waiver if they demonstrate that there will be large increases in premiums or a significant decrease in access to coverage without a waiver. You can read a list of employers and insurers that have received waivers here."

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And here is a page that explains the waiver process, background, and lists the approved waivers:

http://www.hhs.gov/ociio/regulations/approved_applications_for_waiver.html

[eomer]

3. There are several types, actually. and you're talking about a different type than the article is.

The one discussed in the article is a waiver of the minimum loss ratio rules, which could also be described as a waiver of the cap on overhead and profits.

There's the type you mentioned, which waives the prohibition of annual caps on benefits.

And then there is the type that Vermont would like to have that waives the whole thing if a state implements an alternative that meets the goals of reform in a different way. None of this latter type have been granted yet; under current law they can't be until 2014.

[eomer]

5. Oops, that last word should have been 2017 instead of 2014. (eom)

[jwirr]

2. Waivers allow experimentation in a social program. MN set up its

wonderful community based programs for the developmentally disabled with a waiver. It allowed us to use the money provided for each institutionalized patient in the community instead. Hopefully out of these health care waivers there will come some tested models that really work. So far we actually have one that is offering a single payer plan.

[BzaDem]

4. There is a simple reason for this. For budgetary reasons (to get the bill passed), the big changes

don't occur until 2014 (creating a functioning individual market with exchanges/subsidies).

But many of the regulations take place prior to 2014 (like the medical loss ratios).

This can create problems. For example, if McDonalds doesn't want to deal with the increased medical loss ratio, it can just end healthcare for its employees. But this leaves employees out in the cold until 2014.

In 2014, if McDonalds ends healthcare for its employees, they face a penalty, AND the employee can find a policy in a functioning individual market (and potentially have the cost of the plan partially or fully paid for by the government). So employers will be disincentivized from dropping coverage, AND even if they do the employee will still have options.

So there is a reason in some of these instances to delay certain regulations until 2014, when the consequence of employers dropping plans doesn't result in the employee having no options.