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Politico...
Waivers at center of
health debate
By Sarah Kliff
3/14/11
Exceptions may become the rule as the Affordable Care Act heads into
its second year.
Officials at the Department of Health and Human Services have approved
no fewer than 1,040 requests for so-called mini-med waivers, which
would allow companies to cap their annual payouts at a lower level than
dictated by the law.
And over the next year, many states will seek a reprieve from two of
the law’s most wide-reaching provisions: the medical loss ratio, which
limits profits and administrative costs by requiring insurers to spend
at least 80 percent of subscriber premiums on medical costs; and the
maintenance-of-effort provision barring states from dropping Medicaid
eligibility before the program’s expansion in 2014.
In a bellwether last week, the agency granted Maine the country’s first
medical-loss-ratio waiver, concluding the new regulation could drive
insurers away from the state’s small individual insurance market. HHS
is weighing similar requests from New Hampshire, Nevada and Kentucky.
Officials in a third of the states tell POLITICO they’ll ask Washington
for waivers that will allow insurance companies to set aside more money
for administration costs and profits. And more than half of the states
are eying waiver requests to the Medicaid requirement.
That’s all alongside the State Innovation Waivers that the Obama
administration has strongly advocated. The provision allows states to
opt out of key health reform programs, like the mandated purchase of
health insurance and building an insurance exchange, if they meet high
benchmarks for coverage and affordability. Oregon and Vermont are
expected to pursue these waivers and have secured the president’s
support on moving their effective date to 2014 from 2017, when they
currently kick in.
While Republicans charge that companies and states are receiving free
passes from the reform law, Democrats say the administration is
demonstrating flexibility and fairness. Aside from the lawsuits
challenging the law, the waivers have become the center of debate over
implementation, a divisive issue for Obama as he attempts to overhaul a
dysfunctional insurance market without disrupting the system’s
functional parts...
Read the rest of the story at Politico
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