Health waivers for 2012, 2013 a question

The Obama administration, which has taken flak from Republicans for granting more than 1,000 one-year waivers for a portion of the healthcare reform law, still faces an important question of how to handle waivers in 2012 and 2013, before a major component of the law goes into effect.

The one-year waivers are typically granted to organizations that offer limited health insurance, known as “mini-med” plans, that sometimes provide as little as $2,000 in annual coverage. 

They are meant as a stopgap measure until new state-run health insurance exchanges open, which will mark the end of the so-called “mini-med plans,” according to the Department of Health and Human Services.

But the exchanges don’t start up until 2014, meaning HHS must come up with a plan for stabilizing the health insurance market for an additional two years when this round of waivers expires.

The department is just starting to deal with the problem, but its task is complicated by the lack of existing information about the low-value plans, HHS Secretary Kathleen Sebelius told The Hill on Friday.

“It’s a portion that frankly there isn’t a lot of data about,” Sebelius said. “Part of the waiver issue is also for companies to submit data on where they are, what the plans look like. A lot of them don’t even file at the state level.”

The healthcare law requires a phase-out of annual dollar limits on benefits, with a minimum limit of $750,000 in 2011. The limits gradually rise until they are completely eliminated in 2014.

The waivers for that requirement, which so far covered about 2 percent of the private insurance market, have forced Democrats to go to bat for health plans they have repeatedly criticized. They say the state insurance exchanges will allow consumers to shop for affordable, quality coverage, but until 2014, even the worst insurance is better than none at all.

“I think the balance is some coverage, even if it is pretty skimpy and not very sufficient, versus no coverage, and that’s what we’re trying to look at,” Sebelius said. “For a lot of these folks, there is no other option until we get to the state-based exchanges.”

Republicans have eagerly criticized the waivers as proof that the law doesn’t work, and they have accused the administration of using them to reward union allies.

“The fact that over 1,000 waivers have been granted is a tacit admission that the healthcare law is fundamentally flawed,” said House Energy and Commerce Committee Chairman Fred Upton (R-Mich.), who leads one of two panels that have asked HHS to provide more details on the waivers.

The waivers will receive heightened scrutiny on Tuesday, when the House Oversight’s heath subcommittee examines the criteria and methodology used for evaluating waiver applications.

Republicans have asked HHS for an explanation of why some groups’ applications were denied. On Friday, Sebelius told a House Appropriations subcommittee that HHS has approved more than 98 percent of waiver requests.