Obamacare

Health Care Waivers For Everyone!

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OK, so not everyone is getting a waiver to opt out from one of the new health care law's requirements. But perhaps everyone should. Already the Department of Health and Human Services seems to have decided that, at least in the reasonably near future, waivers will be handed out generously to unions, businesses, and state governments alike. Last week, Maine became the first state to officially receive an exemption from the law's medical loss ratio provision, which requires insurers to spend a minimum percentage of premium revenue on government-defined "clinical services." HHS has also approved waivers for more than 1,000 businesses and unions—covering a total of about 2.6 million individuals—in order to prevent those employers from dropping health coverage for their employees.

Maybe this suggests that there are problems with the law? Politico has the administration's response:

"When you make changes to the health care system, there are some changes you cannot make immediately," said Steve Larsen, director of HHS's Center for Consumer Information and Insurance Oversight. "The ACA identified a couple important areas where flexibility is needed to achieve the ultimate goal.

"To the contrary of what critics are saying, you'd be hearing that the law doesn't work [if we didn't issue these waivers]," he added.

I'll give Larsen this: He's right that critics would be arguing that the law didn't work even if HHS was not passing out waivers like handfuls of candy at a Christmas parade. That's because it's fairly obvious that, well, certain provisions in the law aren't working—and it would still be obvious whether or not the administration was granting waivers in response.

But the waivers still matter because they serve as an all-but-explicit admission by the administration that some parts of the health care overhaul aren't working. Unions and other employers got waivers in order to prevent individuals from losing their existing health insurance coverage; Maine got out of the law's insurance spending rules explicitly because officials were worried that those rules would destabilize the state's health insurance market (other state waivers are expected to follow). By issuing the waivers, the administration is publicly acknowledging that 1) parts of the law are causing problems in the health insurance market and 2) the problems are severe enough that enforcement of parts of the law should be temporarily suspended, at least in some cases. The message of the waivers, then, is that the law is broken and needs to be fixed.

Now, I'm all for chucking parts of the law and providing flexibility to both employers and state governments. But as I've noted before, the waiver-granting process is not transparent or well defined. That creates uncertainty headaches for applicants and sets up a situation in which it's potentially very easy for the administration to play favorites. It's also inherently unfair to enforce the rules so differently from businesses to business, state to state—especially when the process is so opaque.

So here's a suggestion: Rather than force employers and state governments to play along with the administration's waiver-granting carnival game, why not just ditch—or at least suspend—those provisions entirely? HHS has already admitted, for all practical purposes, that parts of the law simply aren't working. The muddled waiver process is merely a way of preserving the agency's discretionary power—and the fiction that ObamaCare isn't broken.

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  1. We had to pass it to find out what’s in it!

  2. “”To the contrary of what critics are saying, you’d be hearing that the law doesn’t work [if we didn’t issue these waivers],”

    So the laws ‘works’ when people don’t have to obey it.

    1. Equal protection of the law – how the fuck does that work?

  3. What’s it take to be a union? I mean, if I want to certify a commenters union to qualify for such a waiver, can I do that?

    I’m a Floridian, and down here, unions are mostly a myth, like hobbits and elves.

    1. You’re a scab, ProL. Just a dirty scab.

      1. What’s that, some kind of ogre?

    2. Unions are very real here in Tampa and IBEW Local 915 and Plumbers & Pipefitters Local 123, both vocal supporters of ObamaCare, were among the first to apply for and be granted waivers.

      1. I’m in Tampa, too. I was using a little artistic license, but compared to Rust Belt states (or non-right-to-work states), we’re practically unionless.

    3. Those oppressive bastards still have me working here after a 20 hour control design shift.

  4. Every one of those waivers is a twist of the knife in the guts of Obamacare’s supporters. I harp on them constantly just to see them wince in pain.

    That those supporters happen to be friends and family just shows what a bastard I am.

    1. That those supporters happen to be friends and family just shows what a bastard I am.

      They’re supporting a law that virtually enslaves you and nearly every other American, but you’re the one who’s a bastard?

  5. “To the contrary of what critics are saying, you’d be hearing that the law doesn’t work [if we didn’t issue these waivers],” he added.

    So, if they don’t issue waivers, that proves the law works. If they do issue waivers, that proves the law works.

    I’m waiting for someone denied a waiver to bring an Equal Protection lawsuit. The words “arbitrary and capricious” seem to have been coined for just this situation.

    1. Except that “arbitrary and capricious” seems to be the standard for government action these days.

      1. The muddled waiver process is merely a way of
        preserving the agency’s discretionary
        power

        Indeed. Perhaps “arbitrary and capricious” may some day be a legal argument in favor of something.

        1. I envision a day when the Supreme Court throws out the rational relation test in favor of the arbitrary and capricious test. If a government action isn’t at least arbitrarily connected to a capricious government interest, it isn’t constitutional.

  6. What if they threw a healthcare reform and nobody came?

  7. The message of the waivers, then, is that the law is broken and needs to be fixed.

    What law? You mean the law that has been voided?

    1. The fact that the Administration filed a notice of appeal on time means that the stay on Vinson’s ruling is in force and they can continue to implement the law. What do you bet that they drag out the appeal because they know their case is a dog?

  8. “When you make changes to the health care system, there are some changes you cannot make immediately,” said Steve Larsen, director of HHS’s Center for Consumer Information and Insurance Oversight. “The ACA identified a couple important areas where flexibility is needed to achieve the ultimate goal.

    Shorter Steve Larsen:

    “When you make an omlette…”

  9. “To the contrary of what critics are saying, you’d be hearing that the law doesn’t work [if we didn’t issue these waivers],” he added.

    To the contrary, the fact that so many people are seeking waivers is the proof that the law doesn’t work. The issuing or non-issuing of the waivers has nothing to do with it.

  10. That creates uncertainty headaches for applicants and sets up a situation in which it’s potentially very easy for the administration to play favorites.

    In ProgressiveLand, this is a feature, not a bug.

  11. The fact that Obama still has relatively high popularity seems to indicate that alot of folks don’t understand the principle at work here. Most of my friends aren’t concerned that the HHS Secretary can decide whether you do or do not have to obey a law. Cause, you know, healthcare.

  12. “””Rather than force employers and state governments to play along with the administration’s waiver-granting carnival game, why not just ditch?or at least suspend?those provisions entirely? “””

    Because then they would not be able to reward their friends (campaign contributors) and punish their enemies (everyone else)

  13. From the Obama admin’s perspective, the need for waivers is a feature, not a bug. They get lots of campaign contributions from those granted waivers, and they can harm their political enemies by withholding the waivers.

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