These one-year waivers are being given to mini-health plans, including those offered by restaurants and teachers unions, to give them time to comply with the law.
Think ProgressBloomberg 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:
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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.
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Basically, the HHS is writing the regulations ahead of the plan's full implementation, and giving waivers to allow time for compliance.
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.
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