Health Care Law "Waivers"

[BlueDemKev]

Honest question....what are these "waivers" that are being given out and what is their purpose. The conservative propaganda machine is saying that it's proof the law is flawed and also it's a giveaway to Obama's buddies. Now, while I'm certain there is some politics in almost every type of activity inside the beltway, could somebody please enlighten me about these waivers? What are they, whom are they going to, and why?

[grahamhgreen]

1. It is my understanding that the waivers will allow states to set up their own single-payer systems,

or similar.

Vermont is on the forefront of this and they needed a waiver in order to do so.

I believe there is similar legislation in Oregon.

[ejpoeta]

2. the purpose was for them to put up or shut up. if you don't like how we do it,

then find a way to do it yourself but you have to meet the same goals. in some states this will allow them to do a single payer system. Apparently canada got single payer one providence at a time. at least it gives some hope maybe. if one or two states have a single payer system, people will see it working and want it too. Apparently other countries who successfully implement a system isn't enough... they are FOREIGNERS after all. uggh.

[dionysus]

3. the waiver means a state can opt outof the bill if they can provide equivalent, or better coverage

for the same cost or less. this actually allows california and vermont to move forward with state plans for single payer.

it's actually a good thing.

[Jackpine Radical]

4. The waivers would allow states to set up their own healthcare plans

provided they insure at least the same percentage of people as the Federal plan and do not cost individuals more.

This might be the doorway for individual states to set up single-payer systems.

All-in-all, it could be a very good thing. After all, Canada went province-by-province at first, starting with the "socialist" prairie provinces.

[BlueDemKev]

5. Interesting....thanks, guys.

[Maine_Nurse]

6. There are also employer waivers so they don't have to comply with the law...

Mostly the large, minimum-wage type employers so far. Pretty much neuters the laws.

[Bandit]

7. Pretty much puts an end to the Lawsuits from the states..

:shrug:

[jwirr]

8. In the past waivers have been used by states to set up programs

that fit their needs. For instance when the move for community based services for persons with developmental disabilities began MN asked for money that would have ordinarily been used for institutional care to be waived (used) to develop the community programs that they needed to live in the community.

As to health care the waivers will allow states to do pilot programs that will try different ideas to see what works the best. I think that at least two states are asking to try a single payer option. If we here in MN did not have a congress full of teabaggers we would be doing that as well.

I do not think that the feds give up all rights to say what can be done. A state will have to prove that their program works better for the people needing the services.

[Yo_Mama]

9. The waivers you are reading about in the news

are waivers that allow insurance plans to set annual coverage limits which are otherwise now illegal.

It's mostly large employers, and many unions, that have annual coverage limits to hold down the cost of the insurance plans. These waivers are good for a year at a time and will no longer be given as of 2014 when the exchanges go into effect.

This is the HHS page with the current waivers so you can see for yourself:
http://www.hhs.gov/ociio/regulations/approved_applications_for_waiver.html

This is the guidance on the waiver process:
http://www.hhs.gov/ociio/regulations/patient/ociio_2010-1_20100903_508.pdf

These waivers were provided for under the law because otherwise the law would result in people completely losing coverage. In fact, some places didn't bother with the waiver process and just closed out coverage entirely, or simply passed along most of the cost to the employees so a lot of them had to drop coverage entirely.

For 2011, the annual coverage limit cannot be less than 750K. As you can imagine, a plan that had a 50K or 150K annual limit can't absorb that cost. The reason you see a lot of small unions on that list is that membership is often older, so they adopted a lower annual limit to keep costs down. Most plans with 500K limits or 250K limits could adapt by increasing copayments and restricting other coverage.

As to why the waivers are given, I quote from the guidance:
In order to ensure that individuals with certain coverage, including coverage under limited benefit or mini-med plans, would not be denied access to needed services or experience more than a minimal impact on premiums, the interim final regulations contemplated a waiver process for plan or policy years beginning prior to January 1, 2014 for cases in which compliance with the restricted annual limit provisions of the interim final regulations “would result in a significant decrease in access to benefits” or “would significantly increase premiums.”