Tuesday, July 5, 2011

Obamacare’s Latest Waiver Program

Late Friday afternoon, CMS released several draft payment rules for calendar year 2012.  Included among the 2012 payment regulations was the outpatient hospital proposed rule.  That regulation includes what The Hill described as a waiver program for certain physician-owned hospitals.  While Obamacare prevents most physician-owned hospitals from expanding (and prohibits the construction of new facilities), the regulation provides a process for facilities to seek exemptions to that expansion ban.

CMS’ establishment of this latest waiver program makes it a good time to highlight all the other entities who have already asked for or received waivers from portions of Obamacare:

Unions:  As we’ve previously reported, nearly half of the 3.2 million individuals in plans receiving waivers from the onerous new mandates on annual and lifetime limits are members of union plans.  There has been no official explanation from the Administration why so many recipients of this exemption belong to union plans.  However, Vice President Biden shed some light on this issue over the weekend, when he told a Teamsters rally that “Any of you guys vote Republican…don’t come to me if you do.  You’re on your own, Jack!

AARP:  Recent press coverage has highlighted the fact that AARP’s lucrative insurance business was exempted from many of the law’s mandates – even though AARP claims it never wanted to receive the exemption in the first place.

Nursing Homes:  The New York Times recently reported that the nursing home industry – which supported Obamacare when it passed – is “working with the Administration to figure out if there is some accommodation that can be made” when it comes to exempting nursing homes from the costly employer mandate.

States:  A total of 12 states have already applied for waivers from the medical loss ratio provision – three have been granted, with another nine state applications pending – on the grounds that the regulations will cause insurance carriers to leave the marketplace.

Insurance Brokers:  On Thursday the National Association of Insurance Commissioners task force recommended that insurance agent and broker commissions be removed from the calculation of medical loss ratio.  Due to Obamacare’s new medical loss ratio requirements, broker commissions have been cut so drastically that some agents have lost their jobs – undermining Speaker Pelosi’s claim that the law would create 4 million new jobs.

All these developments raise one obvious question:  If Obamacare is so good, why are so many individuals requesting waivers from it – and why is the Administration granting them?