Are We Really Capping Health Care Costs If Waivers Are Handed Out?

Nearly a million workers won't get a consumer protection in the U.S. health reform law meant to cap insurance costs because the government exempted their employers.

Thirty companies and organizations, including McDonald's (MCD) and Jack in the Box (JACK), won't be required to raise the minimum annual benefit included in low-cost health plans, which are often used to cover part-time or low-wage employees.

Armstrong, Drew (2010-10-7). McDonald's, 29 other firms get health care coverage waivers. USA Today. Retrieved on 2010-10-7.

Honest question:  are we really capping health care costs if waivers are handed out exempting corporations from minimum levels of coverage?

Tags: Health care (all tags)




Kevin Drum has a great post on this at his blog if you want to educate yourself instead of simply snark on the adminstration - but these waivers last until 2014 when these folks will be able to buy superior and complete coverage on the exchanges that are being set up. Between now and then; waivers are being provided to deal with the gap.


by Rhoda 2010-10-07 03:17PM | 1 recs

This bill does nothing to control costs or actually improve healthcare. Its a sham, just like our President

by BuckeyeBlogger 2010-10-07 08:27PM | 0 recs
RE: Please

Does that mean you support the waivers or oppose them? I mean the if the bill is a sham then the waivers are good, but the waivers were given by the administration, which is also a sham, so the waivers are no good. Your really confused here aren't you?

by vecky 2010-10-08 12:24AM | 0 recs
I think

The whoel thing should be scrapped as is and another bill passed that actually does something to lower costs and improve quality of care. Thsi bill provides access with no measure to reduce costs....

by BuckeyeBlogger 2010-10-08 09:21AM | 0 recs
RE: I think

Providing access is an important indicator of quality, surely you will agree. If you want additional cost savings you can pass another (more socialist!) bill in addition. Stuff like allowing Medicare to negotiate drug prices and establishing a nation-wide pool come 2014 would seem to fit right in. But i'm not sure why the current law needs to be scrapped, indeed that will just make the situation worse.

by vecky 2010-10-08 03:12PM | 0 recs
Stale PNHP talking points by Bucky

People who have been complaining since the Tri-Committee Bill and Senate HELP that there were and are no cost controls simply never read the bill. They exist in the form of the MLR provisions, which in the bill that passed into law were set at the 85/80 level. If implemented effectively, and early signs are that the insurance companies weren't able to game MLR in the way they wanted too, this is an excellent and elegant way to prevent the insurers from cheating even in the absence of a public option.

But you need to know how to read and think. People who want to make an honest attempt at actually engaging the bill that was written and not the fantasy one 'explained' by the fantasists that thought HR 676 (the so-called Medicare for All Bill) was actually a seriously intended piece of legislation can start with this diary from Fall 2009, based on an actual reading of what was in the House Bill 3200 Sec 116.

If you don't understand MLR you don't understand anything about how this bill was actually designed to work by original lead authors Kennedy and Dingell. How the lefter end of the left blogosphere managed to convince themselves that those two guys simply sold them out to the insurance companies after a combined 100 years of trying to get universal health care through is beyond me. Ya think you might have given these guys a little more credit and asked WHERE the cost controls were and instead of just accepting the word of a guy at PNHP that they didn't exist? 

They do. In a battle that got fought under the radar the MLR provisions were dropped from the SFC version and only partially restored in either Reid or Pelosi's final version only to be fully restored at the last minute. Which is why AHIP, who had been supporting the bill right through the Fall suddenly started squealing. THEY fully understood the importance of the MLR provisions even if BB doesn't.

by Bruce Webb 2010-10-11 04:09PM | 0 recs

Increasing access wont do anything but actually lower quality in this case. Why, because we have agrowing shortage of primary care physicians and nurses. It will become and is becoming more difficult for patients to actually see doctors. That needs to be addressed. There are two factors pay disparity between primary care and specialists. That needs to be addressed. Second, the cost of medical and nursing education. Its become more difficult for students to choose healthcare as a profession due to the burden of excessive tuition. Those two items have to be addressed. Further, the curriculum at the majority of medical and nursing schools is on illness treatment and not prevention. There is little attention to nutrition, diet as well as the more natural and holistic approaches to medicine. The current curriculum continues to focus on treating disease rather than preventing it. That has to change and very soon.

by BuckeyeBlogger 2010-10-11 09:56AM | 0 recs
Dean Baker has the answer to that

There are plenty of English speaking primary care physicians in this world, countries like India and the Philipines pump them out at whatever rate one might like. The problem is the barriers to entrance maintained by the AMA and the various certifying boards that have an interest in rationing access to the profession. Break that artificial barrier and let the labor market for MDs operate fully and that access issue goes away.

The other issues Buckeye raises are important but pale in relation to the monopolies controlled by professional societies not just in medicine but in areas like law

by Bruce Webb 2010-10-11 04:28PM | 0 recs
On the main question

There is a fundamental misunderstanding in that story. Nothing in the law REQUIRES employers to keep ANY insurance going prior to implementation of the Exchange and the subsidies that go with them. If MacDonald's wants to drop the admittedly minimal and overpriced plan they currently provide to their low wage workers they can. Since the cost of a family plan up to the law's new standard can easily equal the total amount of wages paid to these often part-time employees the choice for the companies is pretty obvious, without the waivers they will drop the insurance.

Now that leaves the question of whether these plans are a rip-off given the high ratio of premium to covered benefit, but that is different from the question of 'insurance yes or no'. Until subsidies kick in there was never any real question of these firms picking up the entire tab directly, the premise of the question assumes what is almost certainly in all cases a counterfactual.

by Bruce Webb 2010-10-11 04:21PM | 0 recs


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