Republicans Demand HHS PPACA Waiver Details

May 25, 2011 at 08:00 PM
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Two Republican lawmakers are asking U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius to give them more information about annual benefits limit requirement waivers.

Sen. Orrin Hatch, R-Utah, the highest ranking Republican on the Senate Finance Committee, and Rep. Dave Camp, R-Mich., the chairman of the House Ways and Means Committee, have sent Sebelius a letter expressing concerns about what they say are inadequate waiver program disclosures.

HHS is phasing in restrictions on health plan annual benefits limits that were included in the Patient Protection and Affordable Care Act of 2010 (PPACA). Starting with policy years beginning between Sept. 23, 2010, and Sept. 22, 2011, non-grandfathered health plans are supposed to have annual benefit caps of at least $750,000. The minimum annual benefits levels will increase twice before 2014. All annual benefits are supposed to go away in 2014.

Many limited-benefit plans have had waivers as low as $2,500.

HHS created a benefits limit waiver program for the limited benefit plans, to keep PPACA from wiping out coverage for the temporary workers, part-time workers and low-wage workers who tend to have the plans.

HHS officials have granted 1,372 waivers, officials say. Larsen estimated during a hearing in February that the waiver program would preserve the health coverage of about 2.4 million of the 160 million U.S. residents who have private, employer-sponsored health coverage.

The Obama administration has released a list of employers and unions that have received benefits limit rule waivers, but it has not released the names of applicants that have been denied waivers or explanations of the denials, Hatch and Camp say.

"The administration's refusal to make public the names of those companies and entities which have been denied waivers, and the reasons for why those waivers were denied, are prime examples of the lack of transparency which has become a hallmark of this administration," Hatch and Camp write in their letter.

Hatch and Camp they have concerns about whether HHS is understating the number of waivers granted and whether political influence affects who gets waivers.

Unions seem to be applying for waivers in droves, while many small business owners say they are unaware of the availability of waivers, Hatch and Camp say in the letter to Sebelius.

"This raises questions about whether your department has failed to conduct meaningful outreach to small businesses on this issue," the lawmakers say.

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