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Thursday, June 16, 2011
Healthcare Waivers
Depending on your political leanings, the 1,400 waivers granted is either proof the Obama administration’s Patient Protection and Affordable Care Act is flexible or evidence that it harbors a fatal flaw. And with so many high-profile businesses, labor unions and health insurance companies gobbling up waivers, construction company owners naturally are wondering what’s in it for them.
Waivers, temporary permission not to participate in PPACA, ostensibly are issued to organizations that offer “mini-med” insurance plans that cost employees little and offer severely limited benefits. The thinking is, an inferior plan is better than no plan. But these programs do little to allay workers’ liability if they become seriously ill. These limited benefits are why the government banned mini-meds effective 2014, with mandates that benefits rise until that effective date. Waiver applicants want to keep their minimal plans, arguing they can’t afford to increase payouts. It’s interesting that more than half the workers exempted so far are union members, while unions represent far less than 15 percent of America’s workforce.
Congressmen Mike Rogers (R-Mich.) and Dan Boren (D-Okla.) introduced the Health Care Waiver Fairness Act that would allow every small-business owner and even individual citizens to apply for a waiver from the new health care law. Until that bill becomes law, the federal Department of Health and Human Services says a group health plan or health insurance issuer may apply for a waiver. Here’s how to apply:
Send the following in an email to healthinsurance@hhs.gov (use “waiver” as the subject of the email):
1. The terms of the plan or policy form(s) for which a waiver is sought;
2. The number of individuals covered by the plan or policy form(s) submitted;
3. The annual limit(s) and rates applicable to the plan or policy form(s) submitted;
4. A brief description of why compliance with the interim final regulations would result in a significant decrease in access to benefits for those currently covered by such plans or policies, or significant increase in premiums paid by those covered by such plans or policies, along with any supporting documentation; and
5. An attestation, signed by the plan administrator or Chief Executive Officer of the issuer of the coverage, certifying 1) that the plan was in force prior to September 23, 2010; and 2) that the application of restricted annual limits to such plans or policies would result in a significant decrease in access to benefits for those currently covered by such plans or policies, or a significant increase in premiums paid by those covered by such plans or policies.
Employers with more than 50 workers are required by the act to offer health insurance to their employees or pay a fine for each worker who buys coverage on his or her own.
In applying for a waiver from the employer mandate, companies may benefit from taking a page from business groups arguing for a wholesale repeal of the provision. Companies can tailor their waiver request to their own situation. Waiver-seekers could argue that because workers are compensated through both wages and benefits, an artificial – that is, non-market-driven – increase in one (health care benefits) necessarily must result in the decrease in the other (wages).
As Brian Blase, political analyst at the Center for Health Policy Studies at The Heritage Foundation notes, “Productivity gains, not acts of Congress, are required to increase worker compensation over time. The Congressional Budget Office estimates that the employer mandate will cost businesses $52 billion in penalties from 2014 to 2019.”
A similar decrease in wages not only hurts working families, but also stymies economic activity and leaves huge gaps in state and federal tax revenue.
It also can be asserted that the mandate retards hiring practices at a time when the economy is just beginning to recover. Because the rule covers employers of 50 or more workers, those businesses hovering near the threshold will be chary to make hires that make them subject to the mandatory coverage. This will be especially true for low-skilled and low-wage workers, where the cost of providing health care coverage represents a disproportionally high cost.
Finally, applicants can show that the cost of additional health care coverage, or conversely the penalties for not providing it, will be shifted to consumers. Blase notes, “who actually pays the tax is determined by the market forces of supply and demand, not by where Congress ‘places’ the tax. Therefore, a significant part of the cost increase will be passed on to businesses’ customers in the form of higher prices.
On a lighter note, if your company is large enough to be affected, it is unlikely that as a non-union company, your health care package (unlike those of the unions, apparently, given all the waivers organized labor has received) falls into the woefully inadequate mini-med category, John Hayward, a writer at the Conservative-leaning Human Events, offers a few tongue-in-cheek suggestions on how to obtain a waiver. Among his advice is to join a union; work for a health care company, a big company, or the government; better yet, live in a district or state represented by a friend of Barack (it has been well-documented that businesses in Nancy Pelosi’s district have received a metric truckload of waivers and that the entire state of Nevada, represented by Senate Majority Leader Harry Reid, has secured a waiver as well).
Waivers, temporary permission not to participate in PPACA, ostensibly are issued to organizations that offer “mini-med” insurance plans that cost employees little and offer severely limited benefits. The thinking is, an inferior plan is better than no plan. But these programs do little to allay workers’ liability if they become seriously ill. These limited benefits are why the government banned mini-meds effective 2014, with mandates that benefits rise until that effective date. Waiver applicants want to keep their minimal plans, arguing they can’t afford to increase payouts. It’s interesting that more than half the workers exempted so far are union members, while unions represent far less than 15 percent of America’s workforce.
Congressmen Mike Rogers (R-Mich.) and Dan Boren (D-Okla.) introduced the Health Care Waiver Fairness Act that would allow every small-business owner and even individual citizens to apply for a waiver from the new health care law. Until that bill becomes law, the federal Department of Health and Human Services says a group health plan or health insurance issuer may apply for a waiver. Here’s how to apply:
Send the following in an email to healthinsurance@hhs.gov (use “waiver” as the subject of the email):
1. The terms of the plan or policy form(s) for which a waiver is sought;
2. The number of individuals covered by the plan or policy form(s) submitted;
3. The annual limit(s) and rates applicable to the plan or policy form(s) submitted;
4. A brief description of why compliance with the interim final regulations would result in a significant decrease in access to benefits for those currently covered by such plans or policies, or significant increase in premiums paid by those covered by such plans or policies, along with any supporting documentation; and
5. An attestation, signed by the plan administrator or Chief Executive Officer of the issuer of the coverage, certifying 1) that the plan was in force prior to September 23, 2010; and 2) that the application of restricted annual limits to such plans or policies would result in a significant decrease in access to benefits for those currently covered by such plans or policies, or a significant increase in premiums paid by those covered by such plans or policies.
In applying for a waiver from the employer mandate, companies may benefit from taking a page from business groups arguing for a wholesale repeal of the provision. Companies can tailor their waiver request to their own situation. Waiver-seekers could argue that because workers are compensated through both wages and benefits, an artificial – that is, non-market-driven – increase in one (health care benefits) necessarily must result in the decrease in the other (wages).
As Brian Blase, political analyst at the Center for Health Policy Studies at The Heritage Foundation notes, “Productivity gains, not acts of Congress, are required to increase worker compensation over time. The Congressional Budget Office estimates that the employer mandate will cost businesses $52 billion in penalties from 2014 to 2019.”
A similar decrease in wages not only hurts working families, but also stymies economic activity and leaves huge gaps in state and federal tax revenue.
It also can be asserted that the mandate retards hiring practices at a time when the economy is just beginning to recover. Because the rule covers employers of 50 or more workers, those businesses hovering near the threshold will be chary to make hires that make them subject to the mandatory coverage. This will be especially true for low-skilled and low-wage workers, where the cost of providing health care coverage represents a disproportionally high cost.
Finally, applicants can show that the cost of additional health care coverage, or conversely the penalties for not providing it, will be shifted to consumers. Blase notes, “who actually pays the tax is determined by the market forces of supply and demand, not by where Congress ‘places’ the tax. Therefore, a significant part of the cost increase will be passed on to businesses’ customers in the form of higher prices.
On a lighter note, if your company is large enough to be affected, it is unlikely that as a non-union company, your health care package (unlike those of the unions, apparently, given all the waivers organized labor has received) falls into the woefully inadequate mini-med category, John Hayward, a writer at the Conservative-leaning Human Events, offers a few tongue-in-cheek suggestions on how to obtain a waiver. Among his advice is to join a union; work for a health care company, a big company, or the government; better yet, live in a district or state represented by a friend of Barack (it has been well-documented that businesses in Nancy Pelosi’s district have received a metric truckload of waivers and that the entire state of Nevada, represented by Senate Majority Leader Harry Reid, has secured a waiver as well).
Labels: Commercial, Construction Industry, Healthcare, Industrial