WASHINGTON BUREAU — The Obama administration has used objective guidelines when granting waivers to limited benefit health plans affected by the new Affordable Care Act benefits limit restrictions, according to officials at the U.S. Government Accountability Office (GAO).
GAO officials who looked into the matter found that the Center for Consumer Information and Insurance Oversight (CCIIO), the agency at the U.S. Department of Health and Human Services (HHS) that handles waiver applications, has granted waivers mostly for applicants that projected the annual limit restrictions would lead to premium increase of more than 10%, in addition to a significant decrease in access to benefits, John Dicken, a GAO directors, writes in a report summarizing the GAO’s annual benefits limit waiver program review.
Conversely, the GAO says, most of the applicants that were denied projected premium increases of 6% or less.
PPACA is supposed to ban lifetime benefits limits in major medical coverage immediately, and it is supposed to phase in a ban on annual benefits limits. CCIIO officials designed the annual benefits limit waiver program to help employers maintain the limited benefit plans they already have through 2014.
In 2014, PPACA is supposed to provide tax credits that millions of people can use to help pay their premiums. Health insurers will be barred from turning away applicants in poor health or basing rates on health status, many employers will have to help pay for workers’ coverage, and individuals and small groups will be able to buy coverage through health insurance exchange programs, if all goes as PPACA supporters hope.
If the CCIIO applies the annual benefits limit rules to limited benefit plans today, before the 2014 changes take effect, the enrollees in those plans may have no way to buy any form of health coverage, waiver program supporters say.
Republican critics of the waiver program say the Obama administration has been using its authority to help its political allies, mostly unions, while imposing burdensome requirements on everyone else.
Several unions have gotten waivers, but most waivers are going to employer plans, according to HHS data.
As of April 25, the CCIIO had received 1,415 annual limit waiver applications and approved most of the applications, the GAO says.
For 1,347 of the applications, or about 95%, CCIIO approved waivers covering all plans in the applications. For another 25 applications, CCIIO approved waivers for some plans and denied waivers for others within the same application.