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January 13, 2014 at 11:48 AM
It looks like an effort to hold down out-of-pocket costs for small-group exchange enrollees could backfire.
Critics of the Patient Protection and Affordable Care Act $2,000 cap on small-group exchange plan deductibles say enforcing the provision as written could wipe out the plans altogether.
Turmoil in the Small Business Health Options Program exchange plan market could have a direct effect on members of Congress and their staffers. PPACA requires them to get coverage through the public exchange.
The U.S. Office of Personnel Management requires the affected officials and government workers who live in the District of Columbia to get their coverage from the D.C. SHOP exchange.
PPACA imposes no caps on deductibles for private “qualified health plans” in the individual exchange market, but it imposes a $2,000 annual deductible for individual coverage and a $4,000 deductible for family coverage in the SHOP market.
The U.S. Department of Health and Human Services waived the deductible for 2014, to help plan issuers hold down co-payments, coinsurance rates and premiums.
