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发帖数: 29846 | 1 从揽权到滥权，奥巴马对某些保险公司和大雇主免除奥巴马的医疗法案中提出的保险要
求一年豁免
http://www.nytimes.com/2010/10/07/business/07insure.html
Waivers Aim at Talk of Dropping Health Coverage
By REED ABELSON
Published: October 6, 2010
As Obama administration officials put into place the first major wave of
changes under the health care legislation, they have tried to defuse
stiffening resistance — from companies like McDonald’s and some insurers
— by granting dozens of waivers to maintain even minimal coverage far below
the new law’s standards.
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Charles Dharapak/Associated Press
“The president wants to have a smooth glide path to 2014,” said Nancy-Ann
DeParle, the director of the Office of Health Reform at the White House.
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The waivers have been issued in the last several weeks as part of a broader
strategic effort to stave off threats by some health insurers to abandon
markets, drop out of the business altogether or refuse to sell certain
policies.
Among those that administration officials hoped to mollify with waivers were
some big insurers, some smaller employers and McDonald’s, which went so
far as to warn that the regulations could force it to strip workers of
existing coverage.
At a time when the midterm elections are looming and Republicans have been
vocal in campaigning against the law, reaction to the rollout has been
closely watched.
To date, the administration has given about 30 insurers, employers and union
plans, responsible for covering about one million people, one-year waivers
on the new rules that phase out annual limits on coverage for limited-
benefit plans, also known as “mini-meds.” Applicants said their premiums
would increase significantly, in some cases doubling or more.
These early exemptions offer the first signs of how the administration may
tackle an even more difficult hurdle: the resistance from insurers and
others against proposed regulations that will determine how much insurers
spend on consumers’ health care versus administrative overhead, a major
cornerstone of the law.
Several leading insurers, including WellPoint, Aetna and Cigna, have also
objected to new rules requiring them to cover even those children who are
seriously ill, warning that they will stop selling new policies in some
states because the rules do not protect them from having to cover too many
sick children.
“The hardest part of health reform is always going to be the transition,”
said Peter T. Harbage, a former state health official who is a policy
consultant in Sacramento. He predicts more insurers and employers will lean
on the government to delay or weaken the new regulations. “I think this
pressure just increases until we get to 2014,” he said, referring to the
year that the law will fully go into effect.
How much the administration can, or should, compromise in ways that could
dilute the effect of the new law in the next few years is a subject of much
debate, depending on the politics from state to state or the economic
dynamics in a particular market.
Policy experts say much of the authority to enforce the new law rests with
the states, and they say the federal government may have little ultimate
control over whether insurers will keep offering coverage in specific
markets.
Nancy-Ann DeParle, the director of the Office of Health Reform at the White
House, acknowledged that the concessions given to companies and insurers
reflected attempts to avoid having people lose their current coverage before
the full law goes into effect while meeting the aim of improving that
coverage.
“It is a balancing act,” Ms. DeParle said. “The president wants to have a
smooth glide path to 2014.”
The waivers issued so far include the policies offered by McDonald’s to its
fast-food workers, typically capped at just a few thousand dollars, sold by
a profit-making company owned by Blue Cross and Blue Shield plans. As a
result of the administration’s efforts, McDonald’s says it is “confident
that we’ll continue to provide health care coverage for our 30,000 hourly
restaurant employees.”
Aetna and Cigna have also received waivers to continue selling limited-
benefit policies, according to the list released by the Department of Health
and Human Services, as have small employers like Sanderson Plumbing
Products and Guy C. Lee Manufacturing. HealthMarkets, which offers policies
through MEGA Life and Health and other insurers, says it also plans to apply
for a waiver for some of its plans.
Some states, like Iowa and Maine, have already said they might seek
additional authority from federal officials to exempt some insurers, at
least for a time, because of the potential disruption if carriers leave the
market over the new standards on medical spending.
“We have some very small carriers in the state,” said Susan E. Voss, the
Iowa insurance commissioner, who said she favored letting state regulators
decide whether some carriers should be given more leeway. The state has
already lost some carriers, including the Principal Financial Group, which
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