The Truth About Waivers: Protecting Coverage For Millions Of Americans
Today, you might have seen news stories about waivers from certain provisions of the Affordable Care Act. There has been no shortage of confusion and deliberate obfuscation on this issue and we want to ensure you have the facts.
Under the Affordable Care Act, we have implemented new rules that phase out, by 2014, health insurance companies’ ability to slap restrictive annual dollar limits on the amount they will pay for your care. But between now and 2014, we also want to make sure workers are able to maintain their existing insurance, because on their own they would likely be shut out of the individual market or face unaffordable options. To do that, the Affordable Care Act allows the Department of Health and Human Services to issue temporary waivers from the annual limit provision of the law if it would disrupt access to existing insurance arrangements or adversely affect premiums, causing people to lose coverage. So far, we have granted 1,372 of these waivers to employers, health plans, and others in all 50 states, covering less than 2 percent of the insurance market and protecting coverage for more than 3.1 million Americans. We have been completely transparent about this process, announcing the waiver process in a regulation last summer, publishing clear guidance on the application process on our website, and posting a list of waivers we have granted on our website.
These temporary waivers will not be available beginning in 2014 when annual limits are banned and all Americans will have affordable coverage options. And millions of Americans – including many small business owners – will be able to shop for affordable coverage in new competitive marketplaces.
Some have raised questions about waivers that were recently granted to companies in California. So there’s no confusion, here are the facts:
- A company called Flex Plan Services is a third-party administrator that provides benefit administration services for employers in a number of states, including: California, Washington, Alaska, and Georgia. One type of plan they administer is known as a health reimbursement arrangements (HRA or employer contributions to a tax free account). Many of the company’s clients are hotels, restaurants and home health agencies, all of whom employ low-wage workers.
- On March 23, Flex Plan Services submitted 92 waiver requests on behalf of 45 employer clients. On April 4, 2011, HHS approved the request.
- HHS applied the same standard to the application from Flex Plan Services that it uses when reviewing any application for a temporary waiver. Waivers are only available if the plan certifies that a waiver is necessary to prevent either a large increase in premiums or a significant decrease in access to coverage.
- In addition, enrollees must be informed that their plan offers coverage with a restricted annual limit.
- No other provision of the Affordable Care Act is affected by these waivers: they only apply to the annual limit policy.
The Affordable Care Act puts an end to many of the worst insurance company practices including refusing to sell a policy to a family because someone had cancer or a child has asthma; cancelling coverage when a patient files claims because of an unintentional mistake in their paperwork; and slapping annual or lifetime limits on how much care you can receive. When these rules are fully in place in 2014, our country will be much better off and the cost of coverage will be within reach for the millions of Americans who now live day to day without coverage, worrying about an injury or an illness that could plunge them into bankruptcy. To get from today’s broken system to tomorrow’s patient-centered system takes time and patience through a reasonable transition period. But, together, we will get there.
By: Richard Sorian, Asst. Sec for Public Affairs, HHS, The White House Blog, May 17, 2011
Debunking The Right’s Health Waiver Conspiracy
Is House Minority Leader Nancy Pelosi helping companies in her district get around new health care rules? Conservatives seem to think so, but their evidence is spotty at best.
Last month, the Obama administration granted a reprieve to 204 businesses and policyholders from new health coverage rules under the Affordable Care Act, bringing the total number of waivers to more than 1370. Many of the waivers are for limited benefit or so called “mini-med” plans—controversial rock-bottom plans that provide a very limited amount of coverage (sometimes as little as $2,000 a year) to beneficiaries that are used heavily in low-wage industries like the restaurant business. New federal rules require such plans to offer a minimum of $750,000 of coverage annually, and the waivers exempt the mini-med plans from such rules on a case-by-case basis.
The Daily Caller reported on Tuesday that businesses in Pelosi’s district received nearly 20 percent of the waivers in April, pointing out that many of them went to high-end restaurants and hotels. Sarah Palin piled on in a subsequent interview with the Caller, calling the discovery “unflippingbelievable!” and “corrupt.”
Pelosi’s communications director, Nadeam Elshami, pushed back against the criticisms in an email to Mother Jones, denying that Pelosi’s district received any special treatment. Her office also denied that it was at all involved in the process of granting waivers for these businesses. “It is pathetic that there are those who would be cheering for Americans to lose their minimum health coverage or see their premiums increase for political purposes,” Elshami wrote Tuesday afternoon, emphasizing that health-care waivers “are reviewed and granted solely by the Administration in an open and transparent process.”
In fact, the recent waiver applications from businesses in Pelosi’s district were not even received by the minority leader’s office. Rather, they were submitted directly to the Obama administration through a third-party company, Flex Plan Services, which provides benefit administration to companies in the Bay Area, Washington state, and elsewhere in the country, according to a statement issued by Richard Solarian, an assistant HHS secretary. On March 23, Flex Plan Services submitted applications for annual limit waivers for their clients’ health plan, including 69 businesses in California, 20 in Washington state, two in Georgia, and one in Alaska, including restaurants, home health care providers, and other service-based companies. On April 4, the U.S. Department of Health and Human Services approved the waiver request for all of Flex Plan Services’ clients—not just the ones in Pelosi’s district.
Flex Plan Services never contacted Pelosi’s office about their waiver request, and her office did neither provided any information to the company about the waivers nor helped facilitate the request, according to her spokesperson.
In other words, the reason the waivers were clumped together was because Flex Plan Services—which is in charge of administrating all of these businesses’ health care benefits—had issued a waiver request for the entire group of businesses. Altogether, the Obama administration has granted 1372 waivers and has denied about 100 requests. The mini-med waivers are essentially a stop-gap measure designed to keep employers from dropping health care benefits all together. The White House explains that waivers are granted if conforming to the rules “would disrupt access to existing insurance arrangements or adversely affect premiums, causing people to lose coverage,” acknowledging that the low-benefits plans are sometimes the only option that some employers can offer. The Democrats’ rationale is that the other changes under federal health reform will eventually allow employers to receive better, more affordable coverage under the health insurance exchange, when it begins operating in 2014.
To be sure, it’s worth closely examining which businesses and policyholders have received waivers, as well as which ones have denied them, along with the Obama administration’s rationale for making such decisions. But, as the April waivers reveal, the very fact that reprieves have been granted to businesses residing in democratic districts doesn’t mean the process is unjust. And to assume that the rationale must be political or “corrupt” is to turn a real policy issue into a partisan bludgeon.
By: Suzy Khimm, Mother Jones, May 17, 2011
The Republican Supreme Court Sticks It To The Little Guy (Again)
Once again the United States Supreme Court under Chief Justice John Roberts has shown the nation it will always favor corporations over people even if it means conjuring new law out of thin air. Like Citizens United, the recent 5-4 ruling in AT&T’s favor gutting the power of consumers to file class-action lawsuits against giant corporations tips the scales of justice against the people and renders the enormous power of corporations even more enormous.
When I first heard about the case, AT&T Mobility v. Concepcion there was little doubt in my mind that the Gang of Five — John Roberts, Antonin Scalia, Samuel Alito, Anthony Kennedy, and Clarence Thomas would figure out a way to ignore Supreme Court precedent and again apply their judicial activism in service to the corporations, and by extension, to the oligarchy they apparently believe the “founders” intended.
It’s kind of funny when we see Republican presidential candidates like Mitt Romeny, Tim Pawlenty, and Newt Gingrich pandering to the “little guy” denouncing “elites” who are trampling on their rights only to remain mute on the fact that their beloved Republican Supreme Court never, ever rules in favor of the “little guy.”
The Republican president Ronald Reagan gave us Scalia and Kennedy; the Republican president George Herbert Walker Bush gave us Thomas; and the Republican president George W. Bush gave us Roberts and Alito. This cabal has shown over and over again where its true loyalties lie, not to “the law,” not to “the Constitution,” not to “calling balls and strikes,” but to a 21st century version of corporate feudalism. This new corporate feudalism that the High Court is determined to thrust on the nation is even more exploitative than the earlier brand of Medieval feudalism because it is absent noblesse oblige.
The serfs toiling on the corporate plantation can only continue to pay Chase and Bank of America for their underwater mortgages, ExxonMobil and Chevron for their $4 a gallon gas, and AT&T, Comcast, T-Mobile and the rest for the privilege of communicating in a modern society. And if the serfs seek redress the High Court will slap them down before they can get anything substantial off the ground. With Citizens United placing a stranglehold of corporate power over our state, local, and federal system of elections, we cannot turn to our political “leaders” for redress, we can’t turn to the courts, and we certainly can’t turn to trying to morally persuade sociopathic non-human entities called corporations — so where does that leave us?
In the current context of unrestrained corporate dominance it’s unconscionable that the Obama administration has not done more to blunt its disastrous effects. The Justice and Treasury Departments, the Securities and Exchange Commission, the Internal Revenue Service, etc. could be doing a hell of a lot more in bringing balance to the equation of corporations versus people. The administration’s lagging performance in holding Wall Street accountable is well known, but it won’t even lift a finger to block grotesque mergers like the one between Comcast and NBC Universal, and AT&T and T Mobile. In all these mergers and acquisitions it’s always the consumers and the employees who lose, while the CEOs and a select few of shareholders and financiers make out like the bandits they are.
Nothing illustrates the corruption rampant in Washington more than the recent resignation of Federal Communications Commission member, Meredith Attwell Baker, a Republican who Obama appointed to show how “bipartisan” he can be, who is now going to work as a lavishly paid shill for the very industry she was supposedly “regulating.” Ms. Baker will now make the big bucks serving Comcast/NBC Universal after she voted for the merger of Comcast and NBC Universal. Sweet. And few in the Beltway see anything unsavory about it.
Our political leaders, our Supreme Court, our captains of industry and finance, are so out of touch it’s going to be a long, long time before ordinary working people see any relief. All of our institutions, political, economic, even religious, social, and cultural, all of them, are failing the people miserably in pursuit of the Almighty Buck. The cunning game of appointing young ideologues to the bench has paid off handsomely for the corporate power structure. Someone should tell those people running around in tri-cornered hats and talking about the “founders” that it might be wise to save an ounce of their collective wrath for the Republicans who have appointed five Justices who are trampling on individual freedoms in service of corporations.
By: Joseph A. Palermo, The Huffington Post, May 15, 2011
Ron Paul And The Civil Rights Act Of 1964
Last May, then-candidate Rand Paul’s (R) Senate campaign in Kentucky ran into a little trouble. The self-accredited ophthalmologist explained in newspaper, radio, and television interviews that he disapproved of the Civil Rights Act of 1964, because the private sector should be allowed to do as it pleases. “[T]his,” Paul said at the time, “is the hard part about believing in freedom.”
Asked specifically by Rachel Maddow, “Do you think that a private business has the right to say, ‘We don’t serve black people’?” Paul replied, “Yes.” Seven months later, he won easily.
Almost exactly a year later, Paul’s father, Republican presidential candidate Ron Paul, explained his nearly identical beliefs about the milestone civil rights legislation.
MSNBC’s Chris Matthews asked the Texas congressman, “The ‘64 civil rights bill, do you think an employer, a guy who runs his shop down in Texas or anywhere has a right to say, ‘If you’re black, you don’t come in my store’?” And with that, Paul explained he would have opposed the Civil Rights Act, adding, “I wouldn’t vote against getting rid of the Jim Crow laws.”
Matthews noted, “I once knew a laundromat when I was in the Peace Corps training in Louisiana, in Baker, Louisiana. A laundromat had this sign on it in glaze, ‘whites only on the laundromat, just to use the laundromat machines. This was a local shop saying ‘no blacks allowed.’ You say that should be legal.”
Paul didn’t deny the premise, but instead said, “That’s ancient history. That’s over and done with.”
I’d note in response that this isn’t “ancient” history — millions of Americans are old enough to remember segregation, and millions more are still feeling the effects. For that matter, that era is “over and done with” precisely because of laws like the Civil Rights Act of 1964. The country didn’t just progress by accident; it took brave men and women willing to bend the arc of history.
Let’s also not lose sight of the larger context. In 2011, the United States has a member of Congress and a Republican presidential candidate who publicly expresses his opposition to the Civil Rights Act of 1964. And because we’ve grown inured to GOP extremism, this somehow seems routine.
Indeed, it’s unlikely Paul’s rivals for the Republican presidential nomination will feel the need to condemn his remarks, and probably won’t even be asked about them.
By: Steve Benen, Political Animal, Washington Monthly, May 14, 2011
Forget The Rich: Tax The Poor And Middle Class
Nothing is certain but death and taxes, it used to be said, but in the madcap times we live in, even they’re up for grabs.
No matter what proof the White House provides that Osama bin Laden indeed has had his bucket kicked — and at this point even al Qaeda admits he’s dead — there still will be uncertainty. Whether they ever release those damned photos or not, a lunatic few will continue to insist that Osama’s alive and well and running a Papa John’s Pizza in Marrakesh.
As for taxes, having to pay them is no longer a sure thing either, especially if you’re a corporate giant like General Electric, with a thousand employees in its tax department, skilled in creative accounting. You’ll recall recent reports that although GE made profits last year of $5.1 billion in the United States and $14.2 billion worldwide they would pay not a penny of federal income tax. Chalk it up to billions of dollars of losses at GE Capital during the financial meltdown and a government tax break that allows companies to avoid paying US taxes on profits made overseas while “actively financing” different kinds of deals.
It gets worse. In 2009, Exxon-Mobil didn’t pay any taxes either, and last year, they had worldwide profits of $30.46 billion. Neither did Bank of America or Chevron or Boeing. According to a report last week from the office of the New York City Public Advocate, in 2009, the five companies, including GE, received a total of $3.7 billion in federal tax benefits.
As The New York Times‘ David Kocieniewski reported in March, “Although the top corporate tax rate in the United States is 35 percent, one of the highest in the world, companies have been increasingly using a maze of shelters, tax credits and subsidies to pay far less… Such strategies, as well as changes in tax laws that encouraged some businesses and professionals to file as individuals, have pushed down the corporate share of the nation’s tax receipts — from 30 percent of all federal revenue in the mid-1950s to 6.6 percent in 2009.”
What’s greasing the wheels for these advantages is, hold on to your hats, cash. Over the last decade, according to the NYC public advocate’s report, those same five companies — GE, Exxon-Mobil, Bank of America, Chevron and Boeing — gave more than $43.1 million to political campaigns. During the 2009-2010 election cycle, the five spent a combined $7.86 million in campaign contributions, a 7 percent jump over their 2007-2008 political spending.
“These tax breaks were put in place to promote growth and create jobs, not bankroll the political causes of corporate executives,” Public Advocate Bill de Blasio said. “… No company that can afford to spend millions of dollars to influence our elections should be pleading poverty come tax time.”
And by the way, those campaign cash figures don’t even include all the money those companies funneled into the 2010 campaigns via trade associations and tax-exempt non-profits. Thanks to the Supreme Court Citizens United decision, we don’t know the numbers because, as per the court, the corporate biggies don’t have to tell us. Imagine them sticking out their tongues and wiggling their fingers in their ears and you have a pretty good idea of their official position on this.
Meanwhile, last week Republicans like Utah’s Orrin Hatch, ranking member of the US Senate Finance Committee, grabbed hold of an analysis by Congress’ nonpartisan Joint Committee on Taxation and wrestled it to the ground. The brief memorandum reported that in the 2009 tax year 51 percent of all American taxpayers had zero tax liability or received a refund. So why, the Republicans asked, are Democrats and others so mean, asking corporations and the rich to pay higher taxes when lots of other people — especially the poor and middle class — don’t pay taxes either?
Hatch told MSNBC, “Bastiat, the great economist of the past, said the place where you’ve got to get revenues has to come from the middle class. That’s the huge number of people that are there. So the system does need to be revamped… We have an unbalanced tax code that we’ve got to change.”
All of which flies in the face of reality. As Travis Waldron of the progressive ThinkProgress website explained, “The majority of Americans who do not pay federal income taxes don’t make enough money to qualify for even the lowest tax bracket, a problem made worse by the economic recession. That includes retired Americans, who don’t pay income taxes because they earn very little income, if they earn any at all.
“And while many low-income Americans don’t pay income taxes, they do pay taxes. Because of payroll and sales taxes — a large proportion of which are paid by low- and middle-income Americans — less than a quarter of the nation’s households don’t contribute to federal tax receipts — and the majority of the non-contributors are students, the elderly, or the unemployed.”
What’s more, ThinkProgress notes, “The top 400 taxpayers — who have more wealth than half of all Americans combined — are paying lower taxes than they have in a generation, as their tax responsibilities have slowly collapsed since the New Deal era.” In the meantime, “working families have been asked to pay more and more.”
So maybe death and taxes are no longer certain, but one thing remains as immutable as the hills. In the words of another golden oldie, there’s nothing surer — the rich get rich and the poor get poorer.
By: Michael Winship, CommonDreams.org, May 10, 2011
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