A House Oversight and Government Reform subcommittee on Tuesday examined HHS' process to grant waivers from the health reform law's regulations on health plan annual benefit limits, as some members questioned both the fairness and transparency of the process.
House subcommittee examines waiver process
In his opening remarks, Rep. Trey Gowdy (R-S.C.), chairman of the House Committee on Oversight and Government Reform's healthcare subcommittee said the need for these waivers developed because many companies use a health coverage strategy that provides some employees with mini-med plans “that run afoul of current federal rules—mandated by the new healthcare law—that set a minimum dollar limit on essential benefits that healthcare plans must provide in 2011, 2012, and 2013.”
Steve Larsen, deputy administrator and director of CMS’ center for consumer information and insurance oversight, testified that HHS issued its regulation on the law’s phase-in of these annual limits last June, and published a bulletin that laid out the waiver process within 90 days. As of late February, Larsen said his office has approved 94% of the waiver applications it has received and has granted waivers to plans covering about 2.6 million people, or about 2%, of the 160 million people who have employer-sponsored health coverage.
But the statute itself does not explicitly call for such waivers in this process, according to hearing witness Edmund Haislmaier, a senior fellow at the conservative Heritage Foundation. In his testimony, Haislmaier noted that the Patient Protection and Affordable Care Act includes 21 other sections in which Congress did grant HHS such explicit authority. Therefore, Haislmaier said, if Congress had intended the agency to institute a waiver process as part of implementation of this particular provision, it would have done so.
“This is not rule of law; this is the rule of ‘who you know,’” Haislmaier said. “No matter how fairly or how generously one tries to administer it, the whole section is suspect.”
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