Health Rules Are Waived More Often

Concerned about the potential disruption that would be created by enforcing the new rules, the administration has granted dozens of additional waivers and also made clear that it would modify other rules affecting these policies. Last week, the Department of Health and Human Services issued more guidance, saying it would use a different method of calculating spending for these plans so they would be able to meet new regulations dictating how insurers should use the premium dollars they collect. While critics say these moves could water down the new law, the administration says it is responding to concerns from employers and others that many workers have no other alternative. The new rules also require that the policies clearly say how much coverage they provide and that they do not satisfy the law’s new standards. “This new guidance helps improve transparency so that consumers know the value and quality of the plan they have,” said Steve Larsen, the director of oversight in the agency’s office of consumer information and insurance oversight. “In 2014, higher-quality coverage will be offered at an affordable price in the new exchanges. Until then, the annual waiver process preserves limited benefit plans offered by employers, preventing significant premium increase or loss of access.” But a spokesman for Senator John D. Rockefeller IV, a West Virginia Democrat who favored strict rules on insurance company spending, said he planned to hold a hearing on the issue. Among the waivers recently granted were for employers like Darden Restaurants, which operates the Red Lobster and Olive Garden restaurants, for 34,000 of its workers. Federal officials have granted 111 waivers to employers, insurers and union plans, who are responsible for covering about 1.2 million people. Darden said the waiver would allow it to offer employees access to affordable coverage as the health care law is started. In addition to granting waivers, the administration also said it would establish a different way of calculating the spending for these plans for the first year that “takes into account the special circumstances of minimed plans.”