Posted by AzBlueMeanie:
On Tuesday the New York Times published this article by Robert Pear, Limit on Costs for Consumers Is Delayed in Health Law:
In another setback for President Obama’s health care initiative, the administration has delayed until 2015 a significant consumer protection
in the law that limits how much people may have to spend on their own health care.
The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a
family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.
The grace period has been outlined on the Labor Department’s Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about
the language — which appeared as an answer to one of 137 “frequently asked questions about Affordable Care Act implementation” — department officials confirmed the policy.
The discovery is likely to fuel continuing Republican efforts this fall to discredit the president’s health care law.
On Mr. Pear's cue, like Pavlov's dog, the right-wing anti-Obama haters barked on command their "ObamaCare is a trainwreck" meme again.
There was actually some good reporting on this yesterday, but you would never know it here in Arizona where the corporate media wants to treat you like a mushroom — keep you in the dark and feed you bullshit.
Jonathan Cohn at The New Republic explained in The Latest Right-Wing Freakout Over Obamacare:
The ruling itself isn't supposed to be such a surprise. The
Administration signaled its intentions in February. But almost nobody
(including me) noticed it until last night, when the Times posted a story by Robert Pear.
Now some of the law’s critics are pouncing. They say it’s more proof
that the law is a “train wreck” and that the administration is sticking
it to consumers.
* * *
Everybody needs to breathe—and to put the story in its proper, rather different context.
The
ruling is indeed frustrating and, for a change, it will actually make a
difference to people who need insurance. Obamacare is supposed to place
a hard limit on your out-of-pocket medical spending. If you have
coverage through an employer—that is, a “group” plan—the limit is
supposed to be $6,350 for an individual and twice that for a family.
But the employers who provide group coverage frequently do so by
breaking out spending into different categories—and, sometimes, hiring
outside companies to manage the different parts. An employee in such a
company would, technically speaking, have several different insurance
plans—one each for medical, prescriptions, dental, and so on.
Employers
told the administration that coordinating records from the different
plans was difficult, so the administration gave them some leeway.
Employers who already have such arrangements—and only employers
who already have such arrangements—can have one extra year to put new
accounting systems in place. During that time, the $6,350 limit will
apply to “major medical”—doctor visits, hospitalizations, and so on—but
not prescriptions, dental, or vision.
For people with chronic disease, that distinction matters. If you
have cancer or multiple sclerosis or bipolar disease, you spend a ton on
prescriptions, on top of all the other money you spend on doctors and
hospitals. Depending on the severity of your condition, you could easily
spend that $6,350 on medical bills and pay still (a lot) more for your
drugs. Julie Appleby of Kaiser Health News has all the details if you want them.
Still,
if you’re on a plan like that now, you face these expenses already.
This decision means only that you’ll wait another year for relief—during
which time, by the way, you’ll benefit from the law’s other
protections. For one thing, you’ll be better off because the spending
cap still applies to major medical expenses, a category that includes
office visits and mental health care. That's not always the case today.
You also don’t have to worry about lifetime caps, which the law
eliminates and people with chronic disease occasionally exhaust. And
that’s not to mention what happens if you end up buying insurance on
your own: Thanks to the law, no insurer can deny you coverage, raise
your premiums, or restrict your coverage because of your pre-existing
condition.
(By the way, an administration official also confirmed that the delay
applies only to group plans. The out-of-pocket limits on the new
insurance exchanges will apply to all covered expenses.)
* * *
Obamacare critics aren't hyping this news because they wish consumer
protections for the sick would take effect now. They're hyping the news
because they wish consumer protections for the sick would go away
forever.
The essential truth of Obamacare remains what it has
always been: It's an imperfect law, being introduced under imperfect
circumstances. But it's still going to make life better for millions of
people—even if some of that helps takes an extra year to arrive.
Greg Sargent writes at the Washington Post, Obamacare: Still not a “trainwreck”:
As Robert Pear reports:
“the administration has delayed until 2015 a significant consumer
protection in the law that limits how much people may have to spend on
their own health care.” Obamacare’s limits on what people pay as part of
deductibles and co-payments has been put on hold.
Ezra Klein has a nice summary of what this means in policy terms.
As he notes, this is a small provision relative to the whole law, and
the Obama administration is showing appropriate flexibility in
implementing a complicated, ambitious reform. Klein also notes the
downside: we still don’t know whether the law — including the
protections designed to limit costs, particularly for the chronically
ill, who would blow past the limits fastest — will work. More delays or
changes may be necessary.
Not all opponents of the law are claiming this latest news proves the law is a “train wreck.” As Ramesh Ponnuru put it, “sometimes a glitch is just a glitch.” Ponuru concluded: “this provision of the law will be able to be implemented.”
* * *
[T]he GOP position is to repeal Obamacare, which is to say, to repeal all
of the law’s consumer protections forever. Now Republicans are hitting
Obama for delaying a portion of the consumer protections for a year?
To be fair, Republicans can argue coherently that today’s news shows
that the consumer protections are unworkable while simultaneously
arguing that the whole law must be repealed. But their criticism
inevitably leads back to a question: do they support such protections
for consumers in principle, or do they oppose them?
Sahil Kapur at Talking Points Memo writes, That Big New Obamacare Setback? Don’t Believe The Hype:
The recent delay of an Obamacare rule capping a person’s health care
costs illustrates the lose-lose political predicament facing President
Obama as he seeks to secure a smooth rollout of his signature
legislative achievement.
The move is separate from the widely discussed one-year delay of the employer mandate.
It would give businesses, large and small, a yearlong reprieve from a
portion of the law that requires them to limit annual out-of-pocket
costs under their health plans to $6,350 for individuals and twice that
amount for families. In 2014, employers that offer coverage through
various [group] plans will only have to abide by the imposed limit for major
medical coverage, but not for other coverage like prescription drugs or
dental, according the Department of Labor.
The out-of-pocket limit will apply as written on the individual health insurance market.
* * *
[Critics make] a politically clever argument — but one that papers over the fact
that these employer reprieves are relatively minor portions of the law,
while the individual mandate is central to its functionality. But more
importantly, the move and its fallout provide a telling example of the
administration’s no-win political situation in smoothing out the edges
of the law’s rollout.
* * *
The Affordable Care Act contains a slew of regulations and mandates
on individuals and businesses in order to make the swath of benefits
under the law economically feasible. Providing some groups a grace
period, whether or not they deserve it, invariably inflames other
constituencies who want their own special treatment. Multiple labor
unions, for instance, were furious that the administration gave large employers a reprieve but didn’t carve out separate exemptions they’ve been asking for.
And conservative lawmakers and advocates, eager to disrupt and
discredit Obamacare, can easily exploit the public’s lack of knowledge
about the complex law and use these moves to paint it as a train wreck
waiting to happen.
As President Franklin Roosevelt said, "It is common sense to take a method and try it. If it fails, admit it frankly and try another, but above all try something."