Fuel Spill: The Republicans Are About to Admit That Obamacare Helps Consumers. (Bet On It.)
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 [change] is likely to fuel continuing Republican efforts this fall to discredit the president’s health care law.
Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.
Some consumers may have to pay even more, as some group health plans will not be required to impose any limit on a patient’s out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday.
— A Limit on Consumer Costs Is Delayed in Health Care Law, Robert Pear, New York Times, today
Damn that Obama administration for forcing people whose insurance policies now have no limit on patients’ out-of-pocket costs to force them to wait another year for that consumer protection to kick in! This is proof positive that we should repeal the statute so that that consumer protection will never kick in!
Freedom! Liberty!
Yep. Definitely fuel for continuing Republican efforts this fall to discredit the president’s health care law. Can’t wait for the fuel spill.
The legal profession has a term for this in its Rules of Evidence: It’s called a statement against interest. The law of physics has a term for it, too: boomerang.
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UPDATE: Ezra Klein posted a good Wonkblog post yesterday explaining what happened, and why. 8/14
beverly
don”t count on it. way i read this is that obamacare is subject to politics in a way that will make sure the people are required to pay for insurance but will not get the protections from the private insurers promised them.
the R’s don’t care about logic because the people don’t care about logic, or even remember what was said to them from one day to the next. unfortunately you can no longer tell the R’s from the D’s.
Well, I think it’s clear that this administration is deep in the pockets of big businesses, corporations and now insurance companies. He gives big businesses and corporations an exemption, and it is going to cost the taxpayer billions. Then he removes the insurance cap that would protect them from insurance gouging.
So all you Obamabots, how do you people sleep at night? You scream and rant about the one percent, whilst your bestowed King beats the financial crap out of the middle class whilst giving the elite one percent a free pass? Bait and switch, bait and switch.
The waviers are temporary and always have been.
So true, Coberly. The Red Team/Blue Team paradigm is truly brilliant. In 3 years after people are thoroughly disgusted with Obama, the people will elect an equally corrupt Red Teamer, then the Red Team voters will promptly fall asleep. So long as the people can blame the other party, they don’t blame the guys who control both of them. Brilliant.
Not sure what you’re referring to, cynthia, when you say he gives big businesses and corporations an exemption that is going to cost the taxpayer billions.
But your comment that then he removes the insurance cap that would protect them from insurance gouging is ridiculous–although it does show that this may be an issue that, although not really complicated, is very susceptible to misunderstanding by people like, well, you. He’s removing this particular cap, for one year, for some insurance companies, that exists at all by sole virtue of the Obamacare statute. It pertains only to people who currently have insurance policies with no, or a higher, cap.
No, Dale, you’re misunderstanding. This applies only to people with current policies, not to people who get policies through the new insurance exchanges.
Beverly-Why is the administration doing this? Why are they hurting certain consumers in 2014? Who is to say Mr. Obama will delay the cap again in 2015? Maybe even delay the employer mandate again as well. All the picking and choosing which aspect of the law will be implemented and which part of the law will be delayed implies either incompetence or political calculations that would make Macheavelli blush. It just seems weird that so much political effort was made to pass this law and now it just seems to be falling apart.
Little John:
Do you have employer sponsored insurance now? If so, you probably have an out-of-pocket cap already. Mine was $2,000 for surgery, hospitalization, etc, and another $1,000 for drugs. From September of 2012 till March 2013, I satisfied it twice.
Since Congress wrote the PPACA, I would have to agree they are not too competent. A large percentage of them (Republicans) refused to participate in writing healthcare reform, a smaller percentage (Lieberman, Baccus, etc.) were in it for their own interests so we missed out on single payer or Medicare for 50 and above, and the Dems appear to waffle back and forth. It is surprising we got anything out of them.
You think the PPACA is complex, get a hold of the underwriting for group and individual healthcare plans. They are just as complex, single spaced, and in smaller type.
Beverly
no. i don’t think i misunderstood. what i said was the impression the most recent retrenchment gives me is that the political games that will be played with obamacare will mean the while we are forced to buy insurance from the current medical mafia, the promised protections will turn out to be unreliable.
i think i understand that those people who have expensive medical conditions… or expect to have them… or even deeply pity those who do… feel they will be better off under obamacare. perhaps they will.
my feeling is that the original problem… high cost of american health care… has not been solved. except that the insurance companies have been saved from their own greed by being given new customers who otherwise would have felt, rightly or wrongly, that it was a bad deal for them.
Coberly:
You have no basis for this belief:
my feeling is that the original problem… high cost of American health care… has not been solved. except that the insurance companies have been saved from their own greed by being given new customers who otherwise would have felt, rightly or wrongly, that it was a bad deal for them.
The S&P Healthcare Indices indicates a slowing of healthcare costs to < than 1% YOY. The CBO has also indicated similar slowing of healthcare cost. Glenn Lafollette and Louise Sheiner of the FED slapped Elmendorf with a report showing healthcare is sustainable at 1% growth. Elmendorf (a killer of Hillarycare at 1/5th the cost of the PPACA) was making up numbers as he went along. When Yves of NC reported on Lafollette and Sheiner's report he was soliciting Yves for a private conversation. The PPACA has enough measures in it to change the cost model from services for fees to better quality outcomes for lower costs.
Little John, read the entire NYT article, which explains why they’re doing it.
Beverly-Will do.
Run-I have been self employed for over nearly 20 years so I have to buy my own coverage. My current deductible is $10,000 but since I’ve never had a claim exceed the deductible my insurance company has reduced that deductible to $5,000. That’s my out-of-pocket cap.
Little John:
$5,000 is peanuts when it comes to if you had no insurance. My total cost exceeded $100,000 and I have a plague in that Community (where they filmed Shawshank Redemption) Hospital on one of the walls there. I had catastrophic healthcare when I was unemployed. I understand the concern. It will work out eventually.
Run
don’t be so quick to say that someone has “no basis for this belief.” People generally have some basis for what they believe.
In this case there is a difference between “has not solved,” and “may have lowered some costs, or the rate of increase of some costs.”
i will consider the problem solved when american health care costs are the same as those in the civilized world. and even then i’ll be looking for ways to make them lower.
Ezra Klein wrote a good blog post this afternoon explaining it, at http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/13/four-ways-to-understand-the-latest-obamacare-delay/?wpisrc=nl_wnkpm.