Friday, December 20, 2013

Extreme Hardship: White House Delays Portion of #ObamaCare Individual Mandate

The ACA includes a "hardship exemption" that allows individuals in worst case situations to avoid the requirements of the individual mandate. The Obama HHS Administration issued the relaxed rules yesterday afternoon, another delay in what's now nearly two dozen delays in this Democrat debacle.

At the Washington Post, "Obama administration relaxes rules of health-care law four days before deadline":
The Obama administration on Thursday night significantly relaxed the rules of the federal health-care law for millions of consumers whose individual insurance policies have been canceled, saying they can buy bare-bones plans or entirely avoid a requirement that most Americans have health coverage.

The surprise announcement, days before the Dec. 23 deadline for people to choose plans that will begin Jan. 1, triggered an immediate backlash from the health insurance industry and raised fairness questions about a law intended to promote affordable and comprehensive coverage on a widespread basis.

The rule change was issued in a bulletin from the Department of Health and Human Services. It is the second major response by the Obama administration to a public and political furor that erupted in the fall when several million people who bought their own insurance began to receive notices that their policies were being canceled because they fell short of new benefit standards. The cancellations prompted complaints that President Obama had reneged on an oft-repeated promise that, under the Affordable Care Act, people who like their health plans could keep them.

At a news conference in mid-November, an apologetic Obama relented to the criticism, announcing that the federal government would let insurance companies continue for another year to offer individuals and small businesses health plans that do not meet the new requirements. The decision, however , is up to each state’s insurance regulator, and not all have gone along.

This second change, prompted by a group of Democratic senators — most of whom face tough reelection campaigns next year — goes substantially further in accommodating people upset about losing their policies. The latest rule will allow consumers with a canceled health plan to claim a “hardship exemption” if they think the plans sold through new federal and state marketplaces are too expensive.

The ability to get an exemption means that the administration is freeing these people from one of the central features of the law: a requirement that most Americans have health insurance as of Jan. 1 or risk a fine. The exemption gives them the choice of having no insurance or of buying skimpy “catastrophic” coverage.

Until now, the law allowed people younger than 30 to buy catastrophic coverage if they couldn’t afford a better health plan. The exception was an effort to attract young adults who have been particularly prone to avoiding coverage in the past. The law also has allowed hardship exemptions for people 30 and older who could not afford the regular coverage.

It is unclear how many people facing canceled policies will choose no insurance, bare-bones coverage or a plan through the insurance exchanges that meet new federal standards. But the prospect that healthy people with canceled insurance might opt out of the new health plans set off immediate alarm among insurance industry leaders, who already have been worried whether enough people who are inexpensive to cover will sign up.
It's catastrophic alright. A catastrophic cascade of ClusterCare fail. Ezra Klein, of all people, indicates the incentives for further abandonment of the law:
"This latest rule change could cause significant instability in the marketplace and lead to further confusion and disruption for consumers," says Karen Ignani, head of the trade group America's Health Insurance Plans. They worry the White House is underestimating the number of people whose plans have been canceled and who will opt to either remain uninsured or buy catastrophic insurance rather than more comprehensive coverage....

This puts the first crack in the individual mandate. The question is whether it's the last. If Democratic members of Congress see this as solving their political problem with people whose plans have been canceled, it could help them stand against Republican efforts to delay the individual mandate. But if congressional Democrats use this ruling as an excuse to delay or otherwise de-fang the individual mandate for anyone who doesn't want to pay for insurance under Obamacare, then it'll be a very big problem for the law.
It's all f-ked up, but RTWT.

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