Research Briefing

Details Of ObamaCare’s Implementation Will Be Left Up To Unelected Bureaucrats

ObamaCare’s Changes For Children With Pre-Existing Conditions “Not Really That Helpful” According To A Mother. “Starting later this year, President Barack Obama’s health care law requires insurers to accept all children regardless of medical history. But the law doesn’t limit what the companies can charge, and the Thompsons fear that could leave them in the same predicament: still no insurance for two children because it costs too much. ‘If that’s the way it’s going to shake out, it’s not really that helpful,’ said Mary Thompson. She checked with her insurer recently and was told Andrew probably would have to have his own policy. ‘I could be looking at a $500-a-month policy for just the two of them,’ she said.” (Ricardo Alonso-Zaldivar, “Premiums May Undermine Coverage Guarantee For Kids,” The Associated Press, 5/10/10)

Millions Of Americans Who Thought They Could Keep Their Plans Could Lose Them Once Obama Administration Defines Which Plan Will, Won’t Be “Grandfathered.” “Millions of Americans could lose some important benefits of the new health overhaul law depending on how the Obama administration chooses to interpret one term: ‘grandfathered.’ … Consumer groups say that if the definition is too lenient many Americans won’t get the full benefit of the law. Meanwhile, some business groups say that if their plans have to forfeit their grandfather status, they’ll be subject to all the new rules that raise costs and premiums. … The administration, which is writing the regulations that implement the new law, is expected to issue its guidance soon on how it interprets the grandfathering clause.” (Phil Galewitz & Mary Agnes Carey, “Health Law’s ‘Grandfather’ Clause Could Deprive Consumers Of Key Benefits,” Kaiser Health News, 5/10/10)

• Beth Sammis, Maryland’s Acting Insurance Commissioner: “What’s Not Clear To Me Is Actually How We Are Going To Define A Grandfathered Plan…” (Phil Galewitz & Mary Agnes Carey, “Health Law’s ‘Grandfather’ Clause Could Deprive Consumers Of Key Benefits,” Kaiser Health News, 5/10/10)
• Employers Cannot Plan For Next Year Without The New Rules. “Some employers are concerned that changes they typically make every year to their employee health coverage -- such as changing a policy’s co-pays or deductibles – could alter a plan’s grandfathered status. ‘(Employers’) ability to manage future costs will be constrained to some degree,’ said Neil Trautwein, vice president and employee benefits policy counsel for the National Retail Federation. … Employers are anxious to see the new regulations from the Obama administration because they need the information this summer as they develop their health benefits for 2011, said Sally Doubet King, a partner with the McGuireWoods law firm in Chicago. ‘I know of several employers who want to be sure not do anything that would take them out of grandfather status,’ she said.” (Phil Galewitz & Mary Agnes Carey, “Health Law’s ‘Grandfather’ Clause Could Deprive Consumers Of Key Benefits,” Kaiser Health News, 5/10/10)

ObamaCare Forces Companies To Lower Administrative Costs, But Doesn’t Define Health Spending. “Sen. John Rockefeller (D-W.Va.) is scolding the nation’s health insurance companies for ‘gaming’ the new health care law and is pushing the administration and states to impose stringent controls under the law on industry expenditures for non-medical purposes. … Under the new health care reform law, 85 percent of subscriber premiums must be spent on medical costs in the group insurance market and 80 percent in individual plans… [T]he health reform law does not provide any further guidance as to what should be included in those activities…” (Sarah Kliff, “Jay Rockefeller: Insurers ‘Game’ New Law,” Politico, 5/9/10)

• Which Could Lead To Lower Quality Care. “As for the evidence-based regulation of activities that improve health care quality, Zirkelbach points to a 2009 AHIP survey that found 95 percent of insurers ‘provide primary care physicians information on clinical performance and tools that support evidence-based medical care and quality improvement.’ Too stringent of an accounting rule here could edge out spending on such things as health information technology, which the administration has invested heavily in.” (Sarah Kliff, “Jay Rockefeller: Insurers ‘Game’ New Law,” Politico, 5/9/10)