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Member, Beacon International Group, Ltd.
WASHINGTON—Regulators have followed objective criteria in deciding requests by limited health care plan sponsors for temporary waivers from a health reform law requirement that they must provide a minimum coverage amount on essential benefits each year, the Government Accountability Office said Tuesday.
Regulators at the Department of Health and Human Services “granted waivers on the basis of applications’ projected significant increases in premiums or significant decreases in access to health care benefits,” the GAO said in a report.
Federal regulators set the waiver criteria last year.
In a sample of 58 approved applications, the GAO found that most plans projected a premium increase of at least 10% if they had to meet the annual limits requirement. By contrast, among 65 plans denied waivers, nearly three-fourths projected premiums increase of 6% or less, GAO said.
95% approved
According to the most recent public information, 1,372 annual limit waivers have been approved, with about 95% of applications receiving approval.
Some Republican health care reform critics have charged that political favoritism played a role in which organizations received the waivers.
But Democrats say the GAO report refutes that charge. “This GAO study makes it absolutely clear that the Republican criticism of the waiver process is just another false criticism of health care reform” Rep. Sander Levin, D-Mich., said in statement.
The waivers are needed because most, if not all, mini-med plans run afoul of federal rules—mandated by the health care reform law—that set a minimum annual dollar limit on essential benefits that health care plans must provide. The minimum limit is $750,000 in 2011, $1.25 million in 2012 and $2 million in 2013.
Starting in 2014, the law bars annual limits for essential benefits.
The minimum limits, though, are far more than the maximum benefits provided through mini-med plans, which typically are offered to low-wage, part-time or seasonal employees.