Administration delays ObamaCare caps on out-of-pocket costs (Aug 13, 2013)

Posted by American News Online

Reported by The Hill

By:  Lara Seligman - 08/13/13



The Obama administration has delayed a main provision in President Obama's healthcare reform law that would limit out-of-pocket insurance costs for consumers until 2015.

The cap, which includes deductibles and co-payments, was supposed to limit consumer costs to $6,350 for an individual and $12,700 for a family. But administration officials have quietly delayed the requirement for some insurers, allowing them to set their own limits starting in 2014. The delay has been outlined on the Labor Department's website since February, but went largely unnoticed.

An administration official said the health law would “protect consumers from the worst insurance company abuses, by banning discrimination based on a pre-existing health conditions [sic], ending lifetime and annual limits on what an insurance company will cover, and capping out-of pocket spending to protect Americans and their families.”

“The February guidance builds on these landmark consumer protections by requiring that health plans limit out-of-pocket spending for major medical coverage for the first time, in 2014, on time,” the official added. “This single limit will apply to additional benefits in 2015.”

The move is the latest setback in the administration’s efforts to implement ObamaCare, the president’s signature domestic achievement. Last month the administration decided to delay the law’s employer mandate which forces large businesses to provide healthcare coverage or pay penalties.

An administration official defended the move to delay the cost caps, telling the New York Times that insurance companies which used different computer systems and companies to administer coverage needed time to comply.

“We knew this was an important issue,” the official said. “We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person’s out-of-pocket costs. They asked for more time to comply.”

The delay on cost caps is sure to fuel GOP efforts to discredit and defund the president’s healthcare law.

Before Congress left for its August recess, the Republican-controlled House voted for the 40th time to defund or repeal elements of ObamaCare, and Tea Party lawmakers have vowed to block any spending measures that fund that law, risking a government shutdown after Sept. 30.

“Once again the president is giving a break to big businesses struggling with his health care law while individuals and families unfairly remain stuck under its mandates,” said Speaker John Boehner (R-Ohio) in a statement. “This report is just the latest evidence that the law is too costly and too complex to work – and that it’s not being implemented fairly.”

“Almost as troubling as the continued failures of the law’s implementation is the lack of transparency,” he continued. “Burying this announcement online in a ‘maze of legal and bureaucratic language’ shows little concern for the promises with which this law was sold. What else in the law isn’t working that we don’t yet know about?”

Boehner said "American families deserve a break" from the health law's mandates as well, calling on the Senate to take up the House measure delaying the individual mandate when lawmakers return from recess.

Both supporters and opponents of the law have launched campaigns to sway public opinion as the administration prepares to begin enrolling consumers in its insurance exchanges on Oct. 1.

The delays underscore the challenges the Obama administration faces as it attempts to roll out the healthcare law. Polls continue to show that the overhaul is unpopular and misunderstood by the public.

The administration, though, insists the law’s implementation is on schedule.

White House press secretary Jay Carney said last month that the administration was “moving forward” and said Republicans had presented no viable alternative to Obama’s healthcare reforms.

Boehner last month, however, vowed “a lot more” votes to derail the law.

Republicans said the delay of the employer mandate highlighted that the law, as a whole, was unworkable.



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