Obama Administration proposes to cut yet another great road thru ACA

According to Kaiser Health News, today the administration will propose exempting “certain self-insured, self-administered plans” from the law’s temporary reinsurance fee in 2015 and 2016.  Kaiser notes the exemption will affect mostly Taft-Hartley union plans which are often not only self-insured, but also self-administered.  Thus the exemption would not apply to insurers or to self-insured employers who hire a third-party to adjudicate their medical benefit claims.I haven't been able to find authority in the ACA as enacted that supports this exemption – other than the sweeping discretionary powers given to the Secretary of HHS. (ACA 1321 (a)(1)(D) “such other requirements as the Secretary determines appropriate.”) So this exemption – as with other exemptions and waivers before it – will be implemented by administrative diktat, not by due process in Congress and public debate of the issue.KHN also observes that “Both unions and business have criticized [the new reinsurance fee] as penalizing employer-sponsored health insurance to support plans bought directly from insurers.”I think KHN is correct.  But it seems to me that fact makes it hard to rationalize the proposed new exemption: ■ In the first place, why exempt some union plans but not all?  Not all union plans are self-administered. ■ Second, why is it important to distinguish between self-insured plans?  Why not treat all self-insured plans the same way, regardless whet...
Source: InsureBlog - Category: Medical Lawyers and Insurers Source Type: blogs