Administration Playing Politics with Health Care

Is the Obama administration playing favorites in granting friendly corporations and unions waivers for health-care reform mandates?

It’s hard to reach any other conclusion in watching the health overhaul unfold: If you have political connections, you can be protected from some of the most onerous and costly mandates in the legislation.

The latest example is the 700-plus waivers that the administration has granted to companies, labor unions, a few states so they can escape, at least temporarily, some of the new law’s requirement to provide comprehensive health benefits to workers.

Despite the ruling this week by U.S. District Judge Roger Vinson in Florida that the law is unconstitutional, the regulatory machinery to implement it is steamrolling ahead.

With conflicting rulings in at least four courts so far, the U.S. Supreme Court is expected to rule on the case in 2012. There is plenty more time for the administration to continue to pick winners and losers.

The latest wave of waivers shouldn’t surprise us. The health law got through the Senate with an armload of special backroom deals to win key votes – from the Cornhusker Kickback to the Louisiana Purchase. Clearly, the deal making didn’t stop when the law passed.

At least 733 companies, labor unions and states, covering more than 2.2 million members, have managed to get special exemptions from a provision that could cost them more money and, in some cases, cause employees to lose their coverage.

A disproportionate number of those receiving waivers were labor unions that worked hard and spent millions of dollars to get the law passed.

The provision at issue targets plans that provide less than comprehensive coverage, called “mini-med” health plans. These lower-cost plans offer limited benefits but are popular with workers for providing access to doctor’s visits, medications and often some protection for larger bills.

It’s not full coverage, but for millions of hourly workers it’s better than being uninsured.

Companies complained to Secretary of Health and Human Services Kathleen Sebelius that they would have to drop this coverage because it doesn’t meet the health law’s mandate that they provide much more expensive benefit plans.

Millions of other companies – and employees – are wondering why they don’t get the special treatment before the December deadline. They either didn’t know about the new requirement or they didn’t have the political connections and highly paid lobbyists to get them the special favors.

But these tactics have a dark side, too. Sebelius is using her power to punish companies as well as reward them. Last year, she railed at insurance companies for explaining that an early wave of insurance mandates will actually increase premiums costs.

“There will be zero tolerance for this type of misinformation and unjustified rate increases,” she wrote in a letter to insurers. Instead of admitting that another set of new mandates are causing premiums to go higher, the administration continues to lash out at people who have the audacity to tell the truth.

A former governor of Kansas, Sebelius threatened to block plans that don’t play according to her rules for offering policies in the new state health insurance exchanges that will provide coverage to millions of people.

None of this sits well with the American people. They didn’t like the special deal making to pass the law, they are frightened about the costs and mandates that are barreling down at them, and they really don’t like seeing the law being unevenly applied so that some get special favors and others don’t.

The final decision about the fate of the health law rests with the courts and with the political process. The House already has voted to repeal it. The more people find out about it, the less they like it. The White House would be well advised to start working with Congress to fundamentally rework the law.

Published in The Sacramento Bee, February 2, 2011.

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