After initially describing the Affordable Care Act as a one-size-fits-all government take over, Republicans are now criticizing HHS for granting temporary waivers to companies and states that may have trouble complying with the new regulations in the law (that would require plans to eliminate annual spending limits and meet medical loss ratio standards). Republicans have gone so far as to accuse the Secretary of cronyism in selecting the waiver recipients, claiming — without presenting a shred of evidence — that she granted a disproportionate number of waivers to unions. Here is Sen. John Barrasso (R-WY) pressing the case this morning on the Senate floor:
BARRASSO: Last Friday night, the Secretary of Health and Human Services granted another 150 waivers. Another 150 waivers. Now there are over 1,040 waivers covering 2.6 million individuals…Well, of those 2.6 million who have received waivers, Madam President, 1.2 million are members of unions. So that’s 46 percent of the waivers have been given to union members. Now, the website were you go to for that information, of course, the Secretary has tried to disguise how they label those individuals and union plans are now called “multi-employer plans.”
Two million individuals represents a relatively small percentage of American workers, but even so, the ever expanding list of waivers would lead one to dismiss the argument that the agency is a top-down ideologically driven institution that’s interested in imposing its own version of health reform on employers and states regardless of consequences. Quite the opposite. In heeding the concerns of employers and giving plans more time to adjust to the new regulations and limit any coverage disruption, HHS is displaying a degree of flexibility that’s necessary in any mass scale implementation.
It’s also difficult to argue that the Secretary is “disguising” the waivers given to unions. If you click over to this page of approved waivers, it says:
Collectively-Bargained Employer-Based Plan Applicants: Most of the other health plans receiving waivers are multi-employer health funds created by a collective bargaining agreement between a union and two or more employers, pursuant to the Taft-Hartley Act. These “union plans” are employment based group health plans and operate for the sole benefit of workers. They tend to be larger than other typical group health plans because they cover multiple employers. There are also single-employer union plans that have received a waiver. In total, 182 collectively-bargained plans have received waivers.
“Union plan” is slightly inaccurate, however, since the plans are actually governed by a board on which employers and unions are equally represented. Moreover, unlike non-union labor negotiations which can be re-negotiated annually, collective bargaining agreements tie unions down for multiple years and the waivers, I suspect, are being granted to give them more time to change their plans and adjust to the new requirements. It’s the kind of flexibility Republicans supported during the health debate, but are now against.