The news broke Tuesday, but the reports are still flying — everyone weighing in on what the latest delay in the implementation of the Affordable Care Act really means. Some of this firestorm is getting pretty heated.
Earlier this week, the Obama administration announced yet another mandate of the ACA — caps on out-of-pocket insurance costs — will be delayed until 2015.
This Fox News report quotes Sen. Rand Paul, R-Ky., as saying “the president doesn’t get to write legislation, and it’s illegal and unconstitutional for him to try.”
It also notes — and I found this especially interesting – that the one-year grace period has actually been posted and avaliable at the U.S. Department of Labor website since February and no one’s bothered to take a look at it till now.
Just last month, I blogged about the employer-mandate play-or-pay delay the day it was announced — it, too, moving to 2015. I didn’t recall this many fiery reactions at the time. Like this one, from Rob Wilson of Employco USA :
We’re starting to see these delays add up one after another, and it’s clear that the Obama administration didn’t have quite the grasp they thought they did on the complexities of the law and the costly outcomes it will incur. They have had since 2010 to put everything in place, and the latest postponement suggests that they’ll never be ready to fully implement the Affordable Care Act. … Putting caps on out-of-pocket costs like co-pays and deductibles will be especially damaging as the law bans lifetime limits for insurance beneficiaries and will inevitably cause premiums to go up.”
And this from CNBC, quoting Sen. Mike Lee, R-Utah:
This is very cynical and shameless what the administration is doing here. To amend the statute, you’re supposed to be required to get legislation, and they didn’t do that.”
Apparently, according to the reports, this latest delay is due to employers needing more time to update their computers in order to comply. Here, in the CNBC report, is a basic rundown of what’s being delayed:
On Tuesday, The New York Times published a large story highlighting the latest delay. … The ACA, as passed by Congress, capped total out-of-pocket medical costs at $6,350 for insured individuals, and $12,700 for families. But the administration is now delaying those caps for group health plans that use multiple service providers, such as plans having one administrator for major medical coverage and another for prescription drug benefits.
The story goes on to describe how damaging this could be for consumers.
The delay means that in 2014, plans that have that segregated arrangement will automatically have those maximum amounts only on out-of-pocket major medical costs. And if, for instance, a group benefit plan already has a cap in place for separately administered out-of-pocket drug benefits, then that plan’s new maximum in 2014 for those benefits must not be in excess of $6,350 for individuals, and double that for families. That means affected people would be on the hook for potentially twice the amount of money they would otherwise have been next year because of the delay.
But if there is not already a cap in place for such separate benefits, then there will be no limit on the out-pocket costs for those benefits through 2014, because of the delay. That means that people needing, for example, cancer medications could find themselves facing tens of thousands of dollars in extra costs.
What are HR leaders and benefits administrators supposed to be telling their employees in the midst of all this? I’m not finding that in the DOL’s posting or the many stories flying around. Stay tuned.