Friday, September 19, 2014

Essential Re-Calculating

Feature or bug?

"A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits"

This problem poses several challenges:

First, if your company's health plan is deemed to be ObamaTax-compliant by the calculator, then you're likely not going to be eligible for any subsidy if you opt for an Exchange-based plan instead.

Another issue is that the calculator seems to be approving plans that lack hospitalization coverage, one of the the key essential health benefits (EHBs). That doesn't necessarily mean that employers are actually offering such plans, but it's a bit disturbing to think that they could.

But I think that Kaiser buries the lede here. It's only when you scroll down that you see this little gem:

"HHS is aware of potential problems with the calculator but has not changed it"

Now, there could be several innocent reasons for this. For example, based on their top-notch efforts rolling out the site, they may not be competent to even address the issue. But I wonder what will happen to employers who rely on the calculator, offering "sub-par" plans to their employees. If and/or when this issue is resolved, what kinds of penalties will they face (if any)? And how many employees will have substantial and unreimbursed hospital expenses while this gets sorted out?

It's just one more example of the real-world consequences of incompetent government over-reach.
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