West Virginia businesses, unions receiving health care waivers

By   /   August 26, 2011  /   1 Comment

By Steven Allen Adams | West Virginia Watchdog

CHARLESTON — Several Businesses, insurance companies, and unions in West Virginia are exempt from the new health care reform law's mandates.

A total of nine state-based health insurance companies, businesses, and unions received health care waivers from the federal government.

According to the Department of Health and Human Services, the agency grants temporary waivers, which exempt applicants from a provision of the Patient Protection and Affordable Care Act that phases out annual dollar limits. If compliance would result in a significant decrease in access to benefits or a significant increase in premiums, HHS grants the waiver.

Starting this year, the Affordable Care Act prevents health care plans from imposing limits below $750,000. Some limited benefit, or “mini-med" plans, only provide $50,000 per year in coverage. Without the health care waivers, these plans would have to raise premiums or stop offering coverall all together.

The waivers are temporary, ending in 2014 when taxpayer-subsidized insurance is available through the Affordable Care Act. In June, HHS announced that no new waivers would be accepted after Sept. 22. As July 2011, a total of 1,578 waivers have been granted, benefiting 3.4 million people enrolled in benefiting health care plans.

To get a waiver, issuers or other group health plan sponsors had to show that meeting the annual limits would diminish access to benefits or increase their premiums. According to the Government Accountability Office, private plans with projected premium increases of 10 percent or more were approved for waivers, while plans with projected premium increases of 6 percent or less were denied.

Critics of the waiver program blame the health care reform law for causing insurance premiums to rise in the first place. Peter Suderman, an associate editor of Reason Magazine, wrote back in June that HHS was handing out waivers to counteract the effects of the Affordable Care Act.

"If anything, the waiver process simply shows that the Obama administration knows that, despite all of the president’s claims about bringing down the cost of both care and insurance premiums, the legislation, as passed, will make health insurance more expensive for a very large number of individuals," Suderman said.

In West Virginia, the following received waivers:

  • Job Squad, Inc.
  • Turnpike Ford, Inc. 
  • Pace Enterprises, Inc.
  • Employer-Teamsters Local Nos. 175 & 505 Health and Welfare Fund.
  • Carpenters Industrial Council Trust Fund.
  • West Virginia Laborers' Trust Fund.
  • United Food and Commercial Workers Local 400 and Employers Health and Welfare Fund.
  • Highmark West Virginia Inc. dba Mountain State Blue Cross Blue Shield on behalf of Ammar's Inc.
  • Health Plan the Upper Ohio Valley.

Out of the nine groups listed above, four are also receiving grants from the Early Retiree Reinsurance Program, which provides $5 billion in financial assistance to employers and unions to use for shoring up retiree health care plans.

The Employer-Teamsters Local Nos. 175 & 505 Health and Welfare Fund, West Virginia Laborers' Trust Fund, United Food and Commercial Workers Local 400 and Employers Health and Welfare Fund, and Highmark West Virginia Inc. dba Mountain State Blue Cross Blue Shield have all been approved for ERRP grants.

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