Kansas, Iowa pursue health law waivers

May 23 2011

Meanwhile, The Hill reports that most of the denials resuting from early waiver requests went to unions. And, in other health reform implementation news, Politico Pro reports on what it describes as an "ACO dilemma."

Kansas Health Institute News: Kansas Requests Waiver From Medical Loss Requirement
[The Kansas Insurance Department] has asked the U.S. Department of Health and Humans Services for a waiver to give health insurance companies three additional years to comply with a requirement in the health reform law that says they are to spend at least 80 percent of their premium dollars on health care services to their policy holders. Without the waiver, companies that fall short of the so-called medical loss ratio in 2011 would have to pay rebates to customers, starting next year. In Kansas, most health insurance companies already meet the requirement (Ranney, 5/20).

Des Moines Register: Waiver Would Let Iowa Health Insurers Save Cash
Health insurers could avoid paying $3.4 million in rebates to customers if federal regulators allow Iowa to delay a component of health care legislation meant to curb insurance company profits and overhead. Six insurers pulled out of Iowa's individual health market last summer after the Obama administration's health care legislation was passed, state regulators said. Part of the law requires insurers to spend at least 80 percent of premiums on health care, and if they don't, they must refund customer premiums until the math works out (Belz, 5/23). 

The Hill: Early Waiver Denials Went Mostly To Unions
Republicans have consistently suggested that labor unions receive favorable treatment as the Obama administration has granted waivers from part of the health care reform law, but unions accounted for most of the denials during the first several months in which waivers were granted. As of mid-February, the Health and Human Services Department had denied 79 requests for waivers. Unions accounted for roughly 60 percent of those denials (Baker, 5/20).

Politico Pro: ACO Dilemma: Lose Cash Or Lose Providers?
In March, the administration released the long-awaited proposed rule on accountable care organizations — networks of hospitals and physicians that are supposed to work together to bring down costs by improving care. They're the symbol of the Obama administration's belief that driving providers to deliver better care will also eliminate large amounts of unnecessary spending… But now that providers have had a time to digest it, even the most likely candidates have rejected it as written. Their biggest concerns include the provisions that are supposed to keep the ACOs from potentially increasing Medicare spending — costing money, rather than saving money — if saving targets aren't reached (Feder, 5/23).