Oops. Looks like we were lied to about Obamacare after all.

[elucidator]

I’ve seen their ways too often for my liking.

[Richard_Parker]

@Bone

I fail to see how an insurance company can issue a plan that is illegal under the ACA. Obama is not supporting a legislative change, this will simply be another area where the law will be enforced selectively. The plans even if re-issued by insurance companies would still violate federal law. What insurance company would knowingly issue a plan that is illegal?

The non-compliant policies in question here do not violate federal law. They just don’t count as “qualified health plans” satisfying the individual mandate. It’s a relatively important difference for these purposes.

[Bone]

@Richard_Parker

The non-compliant policies in question here do not violate federal law. They just don’t count as “qualified health plans” satisfying the individual mandate. It’s a relatively important difference for these purposes.

I agree. I misspoke.

However, the point remains that there is virtually no incentive to issue a non-compliant plan. From Volokh:

It’s nice that regulators may forbear enforcing the relevant regulatory requirements, but this is not the only source of potential legal jeopardy. So, for instance, what happens when there’s a legal dispute under one of these policies? Say, for instance, an insurance company denies payment for something that is not covered under the policy but that would have been covered under the PPACA and the insured sues? Would an insurance company really want to have to defend this decision in court?

…

Under the PPACA, only plans that meet various requirements are “qualified health plans” (QHPs). Only QHPs may be sold on exchanges or satisfy the minimum coverage requirement (the individual mandate). So the PPACA does not expressly prohibit insurance companies from offering such plans (assuming they are allowed by state insurance commissions), but they do not satisfy other provisions of the act so there is no reason to offer them. They remain against the public policy of the United States as defined by the PPACA. Would this effect the enforceability of such an insurance policies terms in private legal dispute in state court? Perhaps not, but it’s understandable if insurance companies will be in no rush to find out.

[watchwolf49]

@elucidator

I’ve seen their ways too often for my liking.

Greed is what’s evil … I use my money and power to provide safe affordable housing for the widows and orphans of our community. Why would you fight against me?

Anyway, I probably should have said that short selling is my insurance agent’s advice. That’s the tie in to this thread. The health care sector in the US is a bubble, my man on the inside predicts 2 years and it will pop, just like the housing sector just did 5 years ago, just like the Dutch iris market in 1637.

It will be horrible, so we might as well profit.

[Richard_Parker]

I agree that this “fix” does not appear to be designed to actually prevent the cancellations. This is about managing the politics.

That said, I don’t agree with Adler’s contention that “they do not satisfy other provisions of the act so there is no reason to offer them.” Obviously, the reason to offer them is the same reason to offer them pre-PPACA: some people want barebones coverage. And since some people are claiming to have increases in the thousands of dollars for premiums for compliant plans, I imagine they’d prefer to pay a couple hundred backs for the penalty and keep their non-compliant plan.

[John_Mace]

Will they still have to pay a penalty? If so, that would seem to be its own political problem.

[Richard_Parker]

In theory they would, as I wrote above.

But I gather the plan is for the IRS not to enforce it.

[Richard_Parker]

Specifically:

Some individuals and small businesses with health insurance coverage have been notified by their health insurance issuers that their coverage will soon be terminated. **We understand that, in some cases, the health insurance issuer is terminating or cancelling such coverage because it would not comply with certain market reforms that are scheduled to take effect for plan or policy years starting on or after January 1, 2014, such as the new modified community rating and essential health benefits package standards. **1 Although affected individuals and small businesses may access quality health insurance coverage through the new Health Insurance Marketplaces, in many cases with federal subsidies, some of them are finding that such coverage would be more expensive than their current coverage, and thus they may dissuaded from immediately transitioning to such coverage.

In light of this circumstance, under the following transitional policy, health insurance issuers may choose to continue coverage that would otherwise be terminated or cancelled, and affected individuals and small businesses may choose to re-enroll in such coverage. Under this transitional policy, health insurance coverage in the individual or small group market that is renewed for a policy year starting between January 1, 2014, and October 1, 2014, and associated group health plans of small businesses, will not be considered to be out of compliance with the market reforms specified below under the conditions specified below. We will consider the impact of this transitional policy in assessing whether to extend it beyond the specified timefrarne.

[Bone]

@Richard_Parker

I agree that this “fix” does not appear to be designed to actually prevent the cancellations. This is about managing the politics.

That said, I don’t agree with Adler’s contention that “they do not satisfy other provisions of the act so there is no reason to offer them.” Obviously, the reason to offer them is the same reason to offer them pre-PPACA: some people want barebones coverage. And since some people are claiming to have increases in the thousands of dollars for premiums for compliant plans, I imagine they’d prefer to pay a couple hundred backs for the penalty and keep their non-compliant plan.

Adler has updated his post and what he is referring to is:

More importantly, under Section 300gg-6 insurers are barred from offering health insurance plans in individual and small group markets that do not include the essential health benefits package.

That section reads:

(a) Coverage for essential health benefits package A health insurance issuer that offers health insurance coverage in the individual or small group market shall ensure that such coverage includes the essential health benefits package required under section 18022(a) of this title.

Do you think not enforcing this provision of the law is within the discretion offered by Heckler v. Chaney? I’m still skeptical that it is but am willing to be convinced. I completely understand this is unlikely to have any impact but I think the overall implications of not enforcing aspects of the law that the administration does not like for whatever reason is on tenuous grounds. If the next administration decided to not enforce other significant parts of the act or other aspects of the law, like the Clean Air Act or some other thing, that would be consistent with this same rationale.

[not_what_you_d_expect]

@magellan01

Good thing the Redistributor in Chief is there to play Robin Hood. One thing good that has come of all this is that more and more people are seeing Obama for what he is: a community organizer with strong socialist leanings determined to redraft the country into his version of fairness. Which means that if you are not beholden to the state, cough it up, because we have lots of people who are. And the more money we can extract from you because you’ve done fairly well in life, the more we can give it to those less fortunate, less intelligent, and/or less hardworking.

Why do you hate Robin Hood? He was always the good guy in the movies.

I don’t mind sharing with those less fortunate, less intelligent and even those that are less hard working. And I’m nowhere close to being rich. It’s a tough world and some people didn’t come with the skills necessary to get through it without help.

[Stratocaster]

@not_what_you_d_expect

I don’t mind sharing with those less fortunate, less intelligent and even those that are less hard working. And I’m nowhere close to being rich. It’s a tough world and some people didn’t come with the skills necessary to get through it without help.

Feel free to give up as much of your money as you’d like.

[Shagnasty]

@Stratocaster

Feel free to give up as much of your money as you’d like.

My sympathies exactly. Progressive and bleeding hearts of all stripes are always willing to give up money and resources and money as long as they come from other people and they can take credit for it while not giving up anything meaningful of their own. You see very few take hands on action to help individual people and many are even opposed to the idea in general because only the government can help people in their view and everything else is counterprodive. Most good conservatives believe in helping individuals personally but not force anyone else to participate.

I believe in true freedom as well. You are free to go into poverty or even die if you can’t contribute something worthwhile. Nobody else is obligated do give you anything if you don’t just because you are born with a DNA sequence that makes you arguably human.

[Terr]

@Shagnasty

My sympathies exactly. Progressive and bleeding hearts of all stripes are always willing to give up money and resources and money as long as they come from other people and they can take credit for it while not giving up anything meaningful of their own.

Exemplified by the “I was all for Obamacare until I found out I was paying for it” litanies in the news.

[adaher]

@Bone

I fail to see how an insurance company can issue a plan that is illegal under the ACA. Obama is not supporting a legislative change, this will simply be another area where the law will be enforced selectively. The plans even if re-issued by insurance companies would still violate federal law. What insurance company would knowingly issue a plan that is illegal?

How would they know when most of the regulations weren’t written until after the election?

[PhillyGuy]

@Shagnasty

Progressive and bleeding hearts of all stripes are always willing to give up money and resources and money as long as they come from other people and they can take credit for it while not giving up anything meaningful of their own.

Between the state hospitals, community mental heath centers, the Indian Health Service, government-funded prenatal care clinics, Medicare, Medicaid, EMTALA, and the bankruptcy courts, you guys lost this battle long ago. The government already forces health care providers to massively provide care at reduced prices, and for free. I want it done in an above-board way, not through subterfuges such as EMTALA and medical bankruptcy.

When an uninsured motorcyclist gets a multi-million dollar head injury, everyone pays some. It’s just hidden. When that motorcyclist is forced to pay for insurance that doesn’t have caps – but does have significant copays – now, there is your individual responsibility.

In this issue, it is the conservatives who are the bleeding hearts wailing about those forced to get real insurance – while ignoring that the most expensive care for those without insurance has been socialized since EMTALA passed in 1986.

[adaher]

“we lost”, only in the sense that up to a certain point, the public desires to help the poor. The condition is that while we’re helping the poor, nothing will change for the middle class.

Now that the left has crossed that line, they are the ones losing.

[Terr]

@Richard_Parker

The non-compliant policies in question here do not violate federal law. They just don’t count as “qualified health plans” satisfying the individual mandate. It’s a relatively important difference for these purposes.

I don’t think you’re right. See The Legality of the Latest ObamaCare Fix - The Volokh ConspiracyThe Volokh Conspiracy

[INDENT] The new policy announced by the President does not alter any of the PPACA’s legal requirements. Under the PPACA, only plans that meet various requirements are “qualified health plans” (QHPs). Only QHPs may be sold on exchanges or satisfy the minimum coverage requirement (the individual mandate). More importantly, under Section 300gg-6 insurers are barred from offering health insurance plans in individual and small group markets that do not include the essential health benefits package. This obligation remains.

[elucidator]

…Now that the left has crossed that line, they are the ones losing.

Hence the popular saying about Fox News: Very rich people paying rich people to tell middle class people to blame the poor.

[adaher]

No need to blame the poor, blame the rich people who want to help the poor but lied to the public because they didn’t trust the hoi polloi.

[elucidator]

@Terr

Exemplified by the “I was all for Obamacare until I found out I was paying for it” litanies in the news.

…Pam Kehaly, president of Anthem Blue Cross in California, said she received a recent letter from a young woman complaining about a 50% rate hike related to the healthcare law.

“She said, ‘I was all for Obamacare until I found out I was paying for it,’” Kehaly said…

Emphasis added for what should have been revealed in the first place…

How very nice ot Ms Keahey to listen so closely to this young lady’s plight.

Oh, and “litanies” is a plural.