Three House Republicans wrote Health and Human Services Secretary Kathleen Sebelius on Friday with a series of questions about waivers granted to companies that say they might drop their workers’ insurance if they have to comply with new consumer protections in the health care law.

Reps. Joe L. Barton and Michael C. Burgess» of Texas and John Shimkus of Illinois said in their letter that they want more information about the one-year waivers, granted to 30 companies, unions and other groups. The organizations — including the fast food giant McDonald’s — asked to be exempted from a provision in the patients’ bill of rights that phases out annual limits on coverage (See related story, CQ HealthBeat, Oct. 7, 2010).

Barton, «Burgess and Shimkus said the companies told news media outlets that they might have to end their health coverage entirely if they didn’t get the waivers.

“This is not the first time we have learned that, when faced with the new costs, regulations and mandates in the health care law, companies will give serious consideration to simply ending their employee health care coverage,” said the Republicans, all members of the Energy and Commerce Committee.

A spokeswoman for HHS said that the agency will respond in writing, and also said that the intent is to keep companies from dropping coverage.

“The Affordable Care Act strengthens employer-based coverage through new consumer protections, tax credits for small businesses, and other savings for employers as we build a bridge to the new marketplace in 2014, where Americans will be able to shop for quality, affordable health care,” she said in an e-mail.

Waivers are granted when proposed premium increases would significantly exceed medical inflation or if a significant number of enrollees would lose access to their current plan because the coverage would not be offered without a waiver, department officials have said.

The White House continues to battle charges that the law will prompt people to lose their coverage, including some salvos coming from members of their own party.

Stephanie Cutter, White House director of special projects, in a blog post on Thursday rebutted an opinion piece in the Wall Street Journal by Tennessee Gov. Philip Bredesen, a Democrat. Bredesen wrote that the law creates economic incentives for employers to end coverage, pushing them into publicly funded health care.

The three House Republicans said in their letter that Democrats in Congress and President Obama during the health care debate told Americans that if they like their current health care plans they can keep them. They said that they are thus “troubled” that big companies like McDonald’s needed a waiver.

The members asked for a list of which companies were granted the waivers and how many employees will be affected, and asked for copies of the waivers as well as a “detailed description of the effects of the waivers.” They also asked if companies not yet publicly named have been granted waivers, and if any companies have been denied waivers and why.

They also asked if HHS has been contacted by any insurers about waivers from the medical loss ratio (MLR), which is also worrying some health plans, and the names of the insurers. The law requires that individual and small group plans spend 80 percent of premium dollars on medical care and quality improvements. Large plans must spend 85 percent.

The National Association of Insurance Commissioners (NAIC) on Thursday concluded months of intense deliberations on a key rule establishing minimum medical payouts by rejecting arguments that would have given insurers much greater flexibility to meet the standards (See related story, CQ HealthBeat, Oct. 21, 2010).

The members also said that they think that the exemptions will likely affect cost estimates of the new law and asked if that impact has been calculated.


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