Obama Administration Delays Out-Of-Pocket Caps To Grant Insurance Companies Transition 'Relief'

Once again, our politicians are putting the interests of health insurance corporations -- and their mega-rich CEOs -- ahead of the American people. The New York Times reported yesterday that the Obama Administration has granted 'transition relief' to a host of health insurance companies whose computer systems are unable to deal with new regulations requiring caps on out-of-pocket expenses.

The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.

The grace period has been outlined on the Labor Department’s Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about the language — which appeared as an answer to one of 137 “frequently asked questions about Affordable Care Act implementation”— department officials confirmed the policy.

This is an absolute outrage! The health insurance companies -- and their friends in the benefits administration business -- had FOUR BLOODY YEARS to prepare for ObamaCare and they couldn't work hard enough to be ready by 2014? The same insurance companies that employ intricate algorithms to detect incredibly sick people throw them off their insurance policies when they need them most?

This cave to the appallingly powerful insurance industry will prove particularly problematic for the chronically ill, as this rule change means that many new insurance customers will no longer have their pharmaceutical expenses capped along with all their other expenses under one umbrella. Instead, they may have two caps, or no caps at all for certain costs.

Advocates for patients said the promise of the law was being deferred. “We have wonderful new drugs, the biologics, to treat rheumatoid arthritis, but they are extremely expensive,” said Dr. Patience H. White, a vice president of the Arthritis Foundation. “In the past, patients had to live in constant pain, often became disabled and had to leave their jobs. The new drugs can make a huge difference, and we were hoping that the cap on out-of-pocket costs would make them affordable. But now many patients will have to wait another year.”

The American Cancer Society shares the concern and noted that some new cancer drugs cost $100,000 a year or more.

“If a prescription drug plan does not currently have a limit, then it will not have to have one in 2014,” said Molly Daniels, deputy president of the lobbying arm of the American Cancer Society. “Patients who require expensive drugs could continue to have enormous financial exposure, despite the clear intent of the law to limit a patient’s total out-of-pocket exposure.”

But, who cares about dying, sick people? The poor insurance companies were the ones who needed the 'relief' according to the Obama Administration.

Federal officials said they were offering transition relief to certain health plans in 2014. But, they said, by 2015, health plans must comply with the law and must have an overall limit on out-of-pocket costs for medical, drug and other benefits combined.

Theodore M. Thompson, a vice president of the National Multiple Sclerosis Society, said: “The promise of out-of-pocket limits was one of the main reasons we supported health care reform. So we are disappointed that some plans will be allowed to have multiple out-of-pocket limits in 2014.”

Health insurance companies need relief?! No, the American people need relief from the barbaric and cruel practices of these corporations.

Why will thousands and thousands of sick Americans continue to suffer and go bankrupt next year? Well, because the 'Affordable' Care Act was designed to protect the profits and interests of health insurance companies, rather than put forth the best possible health care policy -- Medicare for all -- for the majority of Americans.

The Administration -- cowardly as it was to hide this rule change until now -- needs to hear strong pushback from progressives. We should be outraged.