By Mike Lillis - 06/15/10 12:19 AM EDT
The White House on Monday outlined broad new rules designed to prevent employers from dropping health insurance benefits for their workers or shifting huge new costs onto them.
The regulations empower the administration to revoke the so-called grandfather status of businesses that shift “significant” new burdens onto employees — a considerable penalty that would subject those plans to all the consumer protections in the Democrats’ new healthcare reform law.
Democrats exempted existing health insurance plans from a number of provisions of the new law as a concession to the insurance industry and business community. For example, grandfathered plans — those up and running when the legislation became law in March — don’t have to offer an insurance product without a cost-sharing requirement. Businesses, particularly large companies, prefer that arrangement because they don’t have to make sweeping changes to their existing plans.
The new rules say that employers can make “routine and modest” adjustments to their premium, deductible and co-pay requirements, Sebelius said, but “significant” cost hikes or benefit cuts would cost them their exempted status. The goal is to ensure that grandfathered plans “don’t use this additional flexibility to take advantage of their customers,” she said.
“We don’t want a massive shift of cost to employees,” Sebelius said.
Officials expect the new rules to have the greatest impact on the roughly 133 million employees at large companies, whose insurance offerings tend to remain more stable than at smaller businesses. Labor Secretary Hilda Solis told reporters Monday that the new rules will help “minimize market disruptions.”
Republicans, however, are not convinced. Senate Minority Leader Mitch McConnell (R-Ky.) said Monday that the rules would force more than half of the U.S. workforce out of their current health plan — which “flatly contradicts” Democrats’ promises during the debate.
“Here’s one more promise the administration has broken on healthcare,” McConnell said.
Sen. Chuck Grassley (Iowa), senior Republican on the Finance Committee, echoed that message, calling the rules “more proof” that, under the new law, “you actually can’t keep what you like.”
“Change is coming for a lot of people,” Grassley said in a statement, “whether they want it or not.”
The new rules came on the same day analysts at PricewaterhouseCoopers issued a report projecting that employers’ healthcare costs will jump by 9 percent in 2011. The authors predict that employers next year will shift more costs onto workers, hiking deductibles and replacing co-pays with co-insurance policies.
The White House was quick to push back against the report, pointing out that the employer surveys on which it was based were conducted before the Democrats’ reform bill was passed. Also, the analysts noted that the new reform law, much of which takes effect in 2014, had only a “minor” influence on next year’s cost trends.
Asked about the report Monday, Sebelius conceded that many people will wonder why all the benefits of the health reform law don’t begin immediately. Still, she added, the survey “argues the case that we could absolutely not afford to do nothing.”
“People are being absolutely priced out of the marketplace,” she said.