Nevada got a partial waiver from the health care law
By Karoun Demirjian | Las Vegas Sun
A significant development that Democrats are dismissing as par for the course and Republicans are claiming as a political victory.
The Health and Human Services Department announced late Friday that Nevada had secured a statewide waiver from certain implementation requirements of the Obama administration’s health care law, because forcing them through, the department found, “may lead to the destabilization of the individual market.”
The announcement makes Nevada one of only three states to have compliance requirements under the health care bill waived.
Nevada’s Insurance Division had appealed to the feds to reduce the federal requirement that health plans serving people who buy insurance on their own must spend at least 80 percent of the money they collect on medical expenses. Under the national rule, companies that don’t spend that percentage of revenue on medical costs have to cut policyholders rebate checks starting this year.
Nevada asked that requirement be reduced to 72 percent for one year, arguing that top insurance providers would be so strapped to make the payments that they’d exit the state market.
Health and Human Services didn’t fully buy that argument, but did agree to reduce the requirement to 75 percent for a year, expressing concern about what might happen to people with policies from insurers Golden Rule and Aetna if they didn’t.
Together, Golden Rule and Aetna cover 24 percent of Nevada’s insured; but they, along with Sierra Health and MEGA, which cover another 4 percent, are spending nowhere near 80 percent of revenue on health care coverage.
The change is less the feds giving underperforming insurance agencies a free pass than buying time for providers to shape up, or policyholders to ship out with reasonable warning time: Nevada has no law that says if you lose insurance because your insurer shuts down, another company has to pick you up. To prevent that, Health and Human Services determined it had to “provide the opportunity for plans with low ‘medical loss ratios’ to adjust their business models to reach 80 percent” with the reduced, 75 percent mandate for the rest of 2011 — that being the average medical loss ratio that the state’s top 10 insurers currently post.
For Republicans, the waiver is proof of what they’ve been arguing all along — that Obama’s health care law was never going to work and has to go.