Alexander: Obamacare Waiver Guidance is “Not Much Flexibility, Not Much Relief”

Says administration should allow states to have the flexibility to make health care plans more affordable

Posted on December 16, 2015

WASHINGTON, December 16 – The chairman of the Senate health committee today said that guidance released by the Obama administration that tells states how they can obtain waivers from Obamacare is “not much flexibility and not much relief.”

“This so-called waiver provides surprisingly little relief from Obamacare, which should be the entire point of a waiver in the first place,” said Chairman Lamar Alexander (R-Tenn.). “The guidance released today essentially says that if a state needs relief from Obamacare, its only real option is to set up a program that offers the same expensive plans as Obamacare. The administration should start over and create a real waiver that allows states to innovate in order to make health care more affordable for Americans.”

The Treasury and the Dept. of Health and Human Services today published guidance on how the administration plans to grant the State Innovation Waivers authorized as part of Obamacare. More information on the guidance follows:

  • Obamacare created State Innovation Waivers which authorize HHS and the Treasury Dept. to approve state applications to waive the major health insurance coverage requirements of Obamacare, such as insurance market reforms, exchanges, subsidies, benefit requirements, the individual mandate, and the employer mandate, beginning on January 1, 2017. States that receive a waiver will be eligible to use Obamacare funding to create alternative health insurance coverage models in their state.
  • This guidance provides little flexibility to allow states to provide broader options of health care plans so that Americans have the freedom to choose which health plan makes the most sense for themselves, their families, and their businesses.
  • The non-partisan health research firm, Avalere Health, found the most popular Obamacare exchange plans increased premiums by 10 percent on average in 2015. For 2016, the firm anticipates that even the lowest cost silver plan will increase 13 percent and the lowest cost bronze plan will rise by 16 percent, on average.  These rate hikes are driven in large part by Obamacare’s expensive benefit mandates.
  • When it comes to giving states the flexibility to decide what types of health benefits are offered, the guidance provides for little flexibility to provide anything other than Obamacare’s expensive Essential Health Benefits (EHB). “… [T]he waiver must not decrease the number of individuals with coverage that satisfies EHB requirements, [and] the number of individuals with coverage of any particular category of EHB…””
  • Additionally, by only approving waivers that provide insurance that complies with Obamacare's cost-sharing rules, the guidance fails to give the states the ability to offer lower-cost plans that provide catastrophic coverage.
  • The guidance shows that HHS has been implementing Obamacare without building in platforms for state flexibility. The guidance states “The Centers for Medicare & Medicaid Services (CMS) operates the Federally-facilitated Exchange (FFE) platform. Certain changes that affect FFE processes may make a waiver Proposal not feasible to implement at this time. Until further guidance is issued, the Federal Platform cannot accommodate different rules for different states.” This means that any state with a federal exchange will be unable to make changes to the health plans they offer without building completely new systems. ‎

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For access to this release and the senator’s other statements, click here.

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