AIM Argues HHS Has Authority To Grant ACA Waiver
Associated Industries of Massachusetts believes the federal health department has the authority to grant Massachusetts a waiver from new health insurance rate setting requirements under the Affordable Care Act, and earlier this month urged Health and Human Services Secretary Kathleen Sebelius to exempt the state from the rules.
In a letter delivered to the federal Department of Health and Human Services on July 10, A.I.M. President and CEO Richard Lord wrote on behalf of his 5,000 members urging Sebelius to give Massachusetts a full waiver from the rating factors used to calculate premiums, which under the ACA would reduce the factors used in Massachusetts from nine to four, and to allow rates to continue to be filed quarterly rather than annually.
A.I.M. argues the rating changes will increase premiums on average 3.7 percent for employers.
“Allowing Massachusetts to retain these two elements of its 2006 health reform will preserve hard-won expansions of coverage to individuals without causing rate shocks that could increase health insurance costs for up to 60 percent of small employers,” Lord said.
The Legislature recently passed a bill aligning the state health insurance system to the ACA that required Gov. Deval Patrick to formally seek a waiver. The Patrick administration was previously able to secure an agreement to phase in the changes over three-years, but Patrick said in conversations with Sebelius and President Barack Obama the administration told the state it did not have the authority to grant a full waiver. Lord, however, argued in his letter that HHS could grant the waiver, pointing to the lack of language in the federal law “that expressly prohibits HHS from allowing states that have implemented their own health insurance reforms to maintain the most successful elements of those efforts.” Lord also said that HHS had granted waivers to more than 1,200 companies from the ACA restrictions on annual benefit caps, and suggested the Treasury’s decision to postpone until 2015 the requirement that larger employers provide health insurance to workers or pay penalties “suggests that the administration enjoys broad administrative authority to take actions that advance the overall goal of expanding coverage.”
Patrick has expressed little optimism for winning a full waiver.
“I'm so done with that. If they want me to send a formal letter to confirm the conversation I've already had with the secretary of HHS, I'm happy to do that. I have spoken to the president about it as well. And I'm happy to do it again, and put it all in writing. And I have reported to you and to others what the response was, which is that they can't give us what they don't have the legal authority to give us. They gave us what they could,” Patrick told reporters, the same day the A.I.M. letter was delivered.
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