The announcement
these days that president obama has nominated tom perez as following secretary of labor arguably sets the stage
obtain a powerful federal push to restrict the ability of
tons and
immeasurable employers nationwide from sponsoring self-insured cluster health plans.
this provocative conclusion
desires the connection of
several dots,
thus we’ll lay them out specifically
specifically for your own personal own personal consideration.
as this blog has reported previously, federal regulators are asking variant
queries on self-insured cluster plans since the passage
on your own own aca.
plenty of specifically,
they'll are aiming to confirm
whether or not or do not smaller self-insured employers that purchase stop-loss insurance with “low” attachment points constitute a “loophole”
within the health care law
that these employers are somehow “gaming” the machine.
we’ve methodically discredited these assertions multiple times,
though it’s
important to line the stage as new developments are reported and
additional context is provided.
since insurance is largely regulated
regarding the state level, the obvious question arises relating to how the feds
can regulate stop-loss insurance
have to firmly be compelled to they'll ought
to carry out this ?
this'll clearly be done through federal legislation or potentially through regulation.
the regulatory route is
plenty of
subtle such as the aca wont
provide any
specific statutory authority for such action.
though regulators
typically is an artless bunch,
significantly below the current administration.
the inventive theory is federal agencies with jurisdiction
within the public health services act ( phsa ) and
after all the employee retirement income security act ( erisa )
may
rely upon the their general rule-making authority given an internet
below their respective laws to conisder that the federal government
may indeed
need to
regulate stop-loss insurance and re-characterize stop-loss policies
with “low” attachment points as “health insurance” through regulations
separate and apart coming
coming from the new law.
whereas this action
might well be controversial and subject to challenge by congress and private voters,
it might be real that a rule-making
technique may be initiated to attain this policy objective.
primarily
based mostly on discussion with key regulators as recently as last week, this type rule-making
technique
is unlikely to occur this year. this blog speculates that the primary
consideration for inaction at this purpose is regulators are merely
overwhelmed with finalizing the
several rules and connected steerage
required for full aca implementation
with the prime during this year.
once these deadlines pass,
other then, the regulators
will utilize a large amount of bandwidth to circle back on ancillary areas of interest. here’s where we connect the dot with mr. perez’ name on it.
whereas the career professional staffers among dol ( non-political appointees ) are competent
while a minimum of reasonably objective
for many cases, the new agency head
is a thing though.
mr. perez is equipped with baggage from his tenure among the justin department where proof strongly suggests a minimum
of the range of his civil rights enforcement
picks were influenced by political considerations. in
transient, he a “social justice” guy who fits nicely directly into administration’s template for policy-making.
his resume conjointly includes a stint with hhs below the clinton administration
although a senior staff position when
making use of the late senator ted kennedy. rounding out his big government pedigree, he
could be a graduate of harvard law school and
after all the george washington public school of health.
all
during this background suggests mr. perez
can certainly be inclined to position dol
you are plenty of activist agency with regard to health care reform
issues,
and even as stop-loss insurance regulation. this motivation
will seemingly be
considerably acute
in situations when the shop exchanges run into early
problems with lack of enrollment as
a lot of consultants predict.
specifically for your own personal own sake of discussion, let’s assume this analysis is correct.
throughout this case, then secretary perez
may push
then enjoy a a rule-making
technique as described earlier, or
most likely lead an effort to shut the self-insurance “loophole” through federal legislation. let’s connect another dot.
you are technical matter this would a “cleaner” approach
but is not subject to legal challenge. congress
may merely enact legislation amending the definition of “health insurance” below the phsa, erisa and
after all the code to embrace, as an example stop-loss policies by having “low” attachment purpose.
on condition that republicans management the house immediately and are
typically supportive of self-insurance, the politics dont support this potential strategy.
though if you do in fact very
believe recent public commentaries that the administration’s grand
political arrange is keyed upon the objective of democrats winning back
management
on your own own house in 2014, the legislative pathway becomes clearer.
und this scenario, it’s
a lot of hard to imagine that a secretary perez wouldnt push
then enjoy a a legislative “fix. ” in any case, it’s not honest that
a couple of voters are saved coming
coming from the exchanges in favor of receiving quality health gains from their employers, right ? social justice, indeed.
and therefore the past dot is connected.