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<DIV style="FONT: 10pt arial">----- Original Message -----
<DIV style="BACKGROUND: #e4e4e4; font-color: black"><B>From:</B> <A
title=giudi@giudiwrites.com href="mailto:giudi@giudiwrites.com">Giudi Weiss</A>
</DIV>
<DIV><B>To:</B> <A title=IllinoisSinglePayer@yahoogroups.com
href="mailto:IllinoisSinglePayer@yahoogroups.com">illinois single payer
coalition</A> ; <A title=GPChicago@yahoogroups.com
href="mailto:GPChicago@yahoogroups.com">GPChicago@yahoogroups.com</A> </DIV>
<DIV><B>Sent:</B> Tuesday, August 13, 2013 12:09 PM</DIV>
<DIV><B>Subject:</B> [IllinoisSinglePayer] Obamacare does it again</DIV></DIV>
<DIV><BR></DIV>Obama and the ACA rack up another win for the insurance industry,
a huge loss for consumers. And they managed to bury it for the better part
of a year.<BR><BR><BR>
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class=timestamp>August 12, 2013</DIV>
<H1
style="TEXT-TRANSFORM: none; TEXT-INDENT: 0px; MARGIN: 0px; FONT: bold 2.4em/1.08em Georgia, serif; WHITE-SPACE: normal; LETTER-SPACING: normal; COLOR: rgb(0,0,0); WORD-SPACING: 0px; -webkit-text-stroke-width: 0px"><NYT_HEADLINE
type=" " version="1.0">A Limit on Consumer Costs Is Delayed in Health Care
Law</NYT_HEADLINE></H1><NYT_BYLINE
style="TEXT-TRANSFORM: none; TEXT-INDENT: 0px; FONT: 13px Georgia,
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class=byline>By<SPAN class=Apple-converted-space> </SPAN><SPAN
itemid="http://topics.nytimes.com/top/reference/timestopics/people/p/robert_pear/index.html"
itemtype="http://schema.org/Person" itemscope=""
itemprop="author
creator"><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none"
title="More Articles by ROBERT PEAR"
href="http://topics.nytimes.com/top/reference/timestopics/people/p/robert_pear/index.html"
rel=author><SPAN itemprop="name">ROBERT
PEAR</SPAN></A></SPAN></H6></NYT_BYLINE><SPAN
style="TEXT-TRANSFORM: none; BACKGROUND-COLOR: rgb(255,255,255); TEXT-INDENT: 0px; DISPLAY: inline !important; FONT: 13px Georgia, serif; WHITE-SPACE: normal; FLOAT: none; LETTER-SPACING: normal; COLOR: rgb(51,51,51); WORD-SPACING: 0px; -webkit-text-stroke-width: 0px"></SPAN><NYT_TEXT
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<DIV id=articleBody><NYT_CORRECTION_TOP></NYT_CORRECTION_TOP>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">WASHINGTON — In another setback for President Obama’s
health care initiative, the administration has delayed until 2015 a significant
consumer protection in the law that limits how much people may have to spend on
their own health care.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">The limit on out-of-pocket costs, including deductibles
and co-payments, was not supposed to exceed $6,350 for an individual and $12,700
for a family. But under a little-noticed ruling, federal officials have granted
a one-year grace period to some insurers, allowing them to set higher limits, or
no limit at all on some costs, in 2014.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">The grace period has been outlined on the Labor
Department’s Web site since February, but was obscured in a maze of legal and
bureaucratic language that went largely unnoticed. When asked in recent days
about the language — which appeared as an answer to one of 137 “<A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" title="The Web page."
href="http://www.dol.gov/ebsa/faqs/faq-aca12.html">frequently asked questions
about Affordable Care Act implementation</A>” — department officials confirmed
the policy.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">The discovery is likely to fuel continuing Republican
efforts this fall to discredit the president’s<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" class=meta-classifier
title="Recent and archival news about healthcare reform."
href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html?inline=nyt-classifier">health
care law</A>.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Under the policy, many group health plans will be able to
maintain separate out-of-pocket limits for benefits in 2014. As a result, a
consumer may be required to pay $6,350 for doctors’ services and hospital care,
and an additional $6,350 for prescription drugs under a plan administered by a
pharmacy benefit manager.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Some consumers may have to pay even more, as some group
health plans will not be required to impose any limit on a patient’s
out-of-pocket costs for drugs next year. If a drug plan does not currently have
a limit on out-of-pocket costs, it will not have to impose one for 2014, federal
officials said Monday.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">The health law, signed more than three years ago by Mr.
Obama, clearly established a single overall limit on out-of-pocket costs for
each individual or family. But federal officials said that many insurers and
employers needed more time to comply because they used separate companies to
help administer major medical coverage and drug benefits, with separate limits
on out-of-pocket costs.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">In many cases, the companies have separate computer
systems that cannot communicate with one another.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">A senior administration official, speaking on condition
of anonymity to discuss internal deliberations, said: “We knew this was an
important issue. We had to balance the interests of consumers with the concerns
of health plan sponsors and carriers, which told us that their computer systems
were not set up to aggregate all of a person’s out-of-pocket costs. They asked
for more time to comply.”</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Health plans are free to set out-of-pocket limits lower
than the levels allowed by the administration. But many employers and health
plans sought the grace period, saying they needed time to upgrade their computer
systems. “Benefit managers using different computer systems often cannot keep
track of all the out-of-pocket costs incurred by a particular individual,” said
Kathryn Wilber, a lawyer at the American Benefits Council, which represents many
Fortune 500 companies that provide coverage to employees.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Last month the White House announced a one-year delay in
enforcement of another major provision of the law, which requires larger
employers to offer health coverage to full-time employees. Valerie Jarrett, Mr.
Obama’s senior adviser, said that the delay of the employer mandate showed “we
are listening” to businesses, which had complained about the complexity of
federal reporting requirements.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Although the two delays are unrelated, together they
underscore the difficulties the Obama administration is facing as it rolls out
the health care law.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Advocates for people with chronic illnesses said they
were dismayed by the policy decision on out-of-pocket costs.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">“The government’s unexpected interpretation of the law
will disproportionately harm people with complex chronic conditions and
disabilities,” said Myrl Weinberg, the chief executive of the National Health
Council, which speaks for more than 50 groups representing patients.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">For people with serious illnesses like<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" class=meta-classifier
title="In-depth reference and news articles about Cancer."
href="http://health.nytimes.com/health/guides/disease/cancer/overview.html?inline=nyt-classifier">cancer</A><SPAN
class=Apple-converted-space> </SPAN>and<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" class=meta-classifier
title="In-depth reference and news articles about Multiple
sclerosis."
href="http://health.nytimes.com/health/guides/disease/multiple-sclerosis/overview.html?inline=nyt-classifier">multiple
sclerosis</A>, Ms. Weinberg said, out-of-pocket costs can total tens of
thousands of dollars a year.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody"> Despite the delay, consumers in 2014 will still
have many new protections. They cannot be denied<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" class=meta-classifier
title="Recent and archival health news about health
insurance and managed care."
href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/index.html?inline=nyt-classifier">health
insurance</A><SPAN class=Apple-converted-space> </SPAN>or charged higher
premiums because of pre-existing conditions, and many will qualify for subsidies
intended to lower their costs.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">In promoting his health care plan in 2009, Mr. Obama
cited the limit on out-of-pocket costs as one of its chief virtues. “We will
place a limit on how much you can be charged for out-of-pocket expenses, because
in the United States of America, no one should go broke because they get sick,”
Mr. Obama told a joint session of Congress in September 2009.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Advocates for patients said the promise of the law was
being deferred. “We have wonderful new drugs, the biologics, to treat<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" class=meta-classifier
title="In-depth reference and news articles about Rheumatoid
arthritis."
href="http://health.nytimes.com/health/guides/disease/rheumatoid-arthritis/overview.html?inline=nyt-classifier">rheumatoid
arthritis</A>, but they are extremely expensive,” said Dr. Patience H. White, a
vice president of the Arthritis Foundation. “In the past, patients had to live
in constant pain, often became disabled and had to leave their jobs. The new
drugs can make a huge difference, and we were hoping that the cap on
out-of-pocket costs would make them affordable. But now many patients will have
to wait another year.”</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">The American Cancer Society shares the concern and noted
that some new cancer drugs cost $100,000 a year or more.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">“If a prescription drug plan does not currently have a
limit, then it will not have to have one in 2014,” said Molly Daniels, deputy
president of the lobbying arm of the American Cancer Society. “Patients who
require expensive drugs could continue to have enormous financial exposure,
despite the clear intent of the law to limit a patient’s total out-of-pocket
exposure.”</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Federal officials said they were offering transition
relief to certain health plans in 2014. But, they said, by 2015, health plans
must comply with the law and must have an overall limit on out-of-pocket costs
for medical, drug and other benefits combined.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Theodore M. Thompson, a vice president of the National
Multiple Sclerosis Society, said: “The promise of out-of-pocket limits was one
of the main reasons we supported health care reform. So we are disappointed that
some plans will be allowed to have multiple out-of-pocket limits in 2014.”</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">The law also requires coverage of<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(102,102,153); TEXT-DECORATION: none" class=meta-classifier
title="In-depth reference and news articles about Dental
care - adult."
href="http://health.nytimes.com/health/guides/specialtopic/dental-care-adult/overview.html?inline=nyt-classifier">dental
care</A><SPAN class=Apple-converted-space> </SPAN>for children, but these
benefits can be offered in a separate health plan with its own limit on
out-of-pocket costs.</P>
<P
style="LINE-HEIGHT: 24px; MARGIN: 0px 0px 1em; COLOR: black; FONT-SIZE: 1.2em"
itemprop="articleBody">Federal rules say that a free-standing dental plan must
have “a reasonable annual limitation on cost-sharing.” In states where the new
health insurance marketplace will be run by the federal government, the limit on
out-of-pocket costs for pediatric dental benefits can be no more than $700 for
coverage of one child and $1,400 for a plan covering two or more children in the
same
family.</P><NYT_CORRECTION_BOTTOM></NYT_CORRECTION_BOTTOM><NYT_UPDATE_BOTTOM></NYT_UPDATE_BOTTOM></DIV></NYT_TEXT><SPAN
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