Health law implementation hitting snags

Despite pledges to leave employer-based health plans intact, benefits consultants say some firms are considering ending or reducing coverage for their workers, The Associated Press reports, adding: "That's just not going to happen, White House officials say." But an executive for the consulting firm Deloitte said, "What we are hearing in our meetings is, 'We don't want to be the first one to drop benefits, but we would be the fast second.' We are hearing that a lot."

"'My conclusion on all of this is that it is a huge roll of the dice,' said James Klein, president of the American Benefits Council, which represents big company benefits administrators. 'It could work out well and build on the employer-based system, or it could begin to dismantle the employer-based system.'" The White House denies the possibilities of such a trend taking off (Alonso-Zaldivar, 10/24).

Meanwhile, to entice employers to keep benefits, the White House may waive requirements that would make it easier for them to offer new health plans that don't have to meet all requirements of the law, Bloomberg reports. "Under the law passed in March, once companies change plans they must provide added services, including preventative care. The U.S. is weighing whether to allow employers to avoid the requirements, even with a new insurer, as long as benefit levels stay the same, said a White House official who asked not to be identified because the talks are private" (Armstrong, 10/25).

A key component of the health law will be state-run health insurance exchanges, essentially online marketplaces that will also provide a framework for regulators to oversee plans, The New York Times reports. "Massachusetts and Utah [which already have exchanges] provide a glimpse of the future, and they offer radically different models for other states. The battle over health care is shifting to the states, and the design of insurance exchanges will be one of the most pressing issues for state legislators when they convene early next year" (Pear, 10/23).

Meanwhile, Politico Pulse reports that state-run plans for people with pre-existing conditions -- meant to provide coverage to such patients over until 2014, when the exchanges become available -- are surprisingly underused. So states are "gearing up to spend big on professional marketing campaigns." In Missouri, where an official said people were complaining because they thought the plans were free, the experience has been typical of many states. "The monthly premium in Missouri is as high as $972 a month; the program has only had about 140 enrollees since opening this summer. Second issue is finding the long-time uninsured, who are often unfamiliar with enrollment processes or even that the new program exists" (Haberkorn and Kliff, 10/25).