This Obamacare rule delay could really hurt

Insurers are getting a one-year reprieve on a key provision aimed at limiting consumers' out-of-pocket costs.

By Aimee Picchi Aug 13, 2013 1:22PM

Prescription medicine expenses © Don Farrall, Photodisc, Getty ImagesThe Obama administration touts the Affordable Care Act as a way to make health care insurance both widely available and cost-effective. But a new twist in the law may put the second goal at risk. 


Buried in a tangle of bureaucratic language is a key change to Obamacare that will delay an out-of-pocket cost limit for individuals and families, The New York Times reports.


Obamacare had promised to hold out-of-pocket spending to no more than $6,350 for an individual and $12,700 for a family. But federal officials are now allowing some insurers to take an additional year to meet those limits, the newspaper notes. 


Why delay the cost ceiling? Pressure from insurers, according to an unnamed administration official. 


"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," the official said. 


The change was called illegal and unconstitutional by Sen. Rand Paul, R.-Ky., Fox News reports. "The president doesn't get to write legislation, and it's illegal and unconstitutional for him to try and change legislation by himself," Paul said.


People most likely to be hurt by the delay are those with chronic conditions. Multiple sclerosis patients, for instance, can face direct treatment costs that exceed $20,000 per year, according to a 2007 paper. Some drugs for chronic illnesses can cost more than a car, such as Sanofi-Aventis' (SNY) Cerazyme, a treatment for Gaucher disease that can cost as much as $200,000 per year.


The delay was greeted with dismay by representatives of several groups, including the National Multiple Sclerosis Society, which told The New York Times it was disappointed, and the American Cancer Society, which warned that patients "could continue to have enormous financial pressure."


By 2015, health plans must be in compliance with the law.


But given that this tweak comes after Obamacare's one-year delay on its employer mandate to provide insurance, it raises doubts about whether the legislation will actually provide the relief it had promised.


Follow Aimee Picchi on Twitter at @aimeepicchi. 


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688Comments
Aug 13, 2013 1:32PM
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Obamacare is designed to cripple the American economy.
Aug 13, 2013 1:47PM
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Just another lie!  What were you expecting from this administration?  Health care costs would go down with this law?  You could keep your plan?  Quality will go up?  I've got a bridge to sell you if you believe that hogwash.
Aug 13, 2013 1:36PM
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Why would anyone be surprised by this news. Little by little,  Obamacare is crumbling. 
Aug 13, 2013 1:59PM
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Legislation is created by the legislative branch of the government not the administrative branch. Obama continues to negate law on personal wims because it does not suit his goals or that of his party. Either all of the law gets enacted or it gets amended or repealed. There is nothing in this ACA that will benefit anyone but a hand full of irresponsible people while the rest of the population and the industry get screwed. First action is to repeal ACA in its entirety. Second action pass a real healthcare bill that must apply to everyone including government representatives, employees, and the general population with no exceptions or waivers. If they quit trying to take care of special interest groups while screwing everyone else you might find that the laws are simplier and easier to implement and enforce.
Aug 13, 2013 1:46PM
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As usual, the little guy gets screwed.
Aug 13, 2013 1:56PM
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congrats mr. and mrs. middle class, you now have another monkey on your back. this will not be cheap, in fact it's designed to break you to herd you all into single payer, which will be an even bigger monkey on your back. big brother will be in full control while you get none. this is the bill that is now due. the bill you got for voting in all that hope and changie stuff.
Aug 13, 2013 2:00PM
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Even Obama demands an exemption from Obamacare.
Aug 13, 2013 2:31PM
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Nancy Pelosi and Forrest Gump both had it right,

Nancy told us we would find out about Obama Care once they passed it. How's that working out?

Forrest told us Stupid is as Stupid does!   Enough said!

Aug 13, 2013 1:57PM
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Obama lied-again.  After all the deals and special exceptions, one small business in North Carolina will be the only available/eligible/mandated Obama careless entity.  Premium per person will be $5 gazillion per single, per month.  Everyone else is excluded or gets it free. 

 

We gotta start funding Obamas face on Rushmore------at the bottom as worst president ever.

 

 

Aug 13, 2013 2:24PM
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This Obamacare nonsense is getting more ridiculous by the day.
Aug 13, 2013 1:52PM
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Y is it that so many times that big news comes out he is out of town or on vacation. just a thought.
Aug 13, 2013 1:59PM
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We're still deluding ourselves into thinking this law will be 'cost-effective' at any point?
Aug 13, 2013 2:14PM
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odumbo, I would have no problem with odumbocare if and only if you, congress, the unions and large companies you have allowed not to partake in it are part of it.  If I have to partake why do you and the rest of your cohorts get to op out of it, you made the law, if it is good enough for we the people should it not be good enough for you and the rest that you have given the green light to op out of it.
Aug 13, 2013 1:59PM
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Oh, what a surprise!!!  I guess I shouldn't plan on spending any of the money Obama was going to save me.  Let's see, when Obama says costs are going to rise ie electricity and fuel costs, they go up.  When Obama says my health costs will go down, they go up.  Hmmmmm, does that mean he only lies half of the time?

Aug 13, 2013 2:16PM
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Many of you voted him in, twice. Now some will complain, picky, picky.
Aug 13, 2013 2:03PM
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This law was a terrible idea back when Republicans first thought of it and it's still a terrible idea now that Democrats have passed it.  Stupidity might be the only bipartisan concept in Washington. 
Aug 13, 2013 2:32PM
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Just ANOTHER EXAMPLE of why I am SO DAMN GLAD I didn't vote for this unqualified idiot!!  Hope all you damn people who got money/food/Obama phones-whatever and caught the bus to the polls are happy with your "CHANGE".   I can't wait for him to LEAVE THE "WHITE" House-surprised we can still call it that. 
Aug 13, 2013 2:08PM
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Washington is Answerable to no one. I  suppose the fog is clearing!!!!
Aug 13, 2013 2:32PM
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Obama thinks he is ordering from a menu...Enforce this provision, no enforce this provision.  I didn't know he has legislative capabilities too.  Oh yeah, he is the self appointed King of the USA.

Aug 13, 2013 2:48PM
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Elected officials are suppose to represent us the people. So ask yourselves, why did the Politicians vote to EXEMPT themselves from this Obamacare? Because its a piece of s--t. They would have to pay taxes on their " Cadillac Plan" thats why. But the rest of you PAY! Another giveaway to the Insurance Companies. Get Rid of It! 
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