Tuesday, August 13, 2013

FOXNews.com: ObamaCare cap on out-of-pocket costs delayed, in latest setback

FOXNews.com
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ObamaCare cap on out-of-pocket costs delayed, in latest setback
Aug 13th 2013, 12:48

The Obama administration has quietly delayed another major provision of the federal health care overhaul, pushing off until 2015 a mandatory cap on out-of-pocket costs for individuals. 

The New York Times reported on Tuesday that the administration is giving some insurers a one-year grace period to adhere to the limit, which otherwise would have capped individual costs at $6,350 a year and gone into effect in 2014. The change means some insurers could set higher limits or set no limit at all on out-of-pocket costs during that period. 

The grace period apparently was granted earlier this year, though was buried in reams of regulatory material and was not publicly reported until now. 

The confirmation comes weeks after the administration announced it was delaying a key insurance mandate - the requirement on mid-sized and large businesses to provide coverage to full-time workers. 

The mandate, and the cap on costs, were both delayed for one year, in a move officials claimed was meant to give businesses more time to prepare. 

According to the Times, the decision to delay the cap on costs was made because many employers said they needed to upgrade their computer systems. The issue was they used different systems to administer both medical coverage and drug coverage, and they were not set up to "aggregate" all the money an individual spends out of pocket. 

As a consequence of the delay, some health plans in 2014 reportedly will be able to keep separate caps for both medical care and drug plans, or have no cap at all. 

The decision raises concerns that, at least for next year, the health care law will not save people as much money as President Obama claimed. On the campaign trail, Obama has touted caps on out-of-pocket costs as a selling point. 

Insurance companies could still raise premiums to offset some of the lost revenue from caps on out-of-pocket costs. The law, though, does aim to keep premium increases in check, and barring any other delays would still prevent health insurers from denying coverage or charging more based on pre-existing conditions.

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