Rules for creating Obamacare rules

Thursday, the Institute of Medicine issued its report designed to assist the Department of Health and Human Services decide what must be included in Obamacare’s “essential health benefits package”, coming soon to an insurance exchange near you.  The Institute was not charged with creating a list of items that must be included in your insurance policy, like it or not, but rather with telling HHS how to go about deciding what must be included in your policy, like it or not.

While this process was happening, an assortment of lobbyists has already begun circling Washington to promote their own “essential benefits”, including,

[g]roups representing autism specialists, chiropractors, acupuncturists and others [who] see a chance to get broad coverage and are lobbying heavily for specific inclusion in the final package requirements.

But, as the Institute of Medicine points out, the more that must be included in the basic plan, the more costly the policy becomes.

If it was not affordable, then many people would not be able to obtain it, even with government help, and this would conflict with the purpose…

The report suggests that HHS determine what the average premium paid by a small employer will be in 2014, and then tailor the “essential package” to fit within that cost.  It also recommends that HHS meet with small businesses and individuals throughout the country to obtain their input in designing the policy requirements.

HHS Secretary Kathleen Sebelius, responding to the report, said that the department would be following the institute’s recommendations to organize ‘listening sessions’ to get input for what should be included.  ‘Before we put forward a proposal, it is critical we hear from the American people,’ she said in a statement.

However, I would submit that Ms. Sebelius has already heard from the American people.  We now have 1472 businesses who have been granted a 1 year waiver, and 106 businesses who have been granted a 3 year waiver from the requirement that annual benefits be no lower than $750,000 in 2011.  These waivers cover some 3.4 million people.  By 2014, there can be no annual limits on benefits, and no more waivers.

If Ms. Sebelius hasn’t listened to this and proposed appropriate changes, does anyone seriously believe she will listen to Americans on her upcoming “listening tour”?


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The Sound Off Sister was an Assistant United States Attorney for the Southern District of Florida, and special trial attorney for the Department of Justice, Criminal Division; a partner in the Florida law firm of Shutts & Bowen, and an adjunct professor at the University of Miami, School of Law. The Sound Off Sister offers frequent commentary concerning legislation making its way through Congress, including the health reform legislation passed in early 2010.


  1. Plainvillian on October 8, 2011 at 6:32 pm

    One word solution:? Repeal.

  2. Dimsdale on October 8, 2011 at 8:07 pm

    “Listening sessions” are just more administration lip service, feeding pablum to the voters.
    If they really wanted input, ?bamacare would have been dead and buried long ago.

  3. Anybody but Obama on October 9, 2011 at 8:46 am

    “Rules, they’re are no rules, we make them up as we go along”
    Alcee Hastings D 23rd District Florida

  4. winnie on October 9, 2011 at 11:11 am

    Methinks Sebelius is hard of hearing…and thinking…and definitely hard up for some common sense…
    She has no business trifling with our health care, but I guess we have Obama to thank for putting her in charge.? Gack AND gasp.

  5. SeeingRed on October 10, 2011 at 8:31 am

    I fear Obamacare like nothing other from this Regime.? But at this point?we it’ll be ruled on by SCOTUS.? If SCOTUS upholds the mandate I’ll then start thinking about repeal.? The ’12 election will then become the single most improtant in our Nation’s history as?the Republican brand will need to own the House, Senate and of course the WH inorder to repeal this tenant of?social idealism.

    • Lynn on October 12, 2011 at 3:55 pm


  6. Murphy on October 10, 2011 at 9:05 am

    A “listening tour” is useless we need a “Pay attention tour” . Oh my am I violating the Disabilities Act by saying people with ADD shouldn’t work for the government.


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