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”?