For some reason the Boston Globe devotes its top slot on today’s Opinion page to a tired and faulty argument (If a law doesn’t work, waive it away?) from former US GOP Senator John Sununu against the employer mandate in the Patient Protection and Affordable Care Act (PPACA). The Department of Health and Human Services has granted waivers to some employers to allow them to continue offering plans with low annual caps (aka mini-med plans).
Here’s how Sununu puts it:
A note to social engineers of all parties: If you have to protect 3 million people from a brand-new law, it probably wasn’t very well written in the first place. That this was an unintended consequence is clear from the fact that the law never contemplated a need for waivers in the first place. In a stroke of bureaucratic magic, HHS simply granted itself the power, and started dispensing the passes.
This is a real cheap shot. PPACA is being rolled out between 2010 and 2014. The waivers are temporary and expire by 2014, when health insurance exchanges and subsidies for lower income employees are to be in place. The temporary nature of these waivers isn’t even hinted at in the article.
The objective of health reform is to get more people into coverage, not to toss them out. So the waivers are a very reasonable and rational form of government flexibility. As a commenter notes:
Agencies grant waivers all the time, regardless of whether the underlying law specifically contemplated it. Waivers are contemplated for anything that is not a clear statutory requirement (i.e. clearly stated in the law), it is not required that the underlying statute specifically allow it. Otherwise, we would be granting administrative pronouncements of the Executive Branch the same force as laws passed by Congress.
One reason health reform is so messy is that it represents a pragmatic approach. Rather than trying to shift everyone suddenly to a utopian system (such as single payer), reform leaves employer-sponsored insurance in place alongside government programs like Medicaid and Medicare. The real world is messy, something Sununu should at least be willing to acknowledge.
July 25, 2011