Another Obamacare exemption

[Chris0nllyn]

US Virgin Islands and other territories.

Currently, the Department uses the existing Public Health Service Act (PHS Act) definition of "state" for new PHS Act requirements and funding opportunities included in title I of the Affordable Care Act. Under this definition, the new market reforms in the PHS Act apply to the territories. We have been informed by representatives of the territories that this interpretation is undermining the stability of the territories' health insurance markets.

After a careful review of this situation and the relevant statutory language, HHS has determined that the new provisions of the PHS Act enacted in title I are appropriately governed by the definition of "state" set forth in that title, and therefore that these new provisions do not apply to the territories. This means that the following Affordable Care Act requirements will not apply to individual or group health insurance issuers in the U.S. territories:1 guaranteed availability (PHS Act section 2702), community rating (PHS Act section 2701), single risk pool (Affordable Care Act section 1312(c)), rate review (PHS Act section 2794), medical loss ratio (PHS Act section 2718), and essential health benefits (PHS Act section 2707). Specifically, under this interpretation, the definition of "state" set forth in the PHS Act will apply only to PHS Act requirements in place prior to the enactment of the Affordable Care Act, or subsequently enacted in legislation that does not include a separate definition of"state" (as the Affordable Care Act does).

http://www.cms.gov/CCIIO/Resources/Letters/Downloads/letter-to-Francis.pdf

 

[Tilted]

I wouldn't call this an exception to ObamaCare, I'd call it correcting a misinterpretation. Title I of the PPACA is pretty clear on what a state is, and it doesn't include territories. The earlier interpretation was the mistake.

I'd guess what happened here is that the DHHS wanted these various provisions to apply to territories as well as states, so it ignored the plain language of the statue and decided that they would, thinking it would get away with that. Then when the territories complained, the DHHS suddenly realized that - hey, the language in the statute is pretty clear, these provisions don't apply to territories. Now, maybe the DHHS went back to the correct interpretation, even though it would still prefer these provisions apply to territories, because it thought it would lose a court fight that might result if it didn't. Or, what seems more likely to me, after getting push back the DHHS decided that it would be better if these provisions didn't apply to territories (e.g. because of problems they would cause) and the fact that it was wrong to begin with (and the sudden realization there of) provided a convenient excuse to do an about face. Oops, we got it wrong - but look, we fixed our mistake.

 

[Chris0nllyn]

I wouldn't call this an exception to ObamaCare, I'd call it correcting a misinterpretation. Title I of the PPACA is pretty clear on what a state is, and it doesn't include territories. The earlier interpretation was the mistake.

I'd guess what happened here is that the DHHS wanted these various provisions to apply to territories as well as states, so it ignored the plain language of the statue and decided that they would, thinking it would get away with that. Then when the territories complained, the DHHS suddenly realized that - hey, the language in the statute is pretty clear, these provisions don't apply to territories. Now, maybe the DHHS went back to the correct interpretation, even though it would still prefer these provisions apply to territories, because it thought it would lose a court fight that might result if it didn't. Or, what seems more likely to me, after getting push back the DHHS decided that it would be better if these provisions didn't apply to territories (e.g. because of problems they would cause) and the fact that it was wrong to begin with (and the sudden realization there of) provided a convenient excuse to do an about face. Oops, we got it wrong - but look, we fixed our mistake. but you can keep the money you've spent already

As always, thanks for the input.

 

[Hijinx]

I wouldn't call this an exception to ObamaCare, I'd call it correcting a misinterpretation. Title I of the PPACA is pretty clear on what a state is, and it doesn't include territories. The earlier interpretation was the mistake.

I'd guess what happened here is that the DHHS wanted these various provisions to apply to territories as well as states, so it ignored the plain language of the statue and decided that they would, thinking it would get away with that. Then when the territories complained, the DHHS suddenly realized that - hey, the language in the statute is pretty clear, these provisions don't apply to territories. Now, maybe the DHHS went back to the correct interpretation, even though it would still prefer these provisions apply to territories, because it thought it would lose a court fight that might result if it didn't. Or, what seems more likely to me, after getting push back the DHHS decided that it would be better if these provisions didn't apply to territories (e.g. because of problems they would cause) and the fact that it was wrong to begin with (and the sudden realization there of) provided a convenient excuse to do an about face. Oops, we got it wrong - but look, we fixed our mistake.

In other words they were ready to screw the territories too with this abomination, but the territories were too smart for them.