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The Wall Street Journal

Lawmaker Wants Consumers to Have Waiver Rights in Health Overhaul


A senior House Republican on Wednesday introduced legislation that would allow consumers to apply for waivers to key health-law requirements, including the mandate to carry health insurance or pay a fee.

Rep. Mike Rogers of Michigan says his measure would give consumers an opportunity similar to that already enjoyed by employers and unions to win exemptions if the new law significantly increases their premiums or decreases their access to insurance coverage.

As of February, the Obama administration had granted a total of 1,040 one-year waivers to providers of bare-bones insurance plans, including McDonald's Corp. and at least three local branches of the Service Employees International Union.

"If the SEIU gets a waiver and McDonald's gets a waiver…shouldn't the average person who's impacted by this get a waiver too?" Mr. Rogers asked in an interview.

Maine this week became the first state to secure a waiver, lasting for three years, to the law's requirement that insurers spend at least 80% of premiums on actual care. In a letter, an official at the Department of Health and Human Services told the state that MEGA Life and Health Insurance Co., which sells 37% of the state's policies to people who buy plans without the help of an employer, would stop selling such policies in the state if it didn't get the exemption. That would destabilize Maine's individual insurance market, the official wrote.

Mr. Rogers's bill would allow applications for waivers to the requirement that larger employers offer affordable insurance or pay a penalty, in addition to allowing for waivers to the individual insurance mandate. Each provision takes effect in 2014 under current law.

The legislation by Mr. Rogers, who is chairman of the House Intelligence Committee, so far has one Democratic co-sponsor, Rep. Dan Boren of Oklahoma, who is among that chamber's strongest Democratic opponents of the law.

A spokeswoman for Health and Human Services, which has overseen the waivers, declined to comment. The agency has said that the waivers granted so far have largely affected rules about annual coverage caps and are intended as a bridge until 2014 when the law fully kicks in and people will have more insurance options.

The law already allows consumers to apply for a hardship waiver from paying the penalty if they're uninsured. To qualify, individuals must show that the cost of insurance exceeds 8% of their household income. Lower earners—households with income of up to $88,000 for a family of four—will get tax credits to offset the cost of insurance.

Write to Janet Adamy at [email protected]