ObamaCare cap on out-of-pocket costs delayed, Sen. Paul calls move ‘illegal’

By on August 13, 2013
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A report that another provision of ObamaCare — one that would cap out-of-pocket health care costs — was being delayed brought a defiant challenge Tuesday from a top Senate Republican, accusing the president of “illegal and unconstitutional” acts in changing laws without congressional approval.

“The president doesn’t get to write legislation, and it’s illegal and unconstitutional for him to try and change legislation by himself,” Sen. Rand Paul, R-Ky., told Fox News.

The New York Times reported on Tuesday that the administration is giving some insurers a one-year grace period to adhere to the limit, which otherwise would have capped individual costs at $6,350 a year. The full requirement will go into effect in 2015, rather than 2014. The change means some insurers could set higher limits or set no limit at all on out-of-pocket costs during that period.

The grace period apparently was granted earlier this year, though was buried in reams of regulatory material and was not publicly reported until now. Department of Labor guidelines published in February appear to address the delay.

The confirmation comes weeks after the administration announced it was delaying a key insurance mandate — the requirement on mid-sized and large businesses to provide coverage to full-time workers. The mandate, and the cap on costs, were both delayed for one year, in a move officials claimed was meant to give businesses more time to prepare.

According to the Times, the decision to delay the cap on costs was made because many employers said they needed to upgrade their computer systems. The issue was they used different systems to administer both medical coverage and drug coverage, and they were not set up to “aggregate” all the money an individual spends out of pocket.

As a consequence of the delay, some health plans in 2014 will be able to keep separate caps for both medical care and drug plans, or have no cap at all on drug costs.

In response to the report, an Obama administration official stressed that the cap on individual spending for “major medical coverage” will still be in place in 2014, “on time.” It will then be expanded to cover other benefits the following year.

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