From – forbes.com – By Capital Flows
The nation’s largest health insurer, UnitedHealth Group, recently announced it was withdrawing from efforts to “attract customers for the coming year in insurance exchanges created under the Affordable Care Act.” It also stated it may withdraw from the exchanges altogether in 2017.
This announcement spells even more difficulties for the already troubled exchanges. It is ironic then, that instead of trying to fix the exchanges, the government continues to focus its energy on threatening ministries with crushing fines unless they comply with its contraception and abortion-drug mandate. These religious ministries include the Little Sisters of the Poor, an order of Catholic nuns that serve the impoverished elderly and are represented by the Becket Fund for Religious Liberty. The Little Sisters have been forced to go all the way to the Supreme Court and the Court announced it will hear their case this term.
Why are large employers exempt?
Meanwhile, in another sign of extreme dysfunction, while the ACA refuses to exempt the Sisters, it has already exempted companies like ExxonMobil and Pepsi. All of these large employers—and hundreds of more like them—are completely exempt. They may offer contraceptives or not, and the government pays no mind. But the Little Sisters, who have never covered contraceptives in their health plan and who have grave and sincere moral objections to starting now, face millions of dollars in fines for not complying with the mandate.
Like so much else about the Affordable Care Act, this bizarre situation is the result of politics—specifically, the attempt to keep President Barack Obama’s promise that “if you like your plan, you can keep it.” Politifact declared this the “2013 Lie of the Year,” but some pre-ACA plans did in fact remain available under the so-called “grandfathering” exemption, which allows even the largest employers to escape many of the ACA’s requirements by simply keeping the same health plan they offered in March 2010, when the ACA was passed. Because it was designed to keep the President’s promise, the grandfathering exemption is permanent – you can add new employees, change insurance contracts, adjust to keep up with medical inflation, and still remain grandfathered. There is no sunset provision for grandfathered plans. And while many employers are deciding to opt out of grandfathered plans for economic reasons, that’s their choice – they’re free to keep them forever if they want to.
Grandfathered plans cover health insurance for more than 50 million Americans
Of course, the Sisters had no way of knowing in March 2010 that Health & Human Services would saddle them with a contraceptive mandate in July 2011. They changed their plan, and lost grandfathered status. But thousands of other U.S. employers did not. The Kaiser Family Foundation estimated that in 2011, 72% of all U.S. firms offered at least one grandfathered plan. That number has fallen to 37% over time, but it still includes big businesses like ExxonMobil, Pepsi and many more. Some of these employers voluntarily cover all contraceptives; others, like ExxonMobil, do not. (Because there is no centralized list of grandfathered plans, finding out who is grandfathered and what they cover is a laborious process that requires checking the plan documents for each employer.) But no one disputes that the number of affected employees is huge: The government projected that in 2013, employers with grandfathered plans would cover health insurance for at least 56 million Americans.
By any measure, this 56 million eclipses the number of people employed by religious objectors like the Little Sisters. As of 2013, the Little Sisters’ Baltimore home had just 54 full-time employees, and its Denver home had 67. Based on litigation, the government estimates that 122 ministries are affected by its narrow rules for religious nonprofits (79 Fed. Reg. 51092, 51096). Assuming a generous 100 employees each, that’s 12,200 total. And even if the number were ten times that, it would still be less than 1% of the 56 million Americans covered by grandfathered plans in 2013.
A promise that’s already been proven a lie
So, to recap: The government has pursued the Little Sisters of the Poor all the way to the U.S. Supreme Court and threatened them with millions of dollars in fines because they want to keep offering contraceptive-free health plans that comply with their Catholic faith. But the same government has let ExxonMobil, pick and choose which parts of the ACA they will comply with—even if that means some contraceptives are off the table—to keep a five-year-old political promise that has already been proven to be a lie.