Another 39 Mini-Meds Granted PPACA Waivers

July 15, 2011 ( – The Obama Administration has approved another 39 one-year waivers from the provisions of the Patient Protection and Affordable Care Act.


According to a press release, as of the end of June 2011, a total of 1,471 one-year waivers have been granted, and that the number of enrollees in plans with annual limits waivers now stands at 3.2 million .

Broken down by category, HHS noted that the waivers had been granted to:

The Administration notes that, “in order to protect coverage for workers in mini-med plans until more affordable and more valuable coverage is available in 2014”, the law and regulations issued on annual limits allow the Department of Health and Human Services (HHS) to grant temporary waivers from this one provision of the law that phases out annual limits if compliance would result in a significant decrease in access to benefits or a significant increase in premiums.  Plans that receive waivers must comply with all other provisions of the law and must alert consumers that the plan has restrictive coverage and includes low annual limits.  These waivers are temporary – and after 2014, no waivers of the annual limit provision are allowed.  

Denials Detailed

Of course, some applicants for waivers of the annual limits requirements have been denied, either because they “did not demonstrate that compliance with the minimum annual limits requirements would significantly increase premiums or decrease access to benefits”.  

There were nearly 400,000 enrollees in plans that were initially denied, however, there were more than 175,000 enrollees in plans that were denied and then subsequently approved upon reconsideration.  On a net basis, therefore, the total number of enrollees in plans denied, excluding enrollees in plans subsequently approved upon reconsideration stands at 216,399.  The list of denials is online here.

Last month the Obama Administration announced that waiver applications will no longer be accepted after September 22, 2011 (see Health Care Annual Limit Waiver Program Closing Early).  Additionally, on June 17, 2011, the Centers for Medicare & Medicaid Services (CMS) introduced a process for plans that have already received waivers and want to renew those waivers for plan or policy years beginning before January 1, 2014, guidance that extends the duration of waivers that have been granted through 2013, if applicants submit annual information about their plan and comply with requirements to ensure that their enrollees understand the limits of their coverage (see HHS Issues New Guidance on Annual Limit Waivers). 

Existing waiver recipients must apply to extend their current waiver and all applications must be submitted by September 22, 2011; after that date applications for an extension will no longer be considered.  Any plans that have not yet applied for a waiver also must apply by September 22, 2011.