For the first 3 stories: On Sept. 16, after many months of work, Jay Hancock reported that insurance consultants had been selling inexpensive plans lacking hospital benefits to hundreds of large companies employing millions of lower-wage workers. Brokers promoted the plans as meeting the ACA’s toughest standard, the “minimum value” requirement that insurance cover at least 60% of a worker’s expected medical costs. And they did, according to plan features plugged into HHS’s official online spreadsheet. But the calculator was badly flawed, according to actuaries interviewed by KHN. A bigger problem: Employees offered these plans at work are ineligible for tax credits to buy exchange policies that DO include hospitalization. So workers offered such plans would be trapped in substandard coverage. Employers buying these plans were temp companies, retailers, hoteliers and restaurant chains. Nearly half of the 1,600 members of American Staffing Association, with 3 million workers, had signed up or were considering the coverage for 2015. Our stories set off a debate in the industry and reported that the administration would move against the plans two weeks before it did so, in November when HHS said: “It has come to our attention that certain group health plan designs that provide no coverage of inpatient hospital services are being promoted.” Fourth story: In May, Jay was the first to report that numerous consultants and employers were considering removing workers with chronic illness from company plans and shifting them into the exchanges. Such a move would lower costs for employers while raising costs for taxpayers and insurers paying for exchange coverage. Independent lawyers thought it looked legal. HHS started looking at the practice after the story ran, benefits lawyers told us later.
