What you can't do directly . . .

. . . you do indirectly.

The country's labor unions tried hard to exempt themselves from the "Cadillac" tax on expensive (and generous) health insurance policies when the Accountable Care Act was being debated.  Whatever you might think about that tax, Congress wisely decided that labor unions were no different from companies on this matter.

But now Jay Hancock at Kaiser Health News reports that the unions may getting their way, through quiet, back-door administrative changes:

Buried in rules issued last week is the disclosure that the administration will propose exempting “certain self-insured, self-administered plans” from the law’s temporary reinsurance fee in 2015 and 2016.

That’s a description that applies to many Taft-Hartley union plans acting as their own insurance company and claims processor, said Edward Fensholt, a senior vice president at Lockton Cos., a large insurance broker.

Insurance companies and self-insured employers that hire outside claims administrators would still be liable for the fee, which starts at $63 per insurance plan member next year and is projected to raise $25 billion over three years.

Unions, a key Obama ally, have increasingly criticized the Affordable Care Act as threatening the generous medical plans held by many members.

Eliminating the reinsurance fee was one of several resolutions adopted at the AFL-CIO’s September convention.

Although it’s too early to tell whether the Department of Health and Human Services will give union plans all of what they want on the fee, last week’s language “is how HHS often breaks controversial regulatory news,” benefits lawyer R. Pepper Crutcher, Jr. wrote last week. It's not known when the administration will put out a new regulation on reinsurance. 

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