House Republicans Criticize White House for ACA Hardship Extension

On Thursday, House Republicans criticized the Obama administration for threatening to veto GOP-sponsored legislation would delay the Affordable Care Act's individual mandate, after quietly extending a hardship exemption to the mandate that effectively delays it, the Washington Times reports (Howell, Washington Times, 3/13).

Background on Exemptions

According to the Wall Street Journal's "Washington Wire," the ACA always had included individual mandate exemptions for U.S. residents who have suffered a hardship that makes them incapable of obtaining coverage under a qualified health plan. The administration also listed more than a dozen types of hardships, such as homelessness or having a low income in a state that declined to expand Medicaid under the law.

In 2013, HHS finalized that list before expanding it later in the year to include people whose insurance plans were canceled and could not find other coverage. The additional exemption meant that affected consumers would not be penalized if they remained uninsured throughout 2014 (Radnofsky/Hughes, "Washington Wire," Wall Street Journal, 3/13).

Last week, the administration quietly extended that exemption by two years, through 2016. The reprieve drew little immediate attention because HHS issued it as part of a separate ACA policy change. However, the Journal highlighted the change in an editorial published earlier this week (Viebeck, "Healthwatch," The Hill, 3/12).

GOP Criticism

House GOP leaders said the move further proves that the individual mandate should be delayed or repealed altogether.

During a press conference Thursday, House Speaker John Boehner (R-Ohio) said, "The president's always claimed that getting rid of the individual mandate is tantamount to gutting Obamacare, yet the White House quietly added a new hardship exemption -- for essentially everyone -- and it seems they're hoping that no one will notice."

House Majority Leader Eric Cantor (R-Va.) in a statement said the "Obama administration once again tried to sneak through a unilateral change to Obamacare, which essentially allows anyone who has experienced a hardship in obtaining health insurance to opt out of the individual mandate tax without requiring documentation."

Boehner and other Republicans said the new exemption extension is particularly jarring because the White House on Wednesday warned that President Obama would veto a House GOP-led measure (HR 4015) that would offset the cost of overhauling Medicare's sustainable growth rate formula by delaying the individual mandate for five years.

Administration Response

On Thursday, HHS Secretary Kathleen Sebelius -- during a House Appropriations Labor-HHS-Education Subcommittee hearing on the administration's fiscal year 2015 health budget -- defended the exemption extension. She noted that it "applied specifically to people who were in the market who found their new policies unaffordable so that they could qualify."

Other HHS officials also said the hardship exemption was not new and was created along with the other 13 categories of hardship exemptions to address unique circumstances, CQ Roll Call reports (Attias, CQ Roll Call, 3/13).