A week-old story about big companies getting waivers from healthcare reform laws got a lot of traction on the forums. What was striking was the amount of ideology and rhetoric that was spewed, with little comprehension about the issue.

It was like watching a room full of angry people talking about stuff they don't understand... but they care a lot because they are being screwed, and just don't understand how and why. The elite must be chuckling into their sleeves. (Links to forums: Infowars, NewsVine, YahooBuzz, TweetMeme, iTulip, FreeRepublic, Consumerist, Digg, Select Smart, PeakOil, Reddit [the exception to the rule].)

Not that I understand it either, but here's my attempt.

The first problem was that they weren't reading the article. The article wasn't deep enough to explain it all, but it had some good information. It just lacked depth and analysis.

Here's the original article: McDonald's, 29 other firms get health care coverage waivers

It appears that the waivers were for different reasons, because the different companies requesting them seemed to have different insurance policies.

The United Federation of Teachers had some 300k+ members, presumably all of them getting insurance coverage.

McDonald's had 115,000 people covered, and Jack in the Box had 1,000+ people covered. This represents a tiny fraction of their workforce. (JiB boasts of having more than 2000 restaurants. McDonald's obviously has tens of thousands of restaurants.) So these companies are providing healthcare for a select few.

The reasons for waivers were not clearly linked up with the companies - that's a problem with this article - but the reasons listed were:

McD, JiB: not required to raise minimum annual benefit

Unspecified: raise minimum benefit to $750k

United Agricultural Benefit Trust: unspecified

Unspecified, McD: exempt from health coverage cap (you have to pay costs past the cap)

State of Massachusetts: unspecified

United Federation of Teachers: not clear. Premiums rising?

The author was Drew Armstrong of Bloomberg Business News. Maybe it's not his fault - often, editors cut out the information, and USA Today might be removing out information as well. Armstrong's previous piece on the issue was better.

The real story starts with the HHS website (thanks to the link bpr @ itulip provided). HHS responded to the controversy generically. The reason for the waiver was reposted at this law firm: proskauer. Recap:

...the Act generally permits group health plans and insurers to include restricted annual limits on essential health benefits until 2014. These restricted annual limits may not be less than:

• $750,000 for plan or policy years beginning on or after September 23, 2010 but before September 23, 2011

• $1,250,000 for plan or policy years beginning on or after September 23, 2011 but before September 23, 2012

• $2,000,000 for plan or policy years beginning on or after September 23, 2012 but before January 1, 2014

For plan or policy years beginning on or after January 1, 2014, a health plan or insurer generally may not impose any annual limit on essential health benefits.

Notwithstanding the above requirements, the Interim Final Regulations (the Regulations) published on June 28, 2010 provided for the Secretary of HHS to establish a program under which the requirements relating to restricted annual limits may be waived if compliance with the requirements would result in a significant decrease in access to benefits under the plan or policy or a significant increase in premiums. The regulations did not include any details regarding the program, but stated that HHS was expected to issue guidance in the near future.

So, the issue is a coverage cap. Insurance plans must be written so they cover at least $750k of medical costs (in that first time frame). The waiver allows the insurance to cover less than $750k in medical costs.

So these insurance plans probably have caps that cover less than $750k. To reach that goal, there are two options: either raise premiums, or drop coverage and let the employees go without insurance.

On this decision, the pool of waiver applicants is split into those who would see higher premiums and could not afford them, and those who threaten to drop coverage despite being able to afford them.

Into the former group are the union health plans and small businesses and nonprofit individual health plans, who give coverage to everyone, but just not the best insurance. They're shopping in the 99 Cents Store of insurance markets.

Into the latter group are, obviously, McDonalds and Jack In the Box. Both offer coverage only to a tiny fraction of their employees, but are multi-million or multi-billion dollar for-profit enterprises.

There are real evil elitist assholes in the world, but not every applicant for a waiver was an evil elitist asshole.

Look at McDonalds - they have probably millions of employees, but cover only 100k of them. Then they pull this "we can't afford it" bullshit, and threaten to drop coverage for 30,000 workers.

It's even worse, a commenter at LGF (a hard right wing blog) said that McDonald's coverage is $750 a year for up to $2000 of coverage, and according to a commenter at reddit, it's covering expenses already covered by the company's own workers comp. That's terrible "insurance". So the assholes at McDonalds corporate were threatening to pull the bread-crusts from the mouths of children, then blaming healthcare reform for the lost coverage.

In the big picture, there are only 1,000,000 waivers being granted out of some 100 million workers who have coverage. The waivers were granted because HHS didn't want to deal with the heat of putting so many McDonalds and JiB workers out of insurance.

But, maybe they should have told the corporations to go ahead and drop the coverage, and then explain how shitty the coverage was, and put them on some government plan.

Social media?

Also interesting is how most of the "discussion" has the same spin as this article from the Investors Business Daily, a right-wing "business" rag. It's as if the article automatically jumped from USA Today right into the forums, and the discussion was spun to parrot the IBD.

Meanwhile, the handful of insightful comments came from Reddit.com, and news site that's popular with computer geeks.

It seems uncanny.

The comment "They're shopping in the 99 Cents Store of insurance markets." is off mark.

I buy lots at things at the 99 Cents store. I buy Sara Lee bread, Anderson's Split Pea Soup, Rivera Soups, and Nestle Nesquick. These products are the same that you get a Ralph's for double or triple the cost.

The 99 Cents stores are not synonymous with low quality, like the insurance mentioned in the article.

I shop at the 99 a lot, too, but let's be real. Most of the deals there are stock that was pulled from the shelves of gourmet shops like Trader Joe's. A lot of it is stuff headed for the trash and some freegan's belly.

I've found a lot of awesome deals there. Crackers, salmon, fresh pasta, brie and other cheeses, soy milk, USB cables, headphones that were better than full priced ones, phone accessories, cleaning chemicals, utensils, gardening stuff, and seasonal goodies. I like the store, for what it is.

The other stuff there is a mix of things that, per unit, cost the same (or more) than at grocery or electronics stores, or are lower quality items. For example, they sell CD-Rs for 50 cents each. Tortillas are in smaller packs and cost slightly less than at Mexican supermarkets. Onions are half price, but won't last so long in the refrigerator. Plastic bags cost the same as a supermarket. Garden soil costs the same as at a nursery or big box store. Canned goods are sometimes questionable - they're edible but the flavors are often not quite right.

Also, I've seen dangerous products sold at 99 Cents Only (the chain with the big 99), like tools that shatter or have weak handles, plates with hazardous lead glaze, and questionable charcoal (made of coal rather than wood).

It's something like a lightly regulated free market in there - you can get good deals, or get ripped off, or get hurt. You have to go in there armed with knowledge, or you'll suffer. Unfortunately, the way this society works, most people shopping in the 99 cents only store probably shop there because they didn't do so well in chemistry or economics in school. They're being preyed upon.

when the Chinese imports begin to rise in price, you may wish you had supported domestic or local shops. Which are now closing up as the money flows out of the country,

Technically, it's locally owned and HQd in Commerce.

Also, it's weird to think of it, but a lot of stuff i get there is made in the USA, even locally.

When you go to the mom-and-pop 99 cents stores, more of the stuff is imported. Most of these stores don't get the closeouts and expiring food.