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Waiver-mania: Now, nursing homes lobby for Obamacare pardon; Update: San Francisco’s escape hatch

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By Michelle Malkin  •  May 16, 2011 11:58 AM

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On Friday, the White House quietly unveiled more Obamacare waivers.

The CMMS website noted: “As of the end of April 2011, a total of 1372 one-year waivers have been granted. This update includes 221 new approvals.”

Among the new recipients:

Local 485 Health and Welfare Fund
Detroit and Vicinity Trowel Trades Health and Welfare Fund
CWA Local 1182 Security Benefits Fund
CWA Local 1183 Health and Welfare Fund
Bakers Union and FELRA Health and Welfare Fund
SEIU Healthcare IL Home Care & Child Care Fund
UFCW San Diego Employers Health & Welfare Trust
Welfare Fund of the International Union of Operating Engineers Local 15, 15A, 15C, 15D AFL-CIO
USW Local 1-0318 Health and Welfare Trust Fund
United Association of Journeymen and Apprentices Local 198 AFL-CIO Health and Welfare Trust
Teamsters Local 617 Welfare Fund
Local 734 Welfare Fund
Plumbers and Steamfitters Local 60 Health and Welfare Fund

The Hill reminds us that the GOP is still seeking answers on the get-out-of-Obamacare process: “‘The fact that over 1,000 waivers have been granted is a tacit admission that the healthcare law is fundamentally flawed,’ Energy and Commerce Chairman Fred Upton (R-Mich.) said in March. Upton is one of three House committee chairmen who has used new oversight powers to investigate the annual limit waivers.”

As I pointed out during the last waiver go-around in April, HHS is already plotting more waivers for 2012-2013.

Meanwhile, nursing homes are gearing up for their own battle to carve out a new loophole to spare them the ravages of the Obamacare mandate.

It is an oddity of American health care: Many nursing homes and home care agencies do not provide health insurance to their workers, or they pay wages so low that employees cannot afford the coverage that is offered.

The numbers are stark. Among workers who provide hands-on care to nursing home residents, one in four has no health insurance. Among those who provide care to people living at home, one in three is uninsured.

The new health care law is supposed to fix the problem by guaranteeing access to affordable coverage for all. But many nursing homes and home care agencies, alarmed at the cost of providing health insurance to hundreds of thousands of health care workers, have started a lobbying effort seeking some kind of exemption or special treatment.

Mark Parkinson, president of the American Health Care Association, the largest trade group for nursing homes, says the problem is that reimbursement rates for Medicaid and Medicare, set by government agencies, do not pay them enough to offer their employees medical coverage. “We do not have much ability to increase prices because we are so dependent on Medicaid and Medicare” for revenue, he said.

Mr. Parkinson acknowledged that when nursing homes do offer health insurance to employees, the benefits are often limited. The coverage “is probably not up to what will be required” by the federal law, he said.

Medicaid covers about two-thirds of nursing home residents. States set Medicaid rates, and many states, facing severe budget problems, have reduced payments for nursing homes.

Starting in 2014, the law will require employers with 50 or more full-time employees to offer affordable coverage or risk paying a penalty. For a midsize nursing home, that penalty could easily exceed $200,000 a year. Nursing home executives are urging Congress and the Obama administration to spare them from the penalties.

Dude, where’s your waiver?

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Update: Matthew Boyle breaks down all of San Francisco’s special passes. Nancy Pelosi is unavailable for comment.

Related: Jamie Dupree first shed light on the San Fran waiver frenzy on Sunday.

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