The U.S. Department of Health and Human Services has approved more than 1,000 one-year waivers of the Patient Protection and Affordable Care Act (PPACA) provision that restricts annual limits for essential benefits. Through February 28, 1,040 waivers had been approved for plans that cover more than 2.6 million insureds. Most of the affected plans are limited medical benefit ("mini-med") plans, which are generally offered to low-wage, part-time or seasonal employees.

The waivers are necessary for plans that have annual maximum payments for essential benefits below the minimums required by PPACA: $750,000 in 2011, $1.25 million in 2012 and $2 million in 2013. Beginning in 2014, no annual coverage limits will be permitted for essential benefits. In February, HHS said it had approved 94% of waiver requests it had received thus far. Waivers are available when meeting the minimum benefit requirements would result in a significant decrease in access to benefits or a significant increase in premiums.

New state insurance exchanges mandated by PPACA are expected to begin operating in 2014, giving low-wage employees a chance to qualify for government-subsidized coverage. The availability of the exchanges would reduce the need for mini-med plans.