Nearly a million workers won't get a consumer protection in the U.S. health reform law meant to cap insurance costs because the government exempted their employers.

Thirty companies and organizations, including McDonald's (MCD) and Jack in the Box (JACK), won't be required to raise the minimum annual benefit included in low-cost health plans, which are often used to cover part-time or low-wage employees.

The Department of Health and Human Services, which provided a list of exemptions, said it granted waivers in late September so workers with such plans wouldn't lose coverage from employers who might choose instead to drop health insurance altogether.

Without waivers, companies would have had to provide a minimum of $750,000 in coverage next year, increasing to $1.25 million in 2012, $2 million in 2013 and unlimited in 2014.

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"The big political issue here is the president promised no one would lose the coverage they've got," says Robert Laszewski, chief executive officer of consulting company Health Policy and Strategy Associates. "Here we are a month before the election, and these companies represent 1 million people who would lose the coverage they've got."

The United Agricultural Benefit Trust, the California-based cooperative that offers coverage to farm workers, was allowed to exempt 17,347 people. San Diego-based Jack in the Box's waiver is for 1,130 workers, while McDonald's asked to excuse 115,000.

The plans will be exempt from rules intended to keep people from having to pay for all their care once they reach a preset coverage cap. McDonald's, which offers the programs as a way to cover part-time employees, told the Obama administration it might re-evaluate the plans unless it got a waiver.

McDonald's and Jack in the Box didn't immediately respond to requests for comment.

The waiver program is intended to provide continuous coverage until 2014, when government-organized marketplaces will offer insurance subsidized by tax credits, says HHS spokeswoman Jessica Santillo.

The regulations would have hit some insurance plans for young adults in the universal coverage program run by the state of Massachusetts. The program, enacted in 2006, has a plan for individuals ages 18 to 26 who can't get coverage through work, covering about 5,000 people. The waiver obtained by the state "will give us time to implement the transition plan in a manner designed to mitigate premium increases," says Dick Powers, a spokesman for the state program.

The biggest single waiver, for 351,000 people, was for the United Federation of Teachers Welfare Fund, a New York union providing coverage for city teachers. The waivers are effective for a year and were granted to insurance plans and companies that showed that employee premiums would rise or that workers would lose coverage without them, Santillo says.

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