Who knew? Anyone who paid attention to the health care law

"We have to pass the bill so that you can find out what is in it." — House Speaker Nancy Pelosi, March 9, 2010.

She wasn't kidding. The public got to peek under the hood recently when the Wall Street Journal reported that McDonald's Corp. wanted out: out of a requirement in the new health-care law that compels employers to spend 80 to 85 percent of premiums on medical benefits.

Who knew?

For McDonald's mini-med health-care plan, a low-cost, limited plan covering about 30,000 hourly fast-food workers, the minimum medical loss ratio was economically unfeasible. The company asked for a waiver, according to memos provided to the Journal.

It turns out lots of other companies are seeking waivers for limited benefit plans — along with some states, like Maine, with a small number of insurers, according to Joseph Antos, a health-care scholar at the American Enterprise Institute, a conservative think tank.

Another group is lining up to apply for exclusions from the minimum annual cap on benefits that is part of the law. No wonder the Department of Health and Human Services had to put out a memo on waiver guidance. The subject line alone is intimidating:

"OCIIO Sub-Regulatory Guidance (OCIIO 2010-1): Process for Obtaining Waivers of the Annual Limit Requirements of PHS Act Section 2711"

The explanation of the purpose, background and process for filing a waiver isn't much better. The gist of it is this:

The Secretary of HHS is authorized to determine the minimum coverage limits;

The Secretary of HHS is authorized to waive those limits if compliance with them "would result in a significant decrease in access to benefits or a significant increase in premiums," according to the memo.

The state insurance commissioners can give the secretary advice, Antos says, but she doesn't have to take it.

That pretty much describes the operating premise for the legislation that changes health care as we know it.

"The law they passed is a shell of a law," says Michael Cannon, director of health-policy studies at the libertarian Cato Institute in Washington. "Most of the rules have yet to be written."

Who knew?

"If you like your health-care plan, you can keep your health-care plan." — President Barack Obama, Aug. 11, 2009, Aug. 12, 2009, Aug. 13, 2009, etc., etc., etc.