House health bill makes private medical insurance illegal

[Darin Jordan]

http://www.examiner.com/x-2304-DC-Re...urance-illegal

Just so you people know what you are getting into...

[Flying Scotsman]

Darin and I quote

So the Marxists in the Congress and the White House are officially trying to kill an industry and our freedom to purchase whatever insurance we choose for our families. There is not only no precedent for this in a free society, there is no Constitutional authority.

Marxists ???? This dude is a sad puppy....welcome back Mr. McCarthy

Douggie

[Darin Jordan]

Marxists ???? This dude is a sad puppy....welcome back Mr. McCarthy

Douggie

Douggie... if it walks like a duck, and quacks like a duck...

If they implement "socialist" policies... and they implement "socialist" programs...


If they decide it's in their hands to determine who deserves healthcare and who doesn't (does granny get the new hip, or just the pain meds???)

Don't worry... it'll become clearer as time goes on... and the Kool-Aide wares off...

[Flying Scotsman]

Darin, I can not think of a country that has more strict controls on their government and the ability to impeach a President. But that guys post was stupid. You will always have the choice in the USA for private care.

Douggie

[domwilson]

I don't like this either. However, I do think we need some type of healthcare reform.

[domwilson]

Interesting article... http://www.kaiserpapershawaii.org/ka...ntehistory.htm

[Darin Jordan]

You will always have the choice in the USA for private care.

Douggie

Douggie,

You aren't reading the right portion of the article... it's says, VERY CLEARLY, right in the bill, that this isn't the case...

[Darin Jordan]

However, I do think we need some type of healthcare reform.

I couldn't agree more... fix what is BROKEN, in an otherwise EXCELLENT healthcare system... A completely new system is NOT the answer...

[domwilson]

If I read this and the comments correctly, it shifts the decision making process for healthcare from the insurance companies to the government. IMO, both poor choices, it shouldn't be either. Healthcare providers (Doctors) and their patients should be making the decisions. Minimize prescriptions given to "as needed" basis. Encourage healthy lifestyles. Exercise programs, stress management, etc. More community programs that encourage physical activity. Get big business/Government to have less influence over our homes and lives and start living by the "sweat of our brows."

[Flying Scotsman]

Agreed

Douggie

[AndyKunz]

Doug,

When politicians say "voluntary" you have to be careful. Our income tax is a "voluntary" thing, officially. However, if you chose not to volunteer to pay, you get to go to prison (or get a Cabinet-level job).

Our Social Security system is also "voluntary." If you chose not to volunteer to pay 15% of your income to them, they send you to jail, too.

The new "health care" package also has voluntary items in it. If you are old, you can "voluntarily" take a test which determines if you are allowed to live or helped to die with dignity against your will.

Something to think about - you Canadians will no longer be able to come down here to get health care. You won't have anywhere to go but to your official providers any more.

Andy

[Flying Scotsman]

Andy, only the wealthy Canadians partake in your HEALTH system. Us mere mortal Canadians are not always happy with our system, but it does work most of the time. How about yours?:

Douggie

[Bill-SOCAL]

For those that want to be bothered to read the actual bill to understand what this "Gotcha" is all about here it is:

http://www.govtrack.us/congress/bill...bill=h111-3200

Here is the pertinent section. It deals with grandfathered plans

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘grandfathered health insurance coverage’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT-

(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.

(b) Grace Period for Current Employment-based Health Plans-

(1) GRACE PERIOD-

(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.

(B) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:

(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).

(ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.

(iii) Such other limited benefits as the Commissioner may specify.

In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division

(2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE- During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division.

(c) Limitation on Individual Health Insurance Coverage-

(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.

(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage.

It is defining what plans are allowed to be grandfathered. It in no way limits enrollment in new plans or private plans.

[RCprince]

For those that want to be bothered to read the actual bill to understand what this "Gotcha" is all about here it is:

http://www.govtrack.us/congress/bill...bill=h111-3200

Here is the pertinent section. It deals with grandfathered plans



It is defining what plans are allowed to be grandfathered. It in no way limits enrollment in new plans or private plans.

Lol, I read it earlier, where others reading the bill came to the same conclusion as you did. Rightwing scare tactics as usual or maybe it's just R.I.F(Reading Is Fundamental)...Put down the guns and pick the books.

[Darin Jordan]

You guys aren't reading that very well... which is obvious by your conclusions....

In addition, the Government has NO business putting restictions on free-market healthcare coverage, such as this... especially when they are getting into the business themselves...

[Bill-SOCAL]

Unbelievable, simply unbelievable.

[domwilson]

Unbelievable, simply unbelievable.

I think the "free market" in healthcare is out of control. That is why there has been talk of healthcare reform since the late 80's, early 90's.

[RCprince]

http://www.nowpublic.com/world/bill-...urance-illegal



There is talk going around that the Health Care Reform Bill makes Individual Private Health Insurance illegal. I believe that IBDeditorials.com originally posted this hooey and it has circulated around the conservative talking sites like the new gospel.

Please take note of how all the articles don't tell you that the bill is online as H.R. 3200 and the line they quote is in Sec. 102 of the bill.

They quote H.R. 3200 Sec. 102 (a) (1) (A) - "IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1."

Which, taken alone, could be scary and might support their claim. However, taking note that Sec. 102 (a) is "Grandfathered Health Insurance Coverage Defined", it kind of throws their whole claim right out the window of credibility.

Here is the full section 102 (a) (extra emphasis is mine, refer to http://thomas.loc.gov for the full text of the bill)

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT

(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage (IE `grandfathered health insurance coverage') does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

Not tackling any other claims, merits, flaws or anything else about the Health Care Reform, the articles shouting about the bill making Private Insurance illegal are a load of crap.

:::: Further Explanation :::::

Section 102 is laying out the requirements for Grandfathered Health Care Coverage. This means that the text refers to what an Insurance Provider must comply with in order to keep current plans from falling under the Bill's requirements for Insurance.

Your current insurance will not be required to meet the Bill's policies as long as they don't enroll new people, start charging you a lot more or change any of its terms or conditions.

If for some reason you change insurance providers or re-work your insurance, the New Insurance Policy will have to comply with the policies and requirements of the Bill.

Again, "does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1." refers ONLY to keeping a policy's status as "Grandfathered" or Immune to the requirements of the Bill. It does NOT apply to New Policies.

:::::: Getting off original topic a bit ::::::

What it DOES do is make New Policies participate in an Exchange :

Sec. 102 (c)

(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.

Title II, Sec. 201
(a) Establishment- There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.

The Bill goes on to list a lot of requirements for New Private Health Insurance Policies.

Such as :

SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLUSIONS.

SEC. 112. GUARANTEED ISSUE AND RENEWAL FOR INSURED PLANS.

SEC. 113. INSURANCE RATING RULES.

SEC. 114. NONDISCRIMINATION IN BENEFITS; PARITY IN MENTAL HEALTH AND SUBSTANCE ABUSE DISORDER BENEFITS.

SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS

SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.



AND



SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED.


(b) Minimum Services To Be Covered- The items and services described in this subsection are the following:

(1) Hospitalization.

(2) Outpatient hospital and outpatient clinic services, including emergency department services.

(3) Professional services of physicians and other health professionals.

(4) Such services, equipment, and supplies incident to the services of a physician's or a health professional's delivery of care in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.

(5) Prescription drugs.

(6) Rehabilitative and habilitative services.

(7) Mental health and substance use disorder services.

(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.

(9) Maternity care.

(10) Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.

Again, PLEASE go and use http://thomas.loc.gov to look up and read the Full Text of H.R. 3200 and the OTHER healthcare bill currently in the news, H.R. 676

All I am saying is Don't Believe Pundits!! Check for yourself!!!

BY Graywalker

[Bill-SOCAL]

Darin - I'm curious about something. You work for Boeing, correct? Are you a union member?

[RCprince]

Lol

[Darin Jordan]

Darin - I'm curious about something. You work for Boeing, correct? Are you a union member?

Not that this has anything to do with anything here... but yes, we are FORCED to be union members in the area where I work... If you volunterily sign up, they deduct "union dues"... if you don't, they deduct "agency fees"...

In my area, as well, are "non-represented" jobs that do exactly the same thing I do... They tend to have better benefits and get more bonus', etc., than the same union jobs... I'm sure as an effort by Boeing to break that union...

Don't even get me started on how the Unions have DESTROYED our Educational systems, etc... Just like everything else, they took a good thing and turned it into a tool for Government control... OVER-REGULATION, if you will...

[Darin Jordan]

Unbelievable, simply unbelievable.

What's really unbelievable is that the Left, particularly those with DEEP rooted, unshakable, and complete support for this current administration seems to think they are the ONLY ones that have intelligent people to interpret this stuff. How convenient for us to have them around...

Thank goodness there are 50 or so "blue-dog Dems" up there on Capital Hill bringing SERIOUS questions to light about this bill... They are the only hope of something that is actually reasonable, sustainable, and logical getting passed at this point...

"Attention all Planets of the Solar Federation
Attention all Planets of the Solar Federation
Attention all Planets of the Solar Federation
We have assumed control
We have assumed control
We have assumed control"

[RCprince]

Don't even get me started on how the Unions have DESTROYED our Educational systems, etc... Just like everything else, they took a good thing and turned it into a tool for Government control... OVER-REGULATION, if you will...

Say it ain't so, Darin and I actually agree on something.

[domwilson]

Regardless of Party affiliation, there is a problem with our healthcare system. Both sides acknowledge that much. It is broken. Runaway costs, insurance companies playing with peoples lives, denial of services, unneccesary prescriptions and procedures, lack of preventative healthcare, etc. Something needs to be done. Government intervention may not be wanted, but may be neccessary at this point. It is a broken system. It needs to be fixed. Period.

[Rumdog]

Very correct domwilson. ANNNNND guess who has the power to get the ball rolling? Hate him for whatever reason you want. Call him a socialist. At least he is trying to fix sh*t! And the doctors have his back on this issue.

[AndyKunz]

Runaway costs, insurance companies playing with peoples lives, denial of services, unneccesary prescriptions and procedures, lack of preventative healthcare, etc. Something needs to be done.

The government could specify minimum requirements without becoming THE "insurance" company. Look at what they've done to fix retirement issues - they created Social Security. Guess what - IT'S BROKEN and about to become BANKRUPT.

You really want politicians and bureaucrats making life-and-death decisions for you and your family?!?! I sure don't!

Andy

[Bill-SOCAL]

You really want politicians and bureaucrats making life-and-death decisions for you and your family?!?! I sure don't!

But you are apparently OK with financially motivated doctors and nameless insurance people making those decisions, right?

So a doctor who denies service in order to get more money from the insurance company, no issue there?

The insurance company who denies coverage for a "pre-existing condition", like say a tumor you were born with but does not manifest itself until much later in life, no worries there, right?

Honestly is your knee jerk reaction to hating anything Obama/the left comes up with so strong that you think our current system is fine??

[domwilson]

Read this... http://www.commonwealthfund.org/Cont...can-Healt.aspx

And here... http://www.photius.com/rankings/healthranks.html

[AndyKunz]

But you are apparently OK with financially motivated doctors and nameless insurance people making those decisions, right?

So a doctor who denies service in order to get more money from the insurance company, no issue there?

The insurance company who denies coverage for a "pre-existing condition", like say a tumor you were born with but does not manifest itself until much later in life, no worries there, right?

Honestly is your knee jerk reaction to hating anything Obama/the left comes up with so strong that you think our current system is fine??

First Bill, I think you are a big enough boy to realize that I'm not one given to knee-jerk reactions. I believe saying such is one of those name-calling things that people use when their own argument does not hold water.

However, setting that aside, ...

My doctor works for me, not the insurance company. How does one deny service and get more money? I'd like that kind of job, I could deny doing anything and come home with a nice fat paycheck. Perhaps only in California?

Pre-existing conditions are those which are known at the time coverage begins. For instance, when we moved to IL there was a two-week period where, technically, we were without insurance. Several weeks ago my wife mentioned to her doctor during a routine checkup about pain and numbness in her arm. To him it looked like carpal tunnel, which was duly noted on his report. A few days later we got a letter from the insurance company asking questions about her carpal tunnel, and if she had been to see a doctor since XXX about it, because if it had been within that time, it WOULD have been a pre-existing condition and they would have been off the hook. However she hadn't been to ANY doctor for anything during that time period, and so it's covered. Sorry, but tumors you're born with aren't pre-existing conditions.

Here's why I think the system is broke (true story from friend who works in ER): Near the end of every month, a particular woman comes into the ER complaining about the same recurring malady. She has no insurance, but the hospital is required to provide her diagnosis and treatment. She is diabetic, so while she is in ER they must also take care of monitoring her sugar which, since she hasn't eaten in a while, is low. They feed her (for free, since she's diabetic) and while waiting for the food to help she has a private room with air conditioning, television, free (diet) sodas, and "servants."

Who pays her bill? NOBODY! Why does she come? BECAUSE SHE PROBABLY NEEDS MENTAL HELP, and something to fill her life like a job. Also, the free food, TV, and comfort probably doesn't help. Why does the hospital allow this? BECAUSE IT'S THE LAW. That's why our system is hosed.

I'm all for helping people who need help, don't get me wrong. She needs help, but not the kind they HAVE to give her (by law). She needs the kind they're NOT ALLOWED to give her. That's what's so sad. And this is just one person at one small country hospital.

As for who makes the decisions as to what is and isn't covered, those things are known to the customer (me) when signing up. If I don't like the limitations, I shop elsewhere.

The high cost of healthcare in America is a result of government's involvement. If you want to reduce the cost, the gov't needs to be OUT of the insurance system.

Andy

[domwilson]

Actually they are only required to get her "stabilized" and the federal government, sometimes state, will pick up the tab. This was in response to hospitals turning people away in dire need of care because they didn't have insurance. Like gunshot victims, heart attack, stroke etc. As I said before, government intervention may not be wanted, but may be neccessary at this time.