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Thread: Politifact weighs in on chain email criticizing Obama's health care plan

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    Re: Politifact weighs in on chain email criticizing Obama's health care plan

    Thanks for pointing the above issues out, but as I said, I haven't gotten that far yet. And if it's all the same to you, I'd rather wait and read the entire bill before affirming the things you've pointed out as new departments, administrators, or agencies established under the bill as opposed to same established by another law. As I stated previously, the Commissionor and the Secretary were already outlined in previous legistlation. It's quite possible all or most of the entities you've mentioned come along with those and are only re-emphisised in the bill. I'll get back to you with my findings. If I find that what you've pointed out is true I'll let you know.

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    Re: Politifact weighs in on chain email criticizing Obama's health care plan

    During the California Elections, every registered voter is sent an election packet that contains the propositions on that years ballot. In addition to providing the full text of the bill, each proposition also has a non-partisan summary and an objective budget analysis. Also included are an equal number of for/against arguments from 3rd party interest groups.

    Such a system would also help with Congressional legislation. Just having a non-partisan summary for every bill would be a significant step in making legislation comprehendable to the citizenry.

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    Re: Politifact weighs in on chain email criticizing Obama's health care plan

    It's slow going (I'm up to page 100), but here's what I've learn about the HCR bill so far...

    Under the bill, a new department called the Health Choices Administration will be created headed by a Health Choices Commissioner (or "Commissioner) who will work in concert with the Secretary of the Department of Health and Human Services. The overall purpose of the bill is to establish the public health option of health care (government run) that will compete with the private sector. The public health option is called the Health Insurance Exchange (HIE). The HIE will provide health care insurance plans on four levels: large business, small business (divided into two segments - smaller business [up to 20 employees] and smallest business [less than 20 employees], self-employeed and individual coverage. All plans will provide the same types of health coverage: hospitalization, outpatient hospital/clinic care, emergency services, doctor care (general physician and professional/surgical care), prescription drugs, maternity and well-baby care, vision and hearing, rehab services, prescribed medical equipment and medical supplies.

    The Commissioner is appointed by the President and serves a minimum 3-yr term. The Commissioner is charged with managing all aspects of the HIE and is required to submit annual reports to the President on recommendations to improve health care services under the HIE.

    Insurance plans under the HIE are suppose to be on-par with private sector insurance plans. Health care premiums under the HIE are suppose to be competitively priced with that of private sector health insurance. To assist the Commissioner in ensuring compliance w/HIE standards, an 8-panel commission called the Health Benefits Advisory Committee is to be established headed by the U.S. Surgeon general and 7 other non-government individuals. Each committee member serves a 3-year term and do not receive a salary nor commission for serving on the committee. However, they will receive travel cost, if any, and per diem both at the government rate as established by law. The committee is required to perform periodic audits compiled from complaints submitted by individuals whose health insurance coverage is from the HIE. The committee is also required to perform periodic surveys to ensure customer satisfaction, as well as ensure health care entities are complying with HIE standards. Using information from these audits and surveys, the committee is required to submit a report (every 3 yrs) to the Commissioner on ways to improve health services, treatment and other administrative procedures under the HIE.

    That's a general overview as to the primary purpose of the HCR bill. I will provide other information as I learn more in the coming days.
    Last edited by Objective Voice; 08-09-09 at 10:37 PM.

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    Re: Politifact weighs in on chain email criticizing Obama's health care plan

    As promised, I said I'd post my questions or clarifications to the HCR bill as I understood more about what I read in the bill. So, here's my first Q & A/C issue ("Q" = Question obviously, and the "A/C" = Answer or Clarification):

    C: Under Div A, Title I, sec. 102(a), all individuals who have health care insurance by the first day this bill is enacted (in year-1 (Y1), "2013") will retain their current health insurance. But if you go down and read subparagraph (b)(1)(A) "Grace Period", it reads:

    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 (=20130), 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 benefits package requirement under section 121.
    What does sec. 101 say as it applies to the above is:

    Sec. 101 - Requirements for Qualified Health Benefits Plans: On or after the first day of Y1 (2013), a health benefits plan shall not be a qualified health benefits plan under this division ("A" to Title I) unless the plan meets the applicable requirements of the following subtitles for the type of plan and plan year invovled:

    (1) Subtitle B - relating to affordable coverage
    (2) Subtitle C - relating to essential benefits
    (3) Subtitle D - relating to consumer protection
    Subtitle B essentially states that no person shall be excluded or denied health care for pre-existing conditions nor should they be discriminated against on the grounds of their sex, race, or religious preference and that health insurance should be fairly and competitively priced.

    Subtitle C is actually the sticking point. I'll get to why I beleive so in a moment.

    Subtitle D essentially outlines how payments can be made using debit cards as a option to paying for medical cost, that grievances shall be handled fairly and impartially and that information concerning health insurance coverage shall be made available using the best means possible, i.e., the Internet, "plain language", and translated into other languages as necessary. (Though the later linguistic take isn't stated definatively that way, it's not hard to conclude that what it means is insurance information should also be marketed in Spanish or any other languange necessary for the individual police holder to understand it).

    Now, back to Subtitle C. Here's how it reads:

    A qualified health benefits plan shall provide coverage that at least meets the benefit standards adopted under section 124 for the "essential benefits package" described in section 122 for the plan year involved.
    Well, now you have to know what section 124 and 122 say. So...

    Section 124 essentially outlines how the Secretary (of Health & Human Services) will be adopt new or improved health care standards, if any. He can approve (adopt) them or disapprove them.

    Section 122 essentially lifts a few of the restrictions we currently face in today's health care system, such as limiting annual benefits such as one or two dental cleanings per year for example, or restricting coverage of some benefits such as wellness and well-baby care. Such care would come under "essential health care" and make them more accessible and affordable. In-home care would also be covered, as well as, the equipment and services received for in-home care. Covered care (sec. 122(b)) would include:

    • Hospitalization
    • Outpatient hospital/clinic services
    • Emergency room services
    • Professional services by your physician
    • Health services equipment & supplies utilized for health care including in-home treatment and "institutionalized care" (i.e., nursing home care).
    • Prescription drugs
    • Rehab treatment
    • Mental health care
    • Substance abuse/use disorder
    • Preventive services
    • Maturity care (including well-baby and well-child care)
    • Dental (oral) health care
    • Vision Care
    • Hearing services, equipment and supplies


    Essentially, anyone under the age of 21 who has health care will receive these benefits either under their current health care plan (as adopted by the Health Choices Administration) or if they chose to obtain health care coverage under the Health Insurance Exchange (public option) program.

    Q: Per sec 122(c)(2)(B), the annual allowable limits for health care coverage under the HCR bill would be $5,000 per individual and $10,000 for families. However, these cost limits apply only to those expenses that come under "reference benefit packages" provided that there is no cost-sharing involved. Got it? Neither did I. So, my question to those who are in the health care industry is this: What exactly is a reference benefits package and how does cost-sharing fit into it as it applies to insurance coverage?
    Last edited by Objective Voice; 08-12-09 at 04:41 PM.

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    Re: Politifact weighs in on chain email criticizing Obama's health care plan

    I'm up to page 149. There are three areas of the HCR bill I'd like to clear up:

    1. Health Care to illegal immigrants. Not happening! Title II, Subtitle C:

    Section 242: (paraphrase) non-immigrants are not entitled to receive credits that go towards paying premium for health care plans.

    Section 246 reads: Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
    Now, it is true that the HCR bill emphasizes the importance of health care literature and policies be written in "plain language" and that language barriers are addressed, but don't mistake this w/giving illegal aliens free access to medical care. The two sections above make it clear that illegal aliens will not receive health care coverage under the bill.

    2. Rationing health care. I understand why folks are concerned about this, but relax. The HCR bill makes it the responsibility of the Secretary to submit to the Commissioner which recommendations as identified by the Health Choices Advisory Committee which improvements in health care benefits should be made part of health insurance policies. This has been viewed by some to be "the government making decisions on health insurance benefits". I understand that view point because the same changes that would take place in the HIE would also be required to be implimented in private sector health insurance plans. But here's the catch...

    Right now, there is no uniformed means to ensure that the health care benefits offered from one policy presented by one insurance company are the same as offered in another policy offered by another insurance company. That decision is left to the individual insurance companies. And as we all know, most of us receive our health insurance through our employers. Hopefully, we're all reading our policies every year and reviewing them, but even so how many of you know whether or not your benefits package has improved from one year to the next? What this process of review will do is ensure that everyone has access to the same level of benefits no matter the insurer, no matter what part of the country you're from.

    3. Small business will be over-taxed. I don't think so. Business large and small are have been required to pay an excise tax on the health insurance packages they provide to their employees per IRS laws since 1986. Small businesses would only be a penalty, just as large corperations, if they don't bring their benefits package(s) up to standard. I could see more small businesses moving to the HIE plans because they would be cheaper and it would be easier to comply with the new standards, but that doesn't mean that every small business would jump from the private sector to the public option. It just means that they'd have more options available to them from small-business co-ops, private sector insurance and the HIE. And like any business, they'll go with whatever is cheaper to meet the needs of their employees.

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