You are currently browsing the Obama Care Blog Center weblog archives for October, 2009.
13. October 2009 by admin.
Pgs 31-32Employer Offer of Health Insurance Benifits-Employees offered employer healthcare benifits would be ineligible for low income premium tax credit for health insurance purchased through a state exchange, unless the employee offered health insurance does not have actuarial value of at least 65% or unaffordable( defined as 13% of income).Employees seeking an afforability wavier from State exchange must show proof of family income, premium of the lowest cost employer option offered, and must present the waiver to the employer.Within five years a study must be conducted to determine if afforability could be lowered without signifcanally increasing cost of coverage.Medicaid eligible individuals can always choose to leave employers coverage with no fee from the employer employer in this circumstance.Required Payments for Employees Recieving Premium Credits-Employers with 50 or more employees must pay. Full time employees are defined as working 30 or more hours per week and be enrolled in State exchange or recieving a tax credit.Employer must pay a flat dollar amount to be set by the Sec. of HHS and published annually.These funds would go to a general fund.The assessment wold be capped at a ammount equal to $400 multiplied by the number of employees at the firm( regardless of how many are recieving state exchange credit. (ex. $400 X 100= $40,000).Effective date Jan. 1, 2013
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13. October 2009 by admin.
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13. October 2009 by admin.
Obama Care- Baucus Markup- existing coverage eliminated clauses http://bit.ly/X3Qp4 #obama #care #tcot #tlot #sgp #hhrs
age 17:
The States “should” (no requirement, though) seek participation by multiple providers of “plans” so that “eligible participants,” (Those between 133 and 200% of FPL 1 ), may choose from “two or more” plans that provide “Basic Health Plan services.”
States entering into “health care choice compacts” would be eligible to form multi-state risk pools for the purposes of negotiating with health care systems.
(I think allowing this risk pooling to provide a vehicle for the uninsured to purchase individual coverage is a good thing, not as part of THIS Bill, but as a part of Real Health Care Reform.)
Opportunity for Cost Savings
The Bill anticipates a saving from the negotiations by the State of “at least 25%” based on “(e)vidence from similar programs on the state level” which are NOT cited.
“(S)tates choosing to create Basic Health Plans” would receive 85% of the funds provided for “individual tax credit subsidies.” “Tax credit subsidies would be available to citizens of states that have chosen not to create Basic Health Plans.”
So, if your State participates, no tax credit subsidy is available to individuals otherwise eligible to participate in the State plan. If you are eligible, you either participate or lose your “tax credit.”
The above is all part of the amendments to the original Bill
Now we move to:
STATE EXCHANGES AND CONSUMER ASSISTANCE
This is apparently part of the original Bill as it is labeled “Current Law” HA!
Tells us that there is no provision in Federal law for a health insurance exchange, but at least one State does.
The remainder of page 17 is a description of the Massachusetts “Health Insurance Connector Authority” system for “illustrative purposes.”
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13. October 2009 by admin.
FROM PAGES 15-16
Obama said that nobody’s existing coverage would be effected.
THIS IS A LIE:
First, the “grandfathered plans”, those that are not subject to the “ratings board”, which is itself simply government bureaucrats deciding what is “best”, I see NOTHING to define “what is best”, would NOT qualify for ANY tax credits! This language is vague, but if by “no tax credits” we mean NO TAX CREDITS that would include the Employer and the Employee, effectively making the “grandfathered plans” financially less attractive by legislative fiat.
Second is THIS: ALL grandfathered plans are to be PHASED OUT beginning in 2013:
from the Mark-Up
Beginning January 1, 2013, Federal rating rules would be phased in for grandfathered policies in the small group market, over a period of up to five years, as determined by the state with approval from the Secretary. These plans could continue to exist after the transition period, but would be subject to the new rating rules.
The approved “national plans”, according to Page 1 Para 2 would, “pre-empt” state benefits requirements, in essence ending State authority over health insurance.
Also from Paragraph 2, the role of this new Federal authority will be to “develop standards as to how benefit categories should be implemented (e.g., what constitute prescription drug coverage)”, which means, basically, ANYTHING these “regulators” might want it to mean.
This is akin to passing a law and saying “the un-elected regulators can set law and policy for this as they see fit.”
In blatant slap in the face to any PRETENSE that States have ANY sovereignty, the last paragraph says in part “the NAIC will also develop harmonization standards for processes of state insurance regulation that pertain to form filing and rate filing.
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13. October 2009 by admin.
1-12 (I suggest you use the actual pages of the bill, located at the bottom of each page) That’s what I read.
Roles and responsibliities of State Insurance Commissioners
• Oversight of plans
o related consumer protections
o Federal rating rules
NAIC will develop Model Regulation within 12 months to include:
• Federal Health insurance rating
• Issuance
• Marketing requirements
• * STATES MUST ADOPT THE REGULATIONS—if they don’t witithin 24 months, Sec of HHS will contract with an non-governmental entity to establish a program that complies.
•
By 2013- NAIC to have developed rules for ‘Health care choice compacts’ (not clear what that is)
IN 2015 States may form ‘health care choice compacts’ to allow purchase insurance across state lines. Insurers selling policies subject to laws and regulations in state issued or written. State where consumer lives retains authority to address unfair practices, consumer protection, etc.
Assigned Pages 13-14 but had to read page 12 and first part of 15 as well.
Page 12 Grandfathered Plans - they will allow people who already are covered under plans to renew them as long as they offer coverage equal in value to the “young invincible” plan. Last sentence on page 12 says no tax credits would be given to grandfathered plans. Who gets tax credits now for health insurance. It sounds like one way to get people off of their current plans and into the government plan.
Page 13 - Federal rating rules (don’t know what that is) will be phased in for these grandfathered policies over 5 years beginning 07/01/2013.
Page 13 Interstate Sale of Insurance - by 2013 the National Association of Insurance Commissioners will develop rules to create “health care choice compacts”. By 2015 states will have formed these compacts to allow individual health insurance to be purchased across state lines. Insurers would not have to be licensed in the state but would be subject to the regulations of the state where policy issued.
Page 13 & 14 National Plans
National Plans with uniform benefits would be offered across state lines. They must be licensed in every state and would operate through “state exchanges”. It permits states to opt-out. These national plans would have to offer silver and gold benefit levels. Seems to give alot of power to the National Association of Insurance Commissioners (NAIC). (who are they???) While the plans have to be uniform in every state in which they operate, the rates will reflect geographic variation.
Page 14 - Rules Regarding State Opt-Out
In 2015 states can apply for a waiver to opt out of certain aspects of the Act. The Secretary (Health and Human Services I guess) will determine if a waiver will be accepted. In order to be able to opt-out the state must “meet the requirements of this Act such as all residents have affordable, quality insurance coverage”. (I want to know who defines affordable and quality??)
Last part of page 14 says that states must get “citizen input through a referenda or similar means” in order to opt-out and that the state plan “will ensure that all residents have coverage”.
(That seems to make it impossible for any state to opt out of the federal plan because the federal plan is not even ensuring that all people will have coverage. They make it sound like there are options when in reality they make it impossible.)
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13. October 2009 by admin.
CURSORY BILL REPORT
Pages 9-10 assessed by Belle:
In essence the Health insurers are required to contribute to a reinsurance program for individuals. Current laws have individuals and small businesses grouped together to lower costs. The government exchanges would divide the two between individuals and employers insuring 2-50.
WHAT IS NOT CLEAR: It is not clear if Insurance companies, or Employers would contribute…or both.
A Non-Profit entity will be assigned to administer, coordinate funding and operations. They are supposed to be paid administrative costs out of a separate pool of money, which is not defined where exactly that comes from. It is also not clear if the Non-Profit entity would include groups like ACORN for example.
Contributions to the fund must equal $20 Billion in each year, and reflect each entity’s book of Business.
In short, the government will know everything about each company, and everything about the company’s book of business (which currently is protected under trade secrets laws).
HIPAA can refuse to cover individuals seeking portability from group market. What that means is say, you hate the government exchange and wish private insurance instead, the private market can refuse to insure you if it determines because of your health, it would impair the provider.
In short…this is single payer disguised as exchanges.
http://www.teamsarah.org/profiles/blogs/obama-care-baucus-markup-team
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13. October 2009 by admin.
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13. October 2009 by admin.
Jim Bunning on Single Payer Constitutionality
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12. October 2009 by admin.
Obama Care- Freedom Fights back- radio 9p est-team sarah organizes 2 expose #obama #care before vote http://bit.ly/Wcu4m #tcot #sgp #right
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10. October 2009 by admin.
Obama Care- Phil Kerpen on Obama takeover of internet- stop the internet czar- #obama #care
Freedom Radio- 57th State- Phil Kerpen leads charge against internet czar- govt takeover of net http://bit.ly/1QJbBb #tcot #sgp #tech #web
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