FACT CHECK: No 'death panel' in health care bill

[HUGGY]

Will the PLAN destroy private health insurance?



Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.) Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE



(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution—



(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.



(The bill then includes a sliding scale of payments for business with less than $400,000 in annual payroll.)



The Bill also reserves, for the government, the power to determine an acceptable benefits plan: page 24, SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.



5 (a) IN GENERAL.—A qualified health benefits plan that uses a provider network for items and services shall meet such standards respecting provider networks as the Commissioner may establish to assure the adequacy of such networks in ensuring enrollee access to such items and services and transparency in the cost-sharing differentials between in-network coverage and out-of-network coverage.



EVALUATION OF THE PASSAGES:



1. The bill does not prohibit a person from buying private insurance.

2. Small businesses—with say 8-10 employees—will either have to provide insurance to federal standards, or pay an 8% payroll tax. Business costs for health care are higher than this, especially considering administrative costs. Any competitive business that tries to stay with a private plan will face a payroll disadvantage against competitors who go with the government “option.”

3. The pressure for business owners to terminate the private plans will be enormous.

4. With employers ending plans, millions of Americans will lose their private coverage, and fewer companies will offer it.

5. The Commissioner (meaning, always, the bureaucrats) will determine whether a particular network of physicians, hospitals and insurance is acceptable.

6. With private insurance starved, many people enrolled in the government “option” will have no place else to go.


The Health Care Bill

Will the PLAN destroy private health insurance?


I certainly hope so.

And I certainly hope this applies to you: “whatsoever a man soweth, that he shall also reap.”

I'm all in. Bring it.

 

[Meister]

Sorry, but the one is you for misinterpretation. That was in response to the question or statement that private industry will be driven out because they won't be able to effectively compete. Obama was pointing out how successful both UPS and FedEx are (private industry) even though their competition is the United States government. It was a no-brainer, hon.

Will the PLAN destroy private health insurance?



Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.) Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE



(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution—



(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.



(The bill then includes a sliding scale of payments for business with less than $400,000 in annual payroll.)



The Bill also reserves, for the government, the power to determine an acceptable benefits plan: page 24, SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.



5 (a) IN GENERAL.—A qualified health benefits plan that uses a provider network for items and services shall meet such standards respecting provider networks as the Commissioner may establish to assure the adequacy of such networks in ensuring enrollee access to such items and services and transparency in the cost-sharing differentials between in-network coverage and out-of-network coverage.



EVALUATION OF THE PASSAGES:



1. The bill does not prohibit a person from buying private insurance.

2. Small businesses—with say 8-10 employees—will either have to provide insurance to federal standards, or pay an 8% payroll tax. Business costs for health care are higher than this, especially considering administrative costs. Any competitive business that tries to stay with a private plan will face a payroll disadvantage against competitors who go with the government “option.”

3. The pressure for business owners to terminate the private plans will be enormous.

4. With employers ending plans, millions of Americans will lose their private coverage, and fewer companies will offer it.

5. The Commissioner (meaning, always, the bureaucrats) will determine whether a particular network of physicians, hospitals and insurance is acceptable.

6. With private insurance starved, many people enrolled in the government “option” will have no place else to go.


The Health Care Bill

Will the PLAN destroy private health insurance?


I certainly hope so.

Full government control huh? Boy, Huggy.....that sounds like communism to me.

 

[HUGGY]

Will the PLAN destroy private health insurance?



Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.) Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE



(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution—



(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.



(The bill then includes a sliding scale of payments for business with less than $400,000 in annual payroll.)



The Bill also reserves, for the government, the power to determine an acceptable benefits plan: page 24, SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.



5 (a) IN GENERAL.—A qualified health benefits plan that uses a provider network for items and services shall meet such standards respecting provider networks as the Commissioner may establish to assure the adequacy of such networks in ensuring enrollee access to such items and services and transparency in the cost-sharing differentials between in-network coverage and out-of-network coverage.



EVALUATION OF THE PASSAGES:



1. The bill does not prohibit a person from buying private insurance.

2. Small businesses—with say 8-10 employees—will either have to provide insurance to federal standards, or pay an 8% payroll tax. Business costs for health care are higher than this, especially considering administrative costs. Any competitive business that tries to stay with a private plan will face a payroll disadvantage against competitors who go with the government “option.”

3. The pressure for business owners to terminate the private plans will be enormous.

4. With employers ending plans, millions of Americans will lose their private coverage, and fewer companies will offer it.

5. The Commissioner (meaning, always, the bureaucrats) will determine whether a particular network of physicians, hospitals and insurance is acceptable.

6. With private insurance starved, many people enrolled in the government “option” will have no place else to go.


The Health Care Bill

Will the PLAN destroy private health insurance?


I certainly hope so.

Full government control huh? Boy, Huggy.....that sounds like communism to me.

Its better than that!...Its an OBOMANATION. He wants to eat tasty white children and he is willing to pay me top dollar to snatch em up!

 

[Meister]

Will the PLAN destroy private health insurance?


I certainly hope so.

Full government control huh? Boy, Huggy.....that sounds like communism to me.

Its better than that!...Its an OBOMANATION. He wants to eat tasty white children and he is willing to pay me top dollar to snatch em up!

OK...OK I get it now Huggy. A capitalist working with communism, I like it...I like it a lot.

 

[MaggieMae]

Ah, my friend, Maggie the Magician.

It seems that my post #67 so devastated you that you disappeared, and here you are again, reappearing.

Recall, you made the absurd post that the Democrats should be estimeemed because they have found a way to save money, which we all know is the raison d'etre of the Dems, by limiting pharmaceuticals and procedures for the ill and the elderly.

Brilliant.

Subsequent to your absurb post, I listed eight- not a thousand- eight proposals none of which occurred to you or your Democrat friends, and challenged you find problems with the eight, as I have disposed of your attempt to make a silk purse out of a sow's ear.

That's when you disappeared.

Excuse me, Ms. Perfect, but I do like to sleep at night and return in the morning when I'm refreshed.

That said, I responded to your proposals by asking why they are never put forth when Republicans are in charge. Did you answer that question? Do so, and then we can have a debate. I didn't imply they were 'bad' options at all. Ball's in your court, but I don't have all day today, either.

Now, THAT'S the old Mags!

I never said that I was a Republican.

Right back at ya.'

Funny how nobody is these days. Okay, then "non-democrats"? Same comments apply.

 

[MaggieMae]

skullpilot is wrong. Congress has complete control of interstate commerce IAW the Constitution and Supreme Court rulings. If Congress can make the ICC connection to a business activity, then the feds can regulate.

Skull is giving the distant minority opinion. OK, but who cares?

Yeah, I think he knew what I was talking about. Thanks for clarifying the point. As to his analogy about an old person having the same insurance provisions as a young athlete, that too isn't true. Both of them would have a choice of options from which to choose. Kinda like picking from a Chinese menu. At least that's the way I understand it. An older person would likely choose care for such things as osteoporosis and even cancer, whereas a young person might choose preventive care for just the basic minor afflictions.

 

[Skull Pilot]

skullpilot is wrong. Congress has complete control of interstate commerce IAW the Constitution and Supreme Court rulings. If Congress can make the ICC connection to a business activity, then the feds can regulate.

Skull is giving the distant minority opinion. OK, but who cares?

Yeah, I think he knew what I was talking about. Thanks for clarifying the point. As to his analogy about an old person having the same insurance provisions as a young athlete, that too isn't true. Both of them would have a choice of options from which to choose. Kinda like picking from a Chinese menu. At least that's the way I understand it. An older person would likely choose care for such things as osteoporosis and even cancer, whereas a young person might choose preventive care for just the basic minor afflictions.

you obviously didn't read the post to which you are referring.

I specifically said a person with cancer, an 800 pound slob or an Olympic athlete of the same age

but hey why should you be any different than our so called reps. they don't read anything either.

And you never did answer my question

Does the government tell fed ex what it can charge to deliver a package?

Does the government tell fed ex that it can't charge more for an overnight package than it does for standard delivery?

 

[MaggieMae]

Your jokes being apropos aside, I felt bad for the elderly man who was escorted out of the Specter town hall event yesterday. He seemed to be terribly upset about all the wrong things, mainly that the Constitution had been trampled on by big government taking over people's lives. In fact, the man has lung disease and collects Social Security Disability.

So we see that many of the people who are attending these meetings want to just complain about EVERYTHING they see wrong with government and vent their anger at a single legislator at a single event. Town meetings have been going on for decades, usually with low turnout, so where were all these people while this perceived horrible government was building to the point of being unacceptable to them? Why didn't they speak up en masse before now? Instead, and until now, if you ask the guy on the street if he likes his own state's lawmakers in Washington, they almost unanimously answer that yes, they do.

 

[maineman]

Does the government tell fed ex what it can charge to deliver a package?

Does the government tell fed ex that it can't charge more for an overnight package than it does for standard delivery?

does the government presently tell any HMO or PPO what they can or cannot charge as a premium for their services?

 

[PoliticalChic]

Excuse me, Ms. Perfect, but I do like to sleep at night and return in the morning when I'm refreshed.

That said, I responded to your proposals by asking why they are never put forth when Republicans are in charge. Did you answer that question? Do so, and then we can have a debate. I didn't imply they were 'bad' options at all. Ball's in your court, but I don't have all day today, either.

Now, THAT'S the old Mags!

I never said that I was a Republican.

Right back at ya.'

Funny how nobody is these days. Okay, then "non-democrats"? Same comments apply.

Deflections aside, it seems that you must, albeit kicking and screaming, admit that my eight- not one thousand- suggestions for improving US healthcare are superior to your advocating reducing coverage for the elderly and the ill to 'save money' (as though that ever entered into the plans of Democrats).

Truly, your attempts to avoid the substantive issue posed in my 'suggestions' post us unlike your old self.

It was far more fun when you would try to respond.

On the other hand, due to the weakness of your argument, I can understand your action- or, actually, inactions.

So, whadda ya' say, want to admit that the folks in the current administration are true believers, and, in the mold of so many radicals before them, their supposed love for humanity is obviated by its hatred of individuals. They've tipped their collective (pun intended) hands!

And in terms of the 'healthplan' under discussion, they have inserted a panel that will decline treatments and drugs that currently keep the sick and elderly alive, and the 'end of life' consultants will realize more life-ends, and the overall effect will be an iron-fisted grip on the lives of the well and those who wish to stay well.

Because if you can't punch holes in my list of 'suggestions,' that is exactly what it means.

C'mon, put up ya' dukes.

 

[MaggieMae]

Will the PLAN destroy private health insurance?

Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.)

Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE
...

I suggest (to everyone) that rather than pick and choose pasted sections of the House Bill that they look at the outline of the final significant points they will use to formulate the actual bill. Culled from all of the proposals, these are the ones that are still being negotiated:

The House Democratic bill:

WHO'S COVERED: Around 94 percent of non-elderly residents (those not covered by Medicare, which kicks in at age 65) would be covered — compared with 81 percent today. Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants.

COST: About $1.5 trillion over 10 years.

HOW IT'S PAID FOR: Revenue-raisers include $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases; about $500 billion in cuts to Medicare and Medicaid; sizable penalties paid by individuals and employers who don't obtain coverage.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.

REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt. That level could rise to $500,000 under a deal between House leaders and fiscal conservatives.

Employers could apply for a two-year exemption from the mandate if they can prove the requirements would result in job losses that would negatively affect their communities.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFIT PACKAGE: A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors, but under Wednesday's deal with the fiscal conservatives the HHS secretary would instead negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).
___

The Senate Health, Education, Labor and Pensions Committee's bill:

WHO'S COVERED: Aims to cover 97 percent of Americans.

COST: About $615 billion over 10 years, but it's only one piece of a larger Senate bill.

HOW IT'S PAID FOR: Another panel — the Senate Finance Committee — is responsible for figuring out how to cover costs.

REQUIREMENTS FOR INDIVIDUALS: Individuals will have to have insurance, enforced through tax penalty with hardship waivers.

REQUIREMENTS FOR EMPLOYERS: Employers who don't offer coverage will pay a penalty of $750 a year for each full-time worker. Businesses with 25 or fewer workers are exempt.

SUBSIDIES: Available up to 400 percent poverty level, or $88,000 for a family of four.

BENEFITS PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government but would pay doctors and hospitals based on what private insurers now pay.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses could purchase insurance through state-based purchasing pools called American Health Benefit Gateways.

OTHER PROVISIONS: Creates a new voluntary insurance program that would provide a modest daily cash benefit to help disabled people stay in their own homes instead of going into nursing homes.
___

A plan under discussion by a bipartisan group of six senators on the Finance Committee:

WHO'S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.

COST: Around $1 trillion over 10 years.

HOW'S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; a tax as high as 35 percent on very high cost health insurance policies; a requirement for employers to pay into the Treasury for their employees who get their insurance through public programs or receive government subsidies to help pay premiums. Looking to raise $90 billion by taxing health insurance companies as much as 35 percent on policies valued at $25,000 or more.

REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.

REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering a "free rider" penalty based on how much the government ends up paying for workers' coverage.

SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).

BENEFIT PACKAGE: The government doesn't mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee's will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.

CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.
___

The House Republican proposal:

WHO'S COVERED: The House GOP's plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren't estimates about how many additional people would be covered.

COST: Unknown.

HOW'S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.

REQUIREMENTS FOR INDIVIDUALS: No mandates.

REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to "opt-out" rather than "opt-in" rules for offering health coverage.

SUBSIDIES: Tax credits are offered to "low- and modest-income" Americans. People who aren't covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.

BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents' plan through age 25.

GOVERNMENT-RUN PLAN: No public plan.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.

CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private plan.
___
The Associated Press: A look at health care plans in Congress

 

[Skull Pilot]

Does the government tell fed ex what it can charge to deliver a package?

Does the government tell fed ex that it can't charge more for an overnight package than it does for standard delivery?

does the government presently tell any HMO or PPO what they can or cannot charge as a premium for their services?

My point is they will be able to if the current bill is passed.

try to keep up

 

[Skull Pilot]

Will the PLAN destroy private health insurance?

Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.)

Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE
...

I suggest (to everyone) that rather than pick and choose pasted sections of the House Bill that they look at the outline of the final significant points they will use to formulate the actual bill. Culled from all of the proposals, these are the ones that are still being negotiated:

The House Democratic bill:

WHO'S COVERED: Around 94 percent of non-elderly residents (those not covered by Medicare, which kicks in at age 65) would be covered — compared with 81 percent today. Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants.

COST: About $1.5 trillion over 10 years.

HOW IT'S PAID FOR: Revenue-raisers include $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases; about $500 billion in cuts to Medicare and Medicaid; sizable penalties paid by individuals and employers who don't obtain coverage.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.

REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt. That level could rise to $500,000 under a deal between House leaders and fiscal conservatives.

Employers could apply for a two-year exemption from the mandate if they can prove the requirements would result in job losses that would negatively affect their communities.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFIT PACKAGE: A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors, but under Wednesday's deal with the fiscal conservatives the HHS secretary would instead negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).
___

The Senate Health, Education, Labor and Pensions Committee's bill:

WHO'S COVERED: Aims to cover 97 percent of Americans.

COST: About $615 billion over 10 years, but it's only one piece of a larger Senate bill.

HOW IT'S PAID FOR: Another panel — the Senate Finance Committee — is responsible for figuring out how to cover costs.

REQUIREMENTS FOR INDIVIDUALS: Individuals will have to have insurance, enforced through tax penalty with hardship waivers.

REQUIREMENTS FOR EMPLOYERS: Employers who don't offer coverage will pay a penalty of $750 a year for each full-time worker. Businesses with 25 or fewer workers are exempt.

SUBSIDIES: Available up to 400 percent poverty level, or $88,000 for a family of four.

BENEFITS PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government but would pay doctors and hospitals based on what private insurers now pay.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses could purchase insurance through state-based purchasing pools called American Health Benefit Gateways.

OTHER PROVISIONS: Creates a new voluntary insurance program that would provide a modest daily cash benefit to help disabled people stay in their own homes instead of going into nursing homes.
___

A plan under discussion by a bipartisan group of six senators on the Finance Committee:

WHO'S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.

COST: Around $1 trillion over 10 years.

HOW'S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; a tax as high as 35 percent on very high cost health insurance policies; a requirement for employers to pay into the Treasury for their employees who get their insurance through public programs or receive government subsidies to help pay premiums. Looking to raise $90 billion by taxing health insurance companies as much as 35 percent on policies valued at $25,000 or more.

REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.

REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering a "free rider" penalty based on how much the government ends up paying for workers' coverage.

SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).

BENEFIT PACKAGE: The government doesn't mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee's will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.

CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.
___

The House Republican proposal:

WHO'S COVERED: The House GOP's plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren't estimates about how many additional people would be covered.

COST: Unknown.

HOW'S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.

REQUIREMENTS FOR INDIVIDUALS: No mandates.

REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to "opt-out" rather than "opt-in" rules for offering health coverage.

SUBSIDIES: Tax credits are offered to "low- and modest-income" Americans. People who aren't covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.

BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents' plan through age 25.

GOVERNMENT-RUN PLAN: No public plan.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.

CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private plan.
___
The Associated Press: A look at health care plans in Congress

gee why doesn't the AP mention the tax penalties for having the wrong kind of insurance?

or the fact that insurance provided under ERISA will be eliminated?

 

[MaggieMae]

skullpilot is wrong. Congress has complete control of interstate commerce IAW the Constitution and Supreme Court rulings. If Congress can make the ICC connection to a business activity, then the feds can regulate.

Skull is giving the distant minority opinion. OK, but who cares?

Yeah, I think he knew what I was talking about. Thanks for clarifying the point. As to his analogy about an old person having the same insurance provisions as a young athlete, that too isn't true. Both of them would have a choice of options from which to choose. Kinda like picking from a Chinese menu. At least that's the way I understand it. An older person would likely choose care for such things as osteoporosis and even cancer, whereas a young person might choose preventive care for just the basic minor afflictions.

you obviously didn't read the post to which you are referring.

I specifically said a person with cancer, an 800 pound slob or an Olympic athlete of the same age

but hey why should you be any different than our so called reps. they don't read anything either.

And you never did answer my question

Does the government tell fed ex what it can charge to deliver a package?

Does the government tell fed ex that it can't charge more for an overnight package than it does for standard delivery?

No, it lets them charge anything they want. I don't get your point. The insurers in the exchange program will have different premiums based on the coverage chosen. Varied rates, only capped. I don't misinterpret the fact that this is a PUBLIC PLAN, as opposed to PRIVATE PLANS, so you don't need to try to trap me. Nobody is saying the exchange will be run exactly like private insurers run theirs. If the latter didn't have a monopoly on people's lives, a public plan wouldn't be considered.

 

[PoliticalChic]

So we see that many of the people who are attending these meetings want to just complain about EVERYTHING.. .

So, here's a guy with specifics:
The Health Care Bill: What HR 3200, ‘‘America’s Affordable Health Choices Act of 2009,” Says

John David Lewis

August 6, 2009



What does the bill, HR 3200, short-titled ‘‘America’s Affordable Health Choices Act of 2009,” actually say about major health care issues? I here pose a few questions in no particular order, citing relevant passages and offering a brief evaluation after each set of passages.



This bill is 1017 pages long. It is knee-deep in legalese and references to other federal regulations and laws. I have only touched pieces of the bill here. For instance, I have not considered the establishment of (1) “Health Choices Commissio0ner” (Section 141); (2) a “Health Insurance Exchange,” (Section 201), basically a government run insurance scheme to coordinate all insurance activity; (3) a Public Health Insurance Option (Section 221); and similar provisions.



This is the evaluation of someone who is neither a physician nor a legal professional. I am citizen, concerned about this bill’s effects on my freedom as an American. I would rather have used my time in other ways—but this is too important to ignore.



We may answer one question up front: How will the government will pay for all this? Higher taxes, more borrowing, printing money, cutting payments, or rationing services—there are no other options. We will all pay for this, enrolled in the government “option” or not.



(All bold type within the text of the bill is added for emphasis.)





1. 1. WILL THE PLAN RATION MEDICAL CARE?



This is what the bill says, pages 284-288, SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:



‘(ii) EXCLUSION OF CERTAIN READMISSIONS.—For purposes of clause (i), with respect to a hospital, excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the Secretary) of discharges for such applicable condition for the applicable period and such hospital.



and, under “Definitions”:



‘‘(A) APPLICABLE CONDITION.—The term ‘applicable condition’ means, subject to subparagraph (B), a condition or procedure selected by the Secretary . . .



and:



‘‘(E) READMISSION.—The term ‘readmission’ means, in the case of an individual who is discharged from an applicable hospital, the admission of the individual to the same or another applicable hospital within a time period specified by the Secretary from the date of such discharge.



and:



‘‘(6) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of— . . .

‘‘(C) the measures of readmissions . . .



EVALUATION OF THE PASSAGES:

1. This section amends the Social Security Act

2. The government has the power to determine what constitutes an “applicable [medical] condition.”

3. The government has the power to determine who is allowed readmission into a hospital.

4. This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.

5. This is government rationing, pure, simple, and straight up.

6. There can be no judicial review of decisions made here. The Secretary is above the courts.

7. The plan also allows the government to prohibit hospitals from expanding without federal permission: page 317-318.





2. Will the plan punish Americans who try to opt out?



What the bill says, pages 167-168, section 401, TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE:



‘‘(a) TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of—

(1) the taxpayer’s modified adjusted gross income for the taxable year, over

(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer. . . .”



EVALUATION OF THE PASSAGE:



1. This section amends the Internal Revenue Code.

2. Anyone caught without acceptable coverage and not in the government plan will pay a special tax.

3. The IRS will be a major enforcement mechanism for the plan.





3. what constitutes “acceptable” coverage?



Here is what the bill says, pages 26-30, SEC. 122, ESSENTIAL BENEFITS PACKAGE DEFINED:



(a) IN GENERAL.—In this division, the term ‘‘essential benefits package’’ means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial security . . .



(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 . . .

(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 . . .

(5) Prescription drugs.

(6) Rehabilitative and habilitative services.

(7) Mental health and substance use disorder services.

(8) Preventive services . . .

(9) Maternity care.

(10) Well baby and well child care . . .



(c) REQUIREMENTS RELATING TO COST-SHARING AND MINIMUM ACTUARIAL VALUE . . .



(3) MINIMUM ACTUARIAL VALUE.—

(A) IN GENERAL.—The cost-sharing under the essential benefits package shall be designed to provide a level of coverage that is designed to provide benefits that are actuarially equivalent to approximately 70 percent of the full actuarial value of the benefits provided under the reference benefits package described in subparagraph (B).



EVALUATION OF THE PASSAGES:



1. The bill defines “acceptable coverage” and leaves no room for choice in this regard.

2. By setting a minimum 70% actuarial value of benefits, the bill makes health plans in which individuals pay for routine services, but carry insurance only for catastrophic events, (such as Health Savings Accounts) illegal.





4. Will the PLAN destroy private health insurance?



Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.) Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE



(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution—



(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.



(The bill then includes a sliding scale of payments for business with less than $400,000 in annual payroll.)



The Bill also reserves, for the government, the power to determine an acceptable benefits plan: page 24, SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.



5 (a) IN GENERAL.—A qualified health benefits plan that uses a provider network for items and services shall meet such standards respecting provider networks as the Commissioner may establish to assure the adequacy of such networks in ensuring enrollee access to such items and services and transparency in the cost-sharing differentials between in-network coverage and out-of-network coverage.



EVALUATION OF THE PASSAGES:



1. The bill does not prohibit a person from buying private insurance.

2. Small businesses—with say 8-10 employees—will either have to provide insurance to federal standards, or pay an 8% payroll tax. Business costs for health care are higher than this, especially considering administrative costs. Any competitive business that tries to stay with a private plan will face a payroll disadvantage against competitors who go with the government “option.”

3. The pressure for business owners to terminate the private plans will be enormous.

4. With employers ending plans, millions of Americans will lose their private coverage, and fewer companies will offer it.

5. The Commissioner (meaning, always, the bureaucrats) will determine whether a particular network of physicians, hospitals and insurance is acceptable.

6. With private insurance starved, many people enrolled in the government “option” will have no place else to go.





5. Does the plan TAX successful Americans more THAN OTHERS?



Here is what the bill says, pages 197-198, SEC. 441. SURCHARGE ON HIGH INCOME INDIVIDUALS



‘‘SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.

‘‘(a) GENERAL RULE.—In the case of a taxpayer other than a corporation, there is hereby imposed (in addition to any other tax imposed by this subtitle) a tax equal to—

‘‘(1) 1 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $350,000 but does not exceed $500,000,

‘‘(2) 1.5 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $500,000 but does not exceed $1,000,000, and

‘‘(3) 5.4 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $1,000,000.



EVALUATION OF THE PASSAGE:



1. This bill amends the Internal Revenue Code.

2. Tax surcharges are levied on those with the highest incomes.

3. The plan manipulates the tax code to redistribute their wealth.

4. Successful business owners will bear the highest cost of this plan.



6. 6. Does THE PLAN ALLOW THE GOVERNMENT TO set FEES FOR SERVICES?



What it says, page 124, Sec. 223, PAYMENT RATES FOR ITEMS AND SERVICES:



(d) CONSTRUCTION.—Nothing in this subtitle shall be construed as limiting the Secretary’s authority to correct for payments that are excessive or deficient, taking into account the provisions of section 221(a) and the amounts paid for similar health care providers and services under other Exchange-participating health benefits plans.



(e) CONSTRUCTION.—Nothing in this subtitle shall be construed as affecting the authority of the Secretary to establish payment rates, including payments to provide for the more efficient delivery of services, such as the initiatives provided for under section 224.



EVALUATION OF THE PASSAGES:



The government’s authority to set payments is basically unlimited.
The official will decide what constitutes “excessive,” “deficient,” and “efficient” payments and services.




7. Will THE PLAN increase the power of government officials to SCRUTINIZE our private affairs?



What it says, pages 195-196, SEC. 431. DISCLOSURES TO CARRY OUT HEALTH INSURANCE EXCHANGE SUBSIDIES.



‘‘(A) IN GENERAL.—The Secretary, upon written request from the Health Choices Commissioner or the head of a State-based health insurance exchange approved for operation under section 208 of the America’s Affordable Health Choices Act of 2009, shall disclose to officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, return information of any taxpayer whose income is relevant in determining any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009. Such return information shall be limited to—

‘‘(i) taxpayer identity information with respect to such taxpayer,

‘‘(ii) the filing status of such taxpayer,

‘‘(iii) the modified adjusted gross income of such taxpayer (as defined in section 59B(e)(5)),

‘‘(iv) the number of dependents of the taxpayer,

‘‘(v) such other information as is prescribed by the Secretary by regulation as might indicate whether the taxpayer is eligible for such affordability credits (and the amount thereof), and

‘‘(vi) the taxable year with respect to which the preceding information relates or, if applicable, the fact that such information is not available.



And, page 145, section 312, EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS EMPLOYEE AND DEPENDENT COVERAGE:



(3) PROVISION OF INFORMATION.—The employer provides the Health Choices Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury, as applicable, with such information as the Commissioner may require to ascertain compliance with the requirements of this section.



EVALUATION OF THE PASSAGE:



1. This section amends the Internal Revenue Code

2. The bill opens up income tax return information to federal officials.

3. Any stated “limits” to such information are circumvented by item (v), which allows federal officials to decide what information is needed.

The Health Care Bill

 

[Skull Pilot]

Yeah, I think he knew what I was talking about. Thanks for clarifying the point. As to his analogy about an old person having the same insurance provisions as a young athlete, that too isn't true. Both of them would have a choice of options from which to choose. Kinda like picking from a Chinese menu. At least that's the way I understand it. An older person would likely choose care for such things as osteoporosis and even cancer, whereas a young person might choose preventive care for just the basic minor afflictions.

you obviously didn't read the post to which you are referring.

I specifically said a person with cancer, an 800 pound slob or an Olympic athlete of the same age

but hey why should you be any different than our so called reps. they don't read anything either.

And you never did answer my question

Does the government tell fed ex what it can charge to deliver a package?

Does the government tell fed ex that it can't charge more for an overnight package than it does for standard delivery?

No, it lets them charge anything they want. I don't get your point. The insurers in the exchange program will have different premiums based on the coverage chosen. Varied rates, only capped. I don't misinterpret the fact that this is a PUBLIC PLAN, as opposed to PRIVATE PLANS, so you don't need to try to trap me. Nobody is saying the exchange will be run exactly like private insurers run theirs. If the latter didn't have a monopoly on people's lives, a public plan wouldn't be considered.

you almost have it

premiums will be capped but benefits won't be

premiums cannot be higher for sick people or people at high risk of disease and therefore cannot be lower for healthy people. there will be no lifetime limits on benefits paid out even though the premiums paid will be capped.

FYI that's not going to save anyone any money because premiums will have to rise across the board or the private insurers will go under. (Which is the desired end result)

So the person who will use the most benefits doesn't pay his "fair share" (You like that? I finally got to use that term so favored by the libbies)

and the coverage in the exchanges will be all basically the same there will be no difference because of the minimums set by the bill.

In fact you will find yourself paying for stuff in the "basic" coverage that you might not have now like substance abuse counseling.

And if the government allowed health insurance companies to sell policies across state lines like every other kind of insurance, you would see premiums drop like a rock.

but that isn't in the bill that's supposed to promote competition and choice either.

I wonder why.

 

[PLYMCO_PILGRIM]

Guys guys fine....make me do it as i've been reading the bill and actually making notes.

You are all not getting good information on both sides from the media outlets and internet and need to really read the bill.


This is the list of the “preventative services” from the U.S. Preventive Services Task Force which the bill will allow you unlimited coverage for. Anything else you do you have to pay a yearly out of pocket deductible for still (AKA NOT FREE): (THIS CAN BE FOUND IN SECTION 122 of the Bill)
Grade A:

• Cervical cancer screening for women
• Colorectal cancer screening for men and women over 50
• Discuss aspirin chemoprevention with adults who are at increased risk for coronary heart disease
• Screening for high blood pressure in adults aged 18 and older
• Screening for chlamydial infection for all sexually active non-pregnant young women aged 24 and younger and for older nonpregnant women who are at increased risk
• Prophylactic ocular topical medication for all newborns against gonococcal ophthalmia neonatorum
• Screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit
• Screening for human immunodeficiency virus (HIV) all adolescents and adults at increased risk for HIV infection
• Screening all pregnant women for HIV
• Screening persons at increased risk for syphilis infection
• Screening all pregnant women for syphilis infection
• Screening all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco
• Screening all pregnant women for tobacco use and provide augmented pregnancy-tailored counseling to those who smoke
• Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care
• Screening for sickle cell disease in newborns

Grade B:

• One-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65 to 75 who have ever smoked
• Genetic counseling and evaluation for women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes (breast & ovarian cancer)
• Chemoprevention for women at high risk for breast cancer and at low risk for adverse effects of chemoprevention
• Screening mammography, with or without clinical breast examination (CBE), every 1-2 years for women aged 40 and older
• Screening for chlamydial infection for all pregnant women aged 24 and younger and for older pregnant women who are at increased risk
• Screening all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection (that is, if they are young or have other individual or population risk factors)
• Screening and behavioral counseling interventions to reduce alcohol misuse (go to Clinical Considerations) by adults, including pregnant women, in primary care settings
• Screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and followup
• Intensive behavioral dietary counseling for adult patients with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians
• Routine screening for iron deficiency anemia in asymptomatic pregnant women
• Routine iron supplementation for asymptomatic children aged 6 to 12 months who are at increased risk for iron deficiency anemia
• Screening all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults
• Screening women aged 65 and older routinely for osteoporosis. The USPSTF recommends that routine screening begin at age 60 for women at increased risk for osteoporotic fractures
• Structured breastfeeding education and behavioral counseling programs to promote breastfeeding
• Primary care clinicians prescribe oral fluoride supplementation at currently recommended doses to preschool children older than 6 months of age whose primary water source is deficient in fluoride
• Screening to detect amblyopia, strabismus, and defects in visual acuity in children younger than age 5 years

(2) ANNUAL LIMITATIONS-

Y1 is $5,000 for an individual and $10,000 for a family. Such levels shall be increased (rounded to the nearest $100) for each subsequent year by the annual percentage increase in the Consumer Price Index (United States city average) applicable to such year.

****Pay particular attention to this. It’s your annual out-of-pocket expenses for for anything not included in the Grade A or Grade B list of “preventative items and services”. So although a preventative test may be covered, you’ll still be liable for co-pay expenses to walk in the door to get it. And just like with most plans today, you’ll still be liable to share the costs of fixing anything found wrong with you by those tests.****

The parts in " " below are from the bill, the other is me. This is also where the "Death Panel" Rumors originate

Of course we have to have a “Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.” This will be chaired by the Surgeon General and will have “9 members who are not Federal employees or officers and who are appointed by the President”, “9 members who are not Federal employees or officers and who are appointed by the Comptroller General”, and an “even number of members (not to exceed 8 ) who are Federal employees and officers, as the President may appoint.” A committe with up to 27 members, 18 of whom are picked by the President. The bill says these people will “reflect providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies, and at least one practicing physician or other health professional and an expert on children’s health”. But with no checks and balances on the selection of this group, you can bet they will reflect ANY President’s (You libs need to realize a conservative may oversee this program in the near future) personal opinions and/or especially those to whom he owes campaign favors.

And, of course we have to have a Health Choices Administration and a Health Choices Commissioner. At least the commissioner will be appointed by the President “by and with the advice and consent of the Senate”. This will be an independent agency that will audit and enforce compliance for all “qualified health benefit plans”, whether or not the plan participates in the government’s “exchange”. They will be able to levy financial penalties and shut down plans that fail to make their grade. The Commissioner will appoint a “Qualified Health Benefits Plan Ombudsman” to help people stuck in the maze of government’s plan find their way out, but must do so “in a linguistically appropriate manner”


READ THE FLIPPING BILL PEOPLE.....READ IT OR STFU

 

[MaggieMae]

Now, THAT'S the old Mags!

I never said that I was a Republican.

Right back at ya.'

Funny how nobody is these days. Okay, then "non-democrats"? Same comments apply.

Deflections aside, it seems that you must, albeit kicking and screaming, admit that my eight- not one thousand- suggestions for improving US healthcare are superior to your advocating reducing coverage for the elderly and the ill to 'save money' (as though that ever entered into the plans of Democrats).

Truly, your attempts to avoid the substantive issue posed in my 'suggestions' post us unlike your old self.

It was far more fun when you would try to respond.

On the other hand, due to the weakness of your argument, I can understand your action- or, actually, inactions.

So, whadda ya' say, want to admit that the folks in the current administration are true believers, and, in the mold of so many radicals before them, their supposed love for humanity is obviated by its hatred of individuals. They've tipped their collective (pun intended) hands!

And in terms of the 'healthplan' under discussion, they have inserted a panel that will decline treatments and drugs that currently keep the sick and elderly alive, and the 'end of life' consultants will realize more life-ends, and the overall effect will be an iron-fisted grip on the lives of the well and those who wish to stay well.

Because if you can't punch holes in my list of 'suggestions,' that is exactly what it means.

C'mon, put up ya' dukes.

I already said (twice now) that I thought your 8 points were good ones. As for being superior, perhaps they are. It may surprise you to know that I'm not 100% enthralled with everything being stuffed into this bill either. It's too long and too complicated for even the experts to wrap themselves around completely. But I would like to see a bill because it is the first of many steps that will necessarily be involved in getting reform at least off the ground floor. The hard part is taking the blueprint (the bill) and actually designing a workable system, and there will be many bloody battles over how to do that.

As I recall, I don't respond point-by-point to either you or Publius because you both tend to off on tangents covering a wider range of topics that in reality are only remotely related to the topic at hand, and several quoted history lessons tossed in for good measure. I just don't have the time to go that deep, knowing full well if I did that you will come right back with another tome to dissect [exaggeration!!] I feel as though what I post is often lengthy enough, and anything longer will not get read or get lost in translation. And I dearly hate page after page of one-on-ones, so don't even try to engage me on this board in that manner. I will ignore you completely.

 

[PLYMCO_PILGRIM]

Maggie you should as them to slow down and read the bill then if your not happy with all of it.

I think the majority of normal republicans and democrats see that our health system has serious issues that must be addressed, dont let them rush through because the far right is making noise or the far left is telling you you're stupid if you dont want it done SUPER FAST.

Lets all slow em down and make sure the health plan, that will pass in some form, is passed in a way that is beneficial to the People and not to the politicians and their special interests.

 

[MaggieMae]

Will the PLAN destroy private health insurance?

Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.)

Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE
...

I suggest (to everyone) that rather than pick and choose pasted sections of the House Bill that they look at the outline of the final significant points they will use to formulate the actual bill. Culled from all of the proposals, these are the ones that are still being negotiated:

The House Democratic bill:

WHO'S COVERED: Around 94 percent of non-elderly residents (those not covered by Medicare, which kicks in at age 65) would be covered — compared with 81 percent today. Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants.

COST: About $1.5 trillion over 10 years.

HOW IT'S PAID FOR: Revenue-raisers include $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases; about $500 billion in cuts to Medicare and Medicaid; sizable penalties paid by individuals and employers who don't obtain coverage.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.

REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt. That level could rise to $500,000 under a deal between House leaders and fiscal conservatives.

Employers could apply for a two-year exemption from the mandate if they can prove the requirements would result in job losses that would negatively affect their communities.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFIT PACKAGE: A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors, but under Wednesday's deal with the fiscal conservatives the HHS secretary would instead negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).
___

The Senate Health, Education, Labor and Pensions Committee's bill:

WHO'S COVERED: Aims to cover 97 percent of Americans.

COST: About $615 billion over 10 years, but it's only one piece of a larger Senate bill.

HOW IT'S PAID FOR: Another panel — the Senate Finance Committee — is responsible for figuring out how to cover costs.

REQUIREMENTS FOR INDIVIDUALS: Individuals will have to have insurance, enforced through tax penalty with hardship waivers.

REQUIREMENTS FOR EMPLOYERS: Employers who don't offer coverage will pay a penalty of $750 a year for each full-time worker. Businesses with 25 or fewer workers are exempt.

SUBSIDIES: Available up to 400 percent poverty level, or $88,000 for a family of four.

BENEFITS PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government but would pay doctors and hospitals based on what private insurers now pay.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses could purchase insurance through state-based purchasing pools called American Health Benefit Gateways.

OTHER PROVISIONS: Creates a new voluntary insurance program that would provide a modest daily cash benefit to help disabled people stay in their own homes instead of going into nursing homes.
___

A plan under discussion by a bipartisan group of six senators on the Finance Committee:

WHO'S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.

COST: Around $1 trillion over 10 years.

HOW'S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; a tax as high as 35 percent on very high cost health insurance policies; a requirement for employers to pay into the Treasury for their employees who get their insurance through public programs or receive government subsidies to help pay premiums. Looking to raise $90 billion by taxing health insurance companies as much as 35 percent on policies valued at $25,000 or more.

REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.

REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering a "free rider" penalty based on how much the government ends up paying for workers' coverage.

SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).

BENEFIT PACKAGE: The government doesn't mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee's will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.

CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.
___

The House Republican proposal:

WHO'S COVERED: The House GOP's plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren't estimates about how many additional people would be covered.

COST: Unknown.

HOW'S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.

REQUIREMENTS FOR INDIVIDUALS: No mandates.

REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to "opt-out" rather than "opt-in" rules for offering health coverage.

SUBSIDIES: Tax credits are offered to "low- and modest-income" Americans. People who aren't covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.

BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents' plan through age 25.

GOVERNMENT-RUN PLAN: No public plan.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.

CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private plan.
___
The Associated Press: A look at health care plans in Congress

gee why doesn't the AP mention the tax penalties for having the wrong kind of insurance?

or the fact that insurance provided under ERISA will be eliminated?

MAYBE BECAUSE THOSE PROVISIONS HAVE BEEN ELIMINATED BY SIX WEEKS OF NEGOTIATION!!!!!!
Jesusfuckingchrist...