I have the actual HR 3200 bill and have been reading it. It is certainly difficult to read, I have to read it over and over but am catching on to the verbage. Right now there is much to do about Obama claiming we will be able to maintain our choice to enroll in private insurance as opposed to the government plan. Well people, what Obama is telling you is a lie! Below is a copy of Section 102 of the Healthcare Bill regarding private insurance:
1 SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
3 (a) GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘‘grandfathered health insurance coverage’’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:
(what they mean: if you have private insurance that is active BEFORE day one of the institution of the government health plan then you can keep it provided that the below are met:)
10 (1) LIMITATION ON NEW ENROLLMENT.—
(A) IN GENERAL.—Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
(What they mean: the private insurance company is not able to enroll anyone into a private policy on or after the date the government plan is instituted. Therefore, NO NEW enrollments after the government plan is instituted. This means if you lose your job or the insurance company goes under you HAVE to enroll in the government health plan)
17 (B) DEPENDENT COVERAGE PERMITTED.—Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.
(What they mean: if you have a baby or adopt a child or get married then you can add them to your private insurance policy despite the day the government plan was instituted)
21 (2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS.—Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.
(What they mean: If the private insurance has to adjust their plan terms or conditions including benefits and cost sharing then you will no longer be able to keep your private plan and be forced to enroll in the government plan)
1 (3) RESTRICTIONS ON PREMIUM INCREASES.— The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.
(What they mean: The private insurance company can not adjust premiums based on certain group of enrollees without increasing it for all enrollees. If that is done then you will be forced to enroll in the government health plan)
8 (b) GRACE PERIOD FOR CURRENT EMPLOYMENT BASED HEALTH PLANS.—
10 (1) GRACE PERIOD.—(A) IN GENERAL.—The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
(What they mean: Health plans provided and managed by the employer (ie MHHS health plan) alos must adhere to the above rules and if not you will be forced to enroll in the government plan)
20 (B) EXCEPTION FOR LIMITED BENEFITS PLANS.—Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:
1 (i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111–5).
5 (ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.
11 (iii) Such other limited benefits as the Commissioner may specify. In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division.
(What they mean: The employer health plans have to comply with the two acts stated (i, ii) and any other limitations set forth, not stated in this bill)
18 (2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE.—During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division.
(c) LIMITATION ON INDIVIDUAL HEALTH INSURANCE COVERAGE.—
(1) IN GENERAL.—Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.
(What they mean: Any insurance plan sold to an individual that is not active prior to day 1 that the government plan is instituted must be government managed health plans)
6 (2) SEPARATE, EXCEPTED COVERAGE PERMITTED.—Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage. (see section 2791(c) of Public Health Service Act below:)
Section 2791(c) Public Health Services Act
(c) Excepted benefits
For purposes of this subchapter, the term “excepted benefits” means benefits under one or more (or any combination thereof) of the following:
(1) Benefits not subject to requirements
(A) Coverage only for accident, or disability income insurance, or any combination thereof.
(B) Coverage issued as a supplement to liability insurance.
(C) Liability insurance, including general liability insurance and automobile liability insurance.
(D) Workers’ compensation or similar insurance.
(E) Automobile medical payment insurance.
(F) Credit-only insurance.
(G) Coverage for on-site medical clinics.
(H) Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.
(2) Benefits not subject to requirements if offered separately
(A) Limited scope dental or vision benefits.
(B) Benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof.
(C) Such other similar, limited benefits as are specified in regulations.
(3) Benefits not subject to requirements if offered as independent, noncoordinated benefits
(A) Coverage only for a specified disease or illness.
(B) Hospital indemnity or other fixed indemnity insurance.
(4) Benefits not subject to requirements if offered as separate insurance policy
Medicare supplemental health insurance (as defined under section 1395ss (g)(1) of this title), coverage supplemental to the coverage provided under chapter 55 of title 10, and similar supplemental coverage provided to coverage under a group health plan.
(What they mean: Any of the above are not included in the government health plan and thus can not be included in the private health insurance plan unless they are listed and charged seperately.)
Essentially guys, this is the governments way of fazing out private insurance plans. Obama even said he wanted a single payer healthcare plan that covers BASIC healthcare needs. BASIC? That is concerning, what about those of us who need more then basic care? Check out the video below of Obama himself speaking about his desire for a singer payer health care plan in 2003:
http://www.youtube.com/watch?v=fpAyan1fXCE
This is very serious business people. This plan is just a stepping stone to the creation of an imperialist government that chooses for us what we need and how much of it. (healthcare, money, food......) I will continue to read the bill and update as I go. If you want the whole bill email me at valsgal@gmail.com and I will forward the whole bill to you for your reading pleasure.
B
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