Let's get down to brass tacks here. This is incredible stuff. This is an accomplishment no other Congress or President has been able to accomplish for nearly a century. I am proud of my country, I don't care what anyone else thinks. This is magnificent use of our Democracy and it is really working. People of the USA are going to be better for this initiative. Who cares what Republicans think? They hate this country and simply claim the right to use it for their own purpose. The Democrats are making this democracy work for the people. This is monumental.
...Nebraska Sen. Ben Nelson (click title to entry - thank you), who was among three Democratic holdouts, announced that he would back an all-important procedural vote set for Saturday that will allow the chamber to take up the wide-ranging bill unveiled this week by Senate Majority Leader Harry Reid (D-Nev.).And Democratic leaders expect Sens. Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana to support a cloture vote on the so-called "motion to proceed," although the two lawmakers have not formally announced their plans...
I don't know exactly what the context of the new Senate bill is, but, I can continue what I started. Top of Page 20, I believe. Left off with line 16.
I would love to find some merit in this bill, but, there really isn't any. I thought I was on to something when it extended benefits to all those that were family of the insured. It is typical of this bill and the Senate Finance Committee evidently, to give benefits to the people in one paragraph and take them away in another.
Page 20, lines 17 through 25 and Page 21, lines 1 through 6:
There has to be special rules for guaranteed issue? And there are capacity limits to policies as to how many people can belong to a plan? That isn't even competition. THAT is allotment. I don't think so.
‘‘(b) SPECIAL RULES FOR GUARANTEED ISSUE.—
‘‘(1) ENROLLMENT.—Each offeror of a health benefits plan shall establish annual and special enrollment periods meeting the requirements of section 2236(d)(2) and may restrict enrollment described in subsection (a)(1) to such enrollment periods.
‘‘(2) CAPACITY LIMITS.—For purposes of applying subsection (a)(1), if, as determined under regulations prescribed by the Secretary, a plan has a capacity limit, the plan may limit enrollment to that capacity limit but only if the plan selects individuals for enrollment on the basis of the order in which the individuals applied for enrollment and in a manner that does not discriminate in any manner prohibited under section 2202.
Healthcare Bill: Section 2236
‘‘SEC. 2236. FUNCTIONS PERFORMED BY SECRETARY, STATES, AND EXCHANGES.
‘‘(a) AGREEMENTS TO PERFORM FUNCTIONS.—The Secretary shall enter into an agreement with each State (in this section referred to as the ‘agreement’) setting forth which of the functions described in this section with respect to an exchange shall be performed by the Secretary, the State, or the exchange.............
‘‘(d) ENROLLMENT.—The agreement shall provide for the establishment and carrying out of an enrollment process which—
‘'(2) provides for—6
‘‘(A) an initial open enrollment period from March 1, 2013, through May 31, 2013;
‘‘(B) annual open enrollment periods from March 1 through May 31 of subsequent calendar years;
‘‘(C) special enrollment periods specified in section 9801 of the Internal Revenue Code of 1986 and other special enrollment periods under circumstances similar to such periods under part D of title XVIII; and
‘‘(D) special monthly enrollment periods for Indians (as defined in section 4 of the Indian Health Care Improvement Act).
This provision is mostly self explanatory once all the words are there. It states there will be enrollment periods from March 1 throgh May 31st. I don't believe that is a good idea because competition happends on a rolling calender and not just for the weeks of March, April or May. But, that isn't the beautiful part. The beautiful part is that it lays out an enrollment period, EXCEPT WHEN
EXCEPT WHEN
EXCEPT WHEN
Except when there is a 'special circumstance' between a state or states and the Secretary. That means a state doesn't have to offer an enrollment period at all if the Secretary (Under Republican Leadership) agrees it is not necessary. If enrollment periods for health insurance can be manipulated and restricted, people will fall through the cracks. They will end up 'outside' the enrollment period for one reason or another and they won't have health insurance and they'll end up breaking the law.
This kind of lassitude in the bill can't be tolerated. There has to be an open enrollment period for all people with an understanding that once they have enrolled in a health care plan they can't change for a year. If there are going to be penalites for NOT enrolling, then the opportunity to enroll has to be available all the time. There is no reason why enrollment has to be this ridge. No reason at all. Insurance companies are able to enroll people as they come into employment if it is an employer-employee relationship, there should not be any problem with a rolling calender enrollment at any time.
And there cannot be capacity limits. That is giving preferential treatment to insurance companies rather than competition. If Plan A is allowed to have 1 million enrollees and Plan B is allowed to have 1 million enrolles, but, Plan A is a better plan for the money and 1.5 million people want to enroll than it should be possible for 1.5 million people to enroll, while 0.5 million enroll in Plan B. If every plan available is allowed to fill their allotment, there won't be competition. The populous of the USA will be divided up into allotments and every insurance plan will receive their allotment as people are required to enroll in an insurance plan and it will be like a huge insurance cartel.No, no, no !!!!
The ONLY aspect that will compete with this type of allotment enrollment is a government option that is continuously available that people can choose at any time if they find their insurance does not fit their needs or their budget.
And this is from a Senate Finance Committee, huh? Really? Because I would think the Senate Finance Committee would understand competition and NOT undermine it.
I really just want to end this reading of this bill because it is bad law. I don't dare though. There is a basic flaw in this entire 'scheme.' It places the States and States Rights before the authority of the Federal Government. The Federal Government is allowed to legislation broad ranging plans like this and have the states apply them. For the Secretary of Health and Human Services to draw up 'designer health plans' for every state, every native American nation, every province and territory, there would have to be an entirely new beaucracy set up to carry out that function. That isn't the way Federal legislation is supposed to work. Federal legislation is passed and the States apply the law. The Senate Finance Committee Bill (The Baucus Bill) is designed to fail the consumer while throwing weight to 'leaving it all intact' except for adding some Americans to the insurance rolls. That isn't what is needed here and that isn't what has to pass the USA Senate tomorrow.
This bill never stops bothering me. Page 21, lines 9 and 10:
‘‘(1) rescissions of coverage shall be treated in the same manner as non-renewals of coverage; and
Having that language in this bill, allows health care insurance companies to refuse coverage. They are not suppose to refuse coverage.
Recissions are a reversal of a contract.
So, let's say an American family enters into a contract with Insurance Company A. Their history is minor when it comes to cost of health care and they are accepted by Company A without a problem. During the year, one of the children are found to have leukemia from a toxic waste dump down the road. Insurance Company A believes it is best those responsible for the toxic waste dump should be responsible for the health care bills of the child. So, instead of pursuing the toxic waste company for reimbursement, they refuse further coverage of the family and end their contract stating the parents need to obtain a lawyer for reimbursment of cost for the child. Now, the family will have to shop for health insurance all over again, but, this time with a pre-existing condition; so their new policy will be far more expensive than the first one and there goes the American Dream.
When that happens it will become a methodology for the insurance companies to raise premiums on high risk health conditions. The provision goes on to say:
Page 21, lines 11 through 13:
‘‘(2) the premium rate at the time of renewal shall be determined using only the same categories of rate adjustment factors that were used at issue.
That is a great provision, but, it is proceeded by the allowance for Rescission. So, when a person/family runs into a catastrophic health care problem within a year where they want to resubscribe, they can be denied the opportunity to renew their policy at the same rate as when enrolled. They will be forced to buy a different policy because the law requires it and they could literally lose their home if the insurance premiums of the new policy are out of reach.
The Senate Finance Bill has no merits what so ever at all. It victimizes the consumer and lends graces to insurance companies to provide a client base that has no advantage over their profit margins. It is my understanding that Senator Baucus has worked on this bill for years. I find that fact disheartening to a reality that disregards the citizen to uphold the companies. This is pretty terrible stuff.
Page 21, lines 14 through 16 has the Secretary unilaterially rewriting the laws on a whim. Paragraph 2 is the provision for renewing with costs based on the original enrollment formula:
The Secretary may prescribe rules for the application of paragraph (2) during any period during which the reforms under this subpart are being phased in by a State.
I have a full weekend. I will post an entry or two over the weekend, but, to proceed with the reading of this bill requires attention to detail and a lot of explanation that the House Bill did not. I look forward to the debate the Senate will embark on tomorrow, but, for tonight I'll say good night and look forward to reading more on Monday evening. I don't hold much regard for the Senate Finance Committee Bill. It isn't reform. It is playing with words to allow anything goes. It is what we have now, but, worse as it requires for everyone to have health care but doesn't protect the consumer from the ravages of 'the bottom line.'
