Thursday, August 20, 2009

It's that time again. Time to read more of the House Bill for Health Insurance Reform. What amazing wonders will I find this time?



Ya gotta love Barney Frank. He was beautiful. "So what planet do you spend most of your time?" Loved it ! Go get 'em Barney ! How can anyone believe a person that demands to be recognized as someone that refers to the President of the USA as a Nazi? She can't be taken serious. She lost her legitimacy as she turned her statements into hate mongering. It can't be tolerated.


...Under this scenario (click title to entry - thank you), one bill would include the new regulations on insurance companies, such as requiring them not to reject people with preexisting conditions. As conservative opposition to reform has grown at so-called town hall protests this month, President Obama and others have been pushing these regulations as the key lynchpins to reform that would help those with and those without insurance. It is thought these measures could get the more than 60 votes in the Senate needed to survive through any filibuster threat....



Under the House Health Insurance Reform Bill there will enrollments procedures (starting on page 97). They basically look like any other enrollment procedure one would find with an employer. There are special considerations, no different than the private sector, for special circumstances including birth of a child, adoption, marriage with some extra provisions by the bill such as a move outside the service area for a provider, significant change of income and the like. It goes on to say there will be automatic enrollment in one plan or another for people ineligible for Medicaid with 'affordibility' credits upon application for them and acceptance into a program. The bill also states, all plans will be paid directly to the provider and not through the government.

All these provisions are regarding Exchange Eligible people. There is a lot of willingness to have contact with people in need and there will be a website set up to help them in their choices and enrollment, a toll free number, etc. Basically, the bill is making every effort to enroll Americans in a health insurance option that will be appropriate for their eligibility.

I had wondered how this bill would impact SCHIP. There are children in the country with coverage as members of low income families, with parents that cannot afford health insurance. There is a section on page 100 that begins to discuss the provisions of SCHIP. This section also makes it completely clear the health insurance plans are for those born IN the USA.

Page 100, lines 20 through 25 and Page 101, lines 1 through 13.

SPECIAL DUTIES RELATED TO MEDICAID AND CHIP.—
COVERAGE FOR CERTAIN NEWBORNS.—
IN GENERAL.—In the case of a child born in the United States who at the time of birth is not otherwise covered under acceptable coverage, for the period of time beginning on the date of birth and ending on the date the child otherwise is covered under acceptable coverage (or, if earlier, the end of the month in which the 60-day period, beginning on the date of birth, ends), the child shall be deemed— (i) to be a non-traditional Medicaid eligible individual (as defined in subsection (e)(5)) for purposes of this division and Medicaid; and (ii) to have elected to enroll in Medicaid through the application of paragraph 13 (3).


Basically, the health insurance reform bill sides with coverage first and placement of future benefits later. If the parents already have insurance then this section would not apply, but, for those parents (I am thinking primarily new parents.) that do not have health insurance in place when the child is born, then the child will be covered until the time the family can address a plan for coverage.

In regard to SCHIP, it is my estimation that once 'families' are covered there will be children coming off SCHIP to be covered under their family's plan. In receiving coverage as a family, that will relieve the States of some of their programs that cover children as well and assist State budgets to balance without additional burden's of health care for children. That is my understanding to some of this.

There is also a provision within this bill for children currently enrolled through Social Security. A child with such benefits will become automatically 'Exchange eligible' unless the child is already eligible for Medicaid, there would be no further need to qualify. See, there is going to be some shifting of government liability depending on the enrollment status of those served on other government programs.

The bill goes on to say, that the enrollment in Medicaid or in a health insurance on The Exchange remains fluid should eligibility change over time. In other words, if a child is receiving benefits under Medicaid, but, becomes eligible for the Exchange as their parents now have that option, the child can move into a family plan unless the income of the parents dictate the child to be enrolled in Medicaid. Should circumstances change and let's say the parent(s) become unemployed or disabled, the child will always be covered by one method or another. I think what we will see with The Exchange is that parents working in lower paying jobs will qualify for insurance of one kind or another and will be able to include their children on their own insurance plans. Today, the care of children falls to the States or SCHIP without the benefit of parent(s) being covered. I believe that will change.

There will be a Special Inspector General as defined on Page 107, starting with line 18:

DUTIES.—The Special Inspector General shall — conduct, supervise, and coordinate au21
dits, evaluations and investigations of the Health Insurance Exchange to protect the integrity of the Health Insurance Exchange, as well as the health and welfare of participants in the Exchange;


The really interesting aspect to this bill, which can't be appreciated unless one is reading the entire bill personally, are the number of 'past' legislations (existing law) that comes into play in one method of another in this bill. It is as though we, as a nation, have been inching up to this for some time now and this consolidates all the aspects of health care to date in a clear venue of inclusiveness. I sincerely believe this bill consolidates all the past legislative efforts into one clear concise venue. In doing that, there will be a lot of 'duplicity' that will stop with the passage of the bill. This bill isn't nearly as expensive as it seems right now. This bill appears to be very careful to include all citizens at all levels of need or interest without exception, but, I believe in time will trim spending in other areas and absorb much of the other laws it cites. The House was very thorough in their inclusion of all relevant, existing laws.

Page 109, lines 4 through 6: TERMINATION.—The Office of the Special Inspector General shall terminate five years after the date of the enactment of this Act.

Excellant and exactly what I thought this provision was about. See, this bill is so 'careful' in the inclusion of every American citizen it provides a Special Inspector General of oversee the 'start up' of the program. Imagine being a legislator in DC and writing a historical bill such as this is and then find out because of some stupid loophole or lack of wording someone dies when they should have been included under the new law. Imagine how that weighs on the people of the House that wrote these provisions? By providing 'extra help' for the start up of this new law, there will be no losses or misunderstandings. Concise deployment of the law and accounting for the cost and use allowed under the law will be handled by an exclusive office that has oversight while providing oversight. The new law is really intended to streamline health insurance and its cost at every turn. I like it.

Page 109, lines 16 through 21.

PAYMENTS FROM TRUST FUND.—The Commissioner shall pay from time to time from the Trust Fund such amounts as the Commissioner determines are necessary to make payments to operate the Health Insurance Exchange, including payments under subtitle C (relating to affordability credits).

The new law provides for a separate trust fund to be used for expenses exclusive to The Exchange and the operations of the administration of the new law. This trust fund will receive all the taxes and fines from those people that do not abide by the law by subscribing to a health insurance company. Those taxes and fines will be for individuals and companies that are not in complicance with the law. The law doesn't seem to rely on any punitive measures such as prison to reach compliance. If individuals or companies choose to pay the excise tax rather than being in compliance that is their option. There are specific sections of the IRS Tax Code stated in relation to the Trust Fund where monies would be applied and enforced.

Like I said, they were very thorough in their writing of this bill.

There are provisions for States to set up their own health insurance exchanges if State legislators care to engage the issue. The States can even regionalize their exchange if they feel they can provide better than the federal government. However, the State Exchanges have to pass an approval process to be sure they are offering equivalent options at comparable costs or less.



continued below...