I want to know how many Republicans have bought stocks in Health Insurance Companies since President Obama was elected?
That means they are talking out of both sides of their mouths and they don't have a chance in November !!!!!!!!!
If they owned it prior to his election, then it was they and their greed that prevented them from acting at all !
SEC. 1003. ENSURING THAT CONSUMERS GET VALUE FOR THEIR DOLLARS.
Part C of title XXVII of the Public Health Service Act (The law that is cited is at the link I have above. That is the law that is amended.
‘SEC. 2794. ENSURING THAT CONSUMERS GET VALUE FOR THEIR DOLLARS.
The Health Care Reform Act is blind to the past. Does everyone understand that? Writing this law, the legislators took 'the need' of the people of the USA and wrote what would 'construct' good law.
While there are provisions that will allow citizens to keep their medical insurance as it exists today, it is because the provisions work through the 'existing' health care insurance infrastructure.
But, the law as it is written starts from scratch to construct the new FUNCTIONAL infrastructure from the old dysfunctional infrastructure. They aren't destroying it and starting over. They put the health of the nation first in knowing that there has to be an infrastructure to uphold the needs of the people, while molding a more functional design that RESTRAINTS exploitation, abuse and negligence.
So, some of this may seem silly to some folks, but, it is necessary to 'establish' a solid foundation to the new infrastructure.
‘(a) Initial Premium Review Process-
Here again, the rights of the states is considered and the State Regulators are still in place. No one has removed them. They are still there doing their work. This is authority to begin to build a relationship with the federal government to tighten up the health care insurance industry to best serve the people. There will be regional differences that will emerge. The people of the industrialized northeast will have different and similar health concerns than those of the agricultural midsection of the country. There is a chance the price infrastructure may emerge in some differences as well. This is NOT a method to 'homogenize' the country or exploit one region for another. It is a method to 'best serve' the citizens to be sure they have 'reasonable costs' to their health care.
The Republicans always scream one has to cut taxes to grow business. Well, what also grows business is an equitable distribution of the income of Americans. While Americans have monies to spend and should do it well there are some realities to that spending that comprises an economy.
If I may.
There are basic needs citizens have. Education, housing, food, health care, etc. There are choices within those NEEDS that comprise its own economy. BUT. There is also the economy that is 'DISPOSABLE INCOME.' Those are the choices that are somewhat fluid, such as, vacations, electronics, furniture, cosmetics, clothing above that what is necessary to function in life, etc.
All those 'parts' of the economy are vital. There is not one more important than the other WHEN the USA economy is 'happy.' Right now the USA economy is not a happy economy, it is a bit contracted and worried about the future, so it is reserving judgment on spending on items that are a bit unnecessary.
When citizens are unsure about their future there will be less spending in areas of 'interest' vs. need. What will occur with this Health Care Reform Bill is that people will be able to discern what the necessary aspects of living will cost and will be able to build a budget for items that are disposable in their concept. The fun things of life, such as, vacations, etc. So, to realize what this bill will do and how it will not only contribute to a citizens best interest in being well and able to work and able to better enjoy a higher quality of life, it will also make income and expenses more predictable.
With all that said, the economy should expand and become more varied in its dynamics. That is a good thing. Variability in dynamics is directly related to 'growth.' A lot to consider and think about.
But, to return to THE LAW. It is no longer a bill.
‘(1) IN GENERAL- The Secretary, in conjunction with States, shall establish a process for the annual review, beginning with the 2010 plan year and subject to subsection (b)(2)(A), of unreasonable increases in premiums for health insurance coverage.
‘(2) JUSTIFICATION AND DISCLOSURE- The process established under paragraph (1) shall require health insurance issuers to submit to the Secretary and the relevant State a justification for an unreasonable premium increase prior to the implementation of the increase. Such issuers shall prominently post such information on their Internet websites. The Secretary shall ensure the public disclosure of information on such increases and justifications for all health insurance issuers.
‘(b) Continuing Premium Review Process-
‘(1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS- As a condition of receiving a grant under subsection (c)(1), a State, through its Commissioner of Insurance, shall--
‘(A) provide the Secretary with information about trends in premium increases in health insurance coverage in premium rating areas in the State; and
‘(B) make recommendations, as appropriate, to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.
What does all that mean? It means citizens will be PROTECTED from draconian practices by companies that USE their enrollees as a means to profits, unreasonable profits. I already read where the insurance companies will be able to discern up to 20% profit margin in their bottom line. But, the companies that insist on having higher profit margins than what is reasonable to their enrollees in premiums will be eliminated as providers to citizens in 'the health care insurance exchanges.' That is good thing and for more than obvious reasons.
The exchanges as I understand them right now, will be where small businesses can go to join a pool of enrollees to receive good quality health care benefits without huge costs. They will be able to distribute their monies differently. They will be able to 'grow' their businesses, not through draconian tax cuts, but, by receiving better 'cost' vs 'income' to their balance sheets.
Do you see how this works? Just because tax cuts are valued by a 'segment' of the Right Wing does not mean it grows small businesses. If the 'costs' to small businesses aren't contained, there is no 'guarantee' the businesses will grow.
Quite literally, what can occur is that tax cuts provide 'tax relief' to small businesses, but, if they have skyrocketing costs in health care premiums where does the growth go? To economic growth in the country or to Wall Street profits? I really don't think I have to answer that question. And where is the growth of the nation best served? In Wall Street stockholder profits OR in the growth of small businesses and higher variability in the economy? And where will GROWTH be best served, in Wall Street stockholder profits or in small businesses in the country?
‘(2) MONITORING BY SECRETARY OF PREMIUM INCREASES-
‘(A) IN GENERAL- Beginning with plan years beginning in 2014, the Secretary, in conjunction with the States and consistent with the provisions of subsection (a)(2), shall monitor premium increases of health insurance coverage offered through an Exchange and outside of an Exchange.
This is a little complicated in that it is a dynamics of 'decision making' by two sovereign entities and it is intricate. First there is cooperation established in the law between the federal and State authorities. Each has rights in the relationship. The wording strongly indicates this relationship between these two sovereign authorities is cooperative in nature. However, it can change should the relationship become tainted with corruption or adverse outcomes to the States citizens.
The law requests the States to monitor costs of PREMIUMS, not the intricacies of CEO decisions with the companies. The law is clear that this does not control companies. It, however, through its strong interest in the citizens will maintain an interest of the impact of the premiums on that aspect of the business dynamic.
It is establishing, from a somewhat blind perspective, the best relationship between business and the peasants. Sorry, it is the way I see it. Peasants are different from citizens. Peasants are something that is controlled by the company. Peasants are an ownership issue as if the company can do what they want when they want it. The relationship of the citizen with the government is different. Citizen is participatory.
I am going to go on a tangent here. If one recalls the 'up tick' of patriotic symbolism by 'advertising' post Bush/Cheney of 2002, it becomes obvious how businesses pander to citizens to attract their 'value' to their profit margin. That is all I am going to say to entertain the imagination about the difference.
Back to the law. I can't help myself here. Companies are NOT patriotic. Ask the auto workers. "Roger and Me." There is no loyalty to them. However, there is a strong relationship of loyalty between government and citizens. No one can tell me the investment banks gave a darn about the citizens of the country when they through their peasants to the wolves in October of 2008. End of that.
Now, back to the law.
‘(B) CONSIDERATION IN OPENING EXCHANGE- In determining under section 1312(f)(2)(B) of the Patient Protection and Affordable Care Act whether to offer qualified health plans in the large group market through an Exchange, the State shall take into account any excess of premium growth outside of the Exchange as compared to the rate of such growth inside the Exchange.
Okay, so there is some fluidity in decision making. When a State sets up an exchange (and this is where a Public Option plays a heavy roll and I'll get into that. I'll 'weigh' it pro and con.) there is to be monitoring of the premiums inside the exchange and outside the exchange. If the cost of premiums are better outside of the exchange AND availability is to all the participants in the exchange there is little reason to continue that exchange.
There is a 'real chance' that the health care insurance industry MIGHT recover from its slide into higher prices with the requirement of all citizens to carry their own coverage. That is a good possibility and I would not under estimate that potential.
HOWEVER, there is also the possibility that they may only continue to 'self protect' and not involve themselves in the exchanges and continue to find their own way and continue to self destruct (as far as I am concerned) with continually rising premiums.
In both those dynamics lies success for the Health Care Reform Law. If the insurance companies move away for very silly priorities by having a better cash flow then the law will have served the best possible outcome from the perspective that the 'economic integrity' that is valued by so many citizens as unique to Americana actually does work when government is involved to protect citizens and their economies. That is best case scenario.
Worst case scenario is that the insurance companies are irretrievably broken. They will be unable to recover AND provide services to their peasants. The question as to whether they have found a way to still serve their stockholders is up to them to answer, but, that is not the PURPOSE or focus to the law.
The purpose and focus of the law is to protect citizens from exploitation and provide a reasonable cost to health care insurance so they can have high quality lives and DON'T DIE due to Health Insurance Decisions that don't care about peasants. We all know the way the health insurance companies make profits is to raise premiums while cutting services AND eliminating ill peasants. That methodology causes a vicious cycle of escalating costs that are perpetuated by the insurance companies as it relates to the health care DELIVERY infrastructure, i.e. Emergency Rooms, bankruptcies, etc..
So, if that occurs and the insurance companies can't survive even in a 'hyper-optimum' cash flow cycle, in my opinion, then here is the Public Option waiting in the wings and why it should be there as a TRIGGER to failure of this very supportive law to health care insurance companies.
Now, remember, the insurance companies and their CEOs are not controlled by the law. They could literally design the exchanges to fail, followed by the return to draconian practices that will put the citizens back where they were before the law 'set up' the exchanges.
What could occur if the health care insurance companies completely fail and/or return to exploitive practices is the 'federalization' of health care and then the citizens of the country are looking at a Single Payer System. That would be necessary to serve the citizens. It would be absolutely necessary and Homeland Security should have in place a method for that to occur.
A Homeland Security methodology would be emergency distribution of monies from the treasury to pay the health care infrastructure to immediately implement Singer Payer. It is why it is best to work on the deficit and return a 'buffer' of functionality to the USA Treasury.
Now, why the Public Option could best be left out of the picture is that WITHOUT it, the health care insurance companies could recover on their own and literally provide a service at a cost that the Public Option might not be able to compete with. That is what I am hoping happens, SO LONG AS, all the citizens are covered and receiving care. That is also why a Public Option should at least exist in paperwork somewhere so that it is not a foreign entity to the understanding of the government should all else fail.
The idea that a Public Option should compete with Private Insurance is still THE BEST option to any scenario at all. It would be in place and available and act as a lever against ANY exploitive 'plan' or 'practice' by private health care insurance companies. Could the Public Option actually do damage to health care insurance company recovery? Not likely. However, could the Public Option be make to look 'as a fool?' Absolutely. That is why I believe it should be written in as a trigger to an event in case it is needed by citizens and they aren't getting the relief they need and deserve.
The other consideration is that with controlled costs to the citizens and their small businesses what does GROWTH look like and is the economy recovering as well? In that case, the Public Option is a necessity to achieve an end.
Companies and Corporations don't have conscience, the people that run them do. It is why the Robert's Court decision regarding corporations as if a citizen is so completely hideous. In reality the decision was to allow 'the plutocracy experiment' to begin.
‘(c) Grants in Support of Process-
‘(1) PREMIUM REVIEW GRANTS DURING 2010 THROUGH 2014- The Secretary shall carry out a program to award grants to States during the 5-year period beginning with fiscal year 2010 to assist such States in carrying out subsection (a), including--
‘(A) in reviewing and, if appropriate under State law, approving premium increases for health insurance coverage; and
‘(B) in providing information and recommendations to the Secretary under subsection (b)(1).
The exchanges are vital to containing the health care insurance costs without the Public Option in place. The federal government is offering grants to states and territories of the USA in order to assist in setting up the monitoring and the establishment to the infrastructure of the exchanges beginning in 2010. Without monitoring there won't be any way to enforce the law. This is all necessary and vital.
‘(2) FUNDING-
‘(A) IN GENERAL- Out of all funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary $250,000,000, to be available for expenditure for grants under paragraph (1) and subparagraph (B).
$250,000,000 US. That isn't much considering all the work the citizens of the country is getting in return. Not only that it will serve to expand the tax base when new jobs erupt due to the expansion of the agencies that will carry out this law. I remind, the USA is a huge country with 50 States and multiple territories and 300 + million citizens.
‘(B) FURTHER AVAILABILITY FOR INSURANCE REFORM AND CONSUMER PROTECTION- If the amounts appropriated under subparagraph (A) are not fully obligated under grants under paragraph (1) by the end of fiscal year 2014, any remaining funds shall remain available to the Secretary for grants to States for planning and implementing the insurance reforms and consumer protections under part A.
‘(C) ALLOCATION- The Secretary shall establish a formula for determining the amount of any grant to a State under this subsection. Under such formula--
‘(i) the Secretary shall consider the number of plans of health insurance coverage offered in each State and the population of the State; and
‘(ii) no State qualifying for a grant under paragraph (1) shall receive less than $1,000,000, or more than $5,000,000 for a grant year.’.
The above provisions are simply the 'mechanics' of the law to issue grants. It is fairly straight forward and the only question is what will the 'formula' look like. I am not venturing a guess, nor should anyone else. Like I said, each State is a sovereign authority with a unique relationship with the Federal government in this law. I'm not going to try to guess what the Secretary sees as a necessary formula to that relationship.
SEC. 1004. EFFECTIVE DATES.
(a) In General- Except as provided for in subsection (b), this subtitle (and the amendments made by this subtitle) shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act, except that the amendments made by sections 1002 and 1003 shall become effective for fiscal years beginning with fiscal year 2010.(b) Special Rule- The amendments made by sections 1002 and 1003 shall take effect on the date of enactment of this Act.
That is also very straight forward. I believe the 'special rule' provision is being addressed with the Reconciliation Act of 2010 that is currently before the USA Senate.
I'm going to end here for today regarding the new law.
