In the Senate of the United States,
December 24, 2009.
Resolved,That the bill from the House of Representatives (H.R. 3590) entitled ‘An Act to amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes.
AMENDMENTS:
Strike all after the enacting clause and insert the following:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title- This Act may be cited as the ‘Patient Protection and Affordable Care Act’.(b) Table of Contents- The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I--QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS
It continues from here.The bill was adapted and renamed from a previous focus. The House decided to abandon the original contents of this 'bill number' to the Senate version S. 1728 - Service Members Home Ownership Tax Act of 2009 (click here). That is all this is about.
Subtitle A--Immediate Improvements in Health Care Coverage for All Americans
Sec. 1001. Amendments to the Public Health Service Act.‘PART A--Individual and Group Market Reforms
‘subpart ii--improving coverage
‘Sec. 2711. No lifetime or annual limits.a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish—
(1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
(2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue
Code of 1986) on the dollar value of benefits for any participant or beneficiary.
(b) PER BENEFICIARY LIMITS.—Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage that is not required to provide essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act from placing annual or lifetime per beneficiary limits on specific covered benefits to the extent that such limits are otherwise permitted under Federal or State law.
Nothing complicated about this. There is no lifetime annual limits in any health care insurance.
I believe there might be a concern regarding annual limits in this verbiage, however, the President has made it clear that needed to be cleaned up. The Reconciliation Act may address this. The wording is a little muddy. And below the insurance companies cannot take back their coverage, except, if there is fraud by the subscriber. So don't lie. No one should ever lie about their health anyway.
Sec. 2712. Prohibition on rescissions.
''A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not take back such plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved, except that this section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional mis-representation of material fact as prohibited by the terms of the plan or coverage. Such plan or coverage may not be cancelled except with prior notice to the enrollee, and only as permitted under section 2702© or 2742(b).
Rather than inserting the provisions with the table of contents it is better to accept the content the way it is laid out. The table of contents is extensive and complete, so the substance of the bill starts here:
TITLE I--QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS
Subtitle A--Immediate Improvements in Health Care Coverage for All Americans
Part A of title XXVII of the Public Health Service Act ((2) by redesignating sections 2704 through 2707 as sections 2725 through 2728, respectively;
(3) by redesignating sections 2711 through 2713 as sections 2731 through 2733, respectively;
(4) by redesignating sections 2721 through 2723 as sections 2735 through 2737, respectively; and
(5) by inserting after section 2702, the following:
‘Subpart II--Improving Coverage
‘SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.
‘(a) In General- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish--That seems fairly clear.
‘(1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
‘(2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue Code of 1986) on the dollar value of benefits for any participant or beneficiary.
Unreasonable is a fluid term. Who defines unreasonable? The term was placed into the Senate bill because of concerns of the impact on the industry and whether or not there would be undo constraints on the citizens because of it. One has to remember the Senate bill when it came out of the Finance Committee was supposed to be approved of by the Republicans of that committee. In fact what occurred in the Senate Finance Committee was a lot of betrayal of bipartisanship. Senator Baucus was convinced there would be bipartisan support for the bill because of the work done in the Finance Committee. In fact the Republicans on the Finance Committee turned their backs on bipartisanship and only used their opportunity in committee to try to destroy what the House had begun. Basically, the Republicans in the Senate Finance Committee is what 'set up' all the anger and contention in the nation. They were unfaithful to the public trust afforded them.
I consider 'unfaithfulness to the public trust' a huge ethics issue, however, during the majorities of the Republicans the Ethics Committees were nearly carved to the bone and primarily reduced to unlawful acts being the focus of ethics. That isn't an Ethics Committee, that is a simply a record keeping variety of a judicial ruling. Ethics has to be returned to the Ethics Committees of the House and Senate. It allows too much co-mingling of interest of the private sector with the best interest of the citizen.
‘(b) Per Beneficiary Limits- Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage that is not required to provide essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act from placing annual or lifetime per beneficiary limits on specific covered benefits to the extent that such limits are otherwise permitted under Federal or State law.
The language really isn't great here. I don't like the bill singling out the 'individual.' 'per beneficiary' is a focus on the individual. That isn't good. Because it is the individual that is suppose to be protected, not 'the group.' That is to begin with. It allows too much 'play' in an opportunity to attack 'the individual' with the understanding that 'an individual' has different 'qualities' than the group. A group health insurance plan is suppose to protect the individuals in it. This section allows the group to be divided into individuals. I don't like it. The reform is suppose to protect all Americans equally.
The operative words are 'that is not required to provide essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act
That provision states, that if there is health care insurance in the market place, allowed by laws under Federal and State laws that does not provide 'essential' services they are excluded from the laws of this section. No. That is not the way to treat comprehensive health care reform if one is to protect the nation's citizens. It needs to be understood that every citizen is covered by health insurance to cover all essential needs. Annual physicals and regular 'basic screenings' have to be a part of every American's coverage. If a person decides not to exercise their rights to coverage of those benefits and ignores the value of those benefits to their health there is little anyone can do about it. However, to allow health care insurance companies to actually write policies that exclude essential coverage when the nation is attempting to bend the cost curve down is a violation of the public trust as far as I am concerned. The President made it clear that the legislation was to protect all citizens in the same way and to allow exploitation to continue and allow inflationary costs is simply "W"rong. I hope this is cleared up in reconciliation. It is appropriate that the federal government 'LIMIT' the instruments available to the citizens of the USA while providing the private sector the opportunity to protect them. Excluding such instruments from availability to citizens is the right thing to do. There is no reason for them. Why would there be? All people are the same physiologically. To allow such policies to exist is contrary to COMPREHENSIVE reform. Once a person is insured with 'proper' health care there is no need for any other coverage. That would be duplication of services and allow for exploitation that should not exist. Nothing saying people can't be covered by two insurances as in married folks and their children, but, there really is no need for it. If deductibles are realistic and affordable there is little need for two insurance companies to cover one person. Two insurance companies covering one person increases the cost of health care. Riders such as the 'supplement' to Medicare can be a part of a 'second' policy to cover all deductibles, however, and I can't say this enough, if the deductibles per person are reasonable there is no need for even a rider on their policies to cover all the deductibles. The reason why such instruments exist today is because deductibles are out of control. They are increased while costs to purchase also increases.
I think that is enough about that.
continued...
