This is not a pre-programmed announcement. The media is getting too 'interpretive' of every word the President, his cabinet and staff say. Never once in all the words I heard President Obama speak did I ever hear him say he did not favor a Public Option. The media is chronically misinterpreting the President, primarily because it gives them something to talk about. There is also the mistake that 'The President's Staff or Cabinet' speaks for him. I have never found that to be the case. Obama is as Obama does. Just that simple. I understand the way he contextualizes 'emphasis' to 'accent' a 'specific faux pas' by others somewhat focused on one aspect of a legislation or topic. Okay.
...Obama insisted Sebelius had not misspoken, and asserted that "the press got a little excited and some folks on the left got excited" and had misinterpreted both her meaning and Obama's intentions. He insisted his position has not changed, that he supported a public option, but also that this option was only one part of a larger group of choices. Obama added that he and Sebelius agreed that "all these other insurance reforms are just as important as the public option."...
There is an interesting point to be made at page 149, lines 14-24.
SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
IN GENERAK.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution—
There is a provision in the bill which would allow employers to contribute to the Health Choices Commission without opting for any insurance option. In other words, employers don't have to participate in any insurance, but, they would have to pay a penalty. The bill likes to call it a contribution, but, it isn't optional, so its a penalty. Those penalties would go directly into the trust fund and would not be used for paying for any insurance. A penalty is a penalty. Nothing else to say.
Page 150, line 8 begins "Special Rules for Small Employers"
This provision does the same thing except it adds increments to the size of the penalty depending on the annual payroll of the small employer. Of course any of these 'contributions/penalities' are to inspire businesses of any size to have health insurance for their employees, rather than having it fall to the government/public option. That's another thing, if the House Bill was interested in 'taking over' health insurance it would not penalize employers whom do not supply health insurance, it would simply tax them across the board depending on the number of employees and their annual salary payouts.
That is not what is occurring.
The bill obviously wants employers to have health insurance for their employees. It is the traditional method of accessing health care and usually results in fair prices for a group.
So the penalty/contribution for small businesses breaks down into annual salaries paid with 0% for employers that do not pay more than $250,000. The next increment is $250,000 to $300,000 which would be a 2% contribution. Then $300,000 to $350,000 with a contribution of 4% and finally $350,000 to $400,000 which asks for contribution of 6%.
The bill goes on to define more of the terms, state what a violation of this provision would be and the result, (no jail time, just fines/contributions), periodic investigations for non-compliance (assuming employees are making a complaint or feel compromised to complain for fear of losing their jobs), and the definition of what exactly is considered "health coverage participation requirements.' There are more definitions and provisions for full time vs part time employees, and the Secretary may formulate regulations to secure this part of the provision for the bill.
The primary penalty is stated to be a maximum of $100 per day from the day of the infraction to the day it is corrected. No penalty where it is obvious the employer was exerting due diligence to remedy the non-compliance and there is no penalty if the employer corrects the non-compliance within 30 days. This penalty will be assigned to a maximum of $500,000. Now, $100 per day may seem like nothing to some, but, for small employers $100 per day is considerable. There is even a provision that requires a coordination of any excise tax from the Income Tax Code, so there is no duplication of penalites. All penalties will of course be assigned to the USA Treasury. Won't that be something, huh? The USA Treasury is actually going to have an income other than that of Bernanke's printing press.
Then after all that non-compliance mess, there comes a provision on Page 160, beginning with line 1 through 14 that states:
SEC. 323. SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS UNDER THE PUBLIC HEALTH SERVICE ACT.
IN GENERAL.—Part C of title XXVII of the Public Health Service Act is amended by adding at the end the following new section:
SEC. 2793. NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
ELECTION OF EMPLOYER TO BE SUBJECT TO NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS.—
IN GENERAL.—An employer may make an election with the Secretary to be subject to the health coverage participation requirements.
This of course is the election by an employer to provide health insurance for their employees. That is after all what this bill is all about. This bill is not about ONLY creating a Public Option with yet to be known participating physicians, but, it is to 'cause' every employer to supply health insurance to their employees with shared costs. And it has to be good insurance that is 'reasonable' to the coverage it offers. The employers are not left to the vultures that would see them play pheonomenally high premiums. After all there is a percentage of the premiums paid by the employee, so the bill provides for a pool of health insurance options to choose from for employers, if they so need that.
Each plan will state within the policy purchased by the employer that it satisfies the requirements of the bill. So there. The employers don't have to guess that a particular policy will satisfy the requirements of the bill, any 'options' employers are seeking MUST state within the policy itself they meet standards. Then it just becomes a comparison of prices and increased options such as adding vision or dental, etc. Basically insurance purchasing 'made easy.'
There will be periodic investigations by the Secretary to garner an understanding of compliance within the community of employers participating in the health insurance to employees aspect of the bill. That investigation will result in a discovery as to the compliance somewhat of the employer, but, more the compliance of the insurance provider so long as the policy states it reflects all requirements by the new law. The liability for such non-compliance can't really be that of the employer, so long as the employer is acting in good faith, but, more the insurance companies that have not provided a product that meets government standards.
The bill provides for a 'mix' of health insurance policies to be purchased by the employer providing for Full Time and Less than Full Time employees.
I have a little problem with this provision. Page 162, lines 7 through 14.
TERMINATION OF ELECTION IN CASES OF SUBSTANTIAL NONCOMPLIANCE.—The Secretary may terminate the election of any employer under subsection (a) if the Secretary (in coordination with the Health Choices Commissioner) determines that such employer is in sub stantial noncompliance with the health coverage participation requirements and shall refer any such determination to the Secretary of the Treasury as appropriate.
The problem I have with that is on one hand the bill is stating any health insurance has to state as a 'certification' if you will that the policy is in compliance with the law. Yet, if upon investigation the employer can be designated as "Substantial Noncompliance" and automatically rendered to pay 'contributions/penalties.' Follow? If the health insurance company is certifying the product they are selling an employer meets federal standards, then it should be the insurance company that is brought on charges of fraud. Unless there was a specific policy written for an employer at the request of a company that bends the rules enough to be in somewhat compliance but not complete compliance, then it has to be the insurance company that is 'chargred.' And I do believe the charge has to be fraud with penalities of fines and potentially prison for those that are defrauding an employer. I am assuming the employer is acting in good faith to secure the 'proper' health insurance. I think that provision needs to be reworked to have the responsibilty fall on the insurance company and not the employers. That would assign the employer to 'contributions/penalities' for a time that might be unbearable to the employer.
The bill goes on to define penalties, however, it is still my point of view that once an insurance company that has certified their policy meets federal standards FAILS to achieve that standard, it is not the employer that is 'criminal' and subject to fines and prison, but, the insurance company and to take it a step further. When the insurance company is found to be selling a product that is out of compliance with the federal law, there are also civil remedies by the employees that were to be covered. In other words, the employer having acted in good faith, is not liable either criminally or civily, but, the insurance company that is both criminally and civilly liable to those that were to be covered according to federal law. Employees would have civil remedies to be paid for services they may have paid for out of pocket that were not theirs to pay.
The bill provides for multi-employer health insurance plans. Good idea. If employers with $500,000 in salaries paid annually can be in a pool with other employers of the same size or smaller or larger the base of support for the health insurance carrier widens and the premiums will be less.
Oh, there is also tax on individuals without 'acceptable health care coverage.' Page 167, lines 5 through 17:
TITLE IV—AMENDMENTS TO INTERNAL REVENUE CODE OF 1986
Subtitle A—Shared Responsibility
PART 1—INDIVIDUAL RESPONSIBILITY
SEC. 401. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
IN GENERAL.—Subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by adding at the end the following new part:
‘‘PART VIII—HEALTH CARE RELATED TAXES
‘‘SUBPART A. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
‘‘Subpart A—Tax on Individuals Without Acceptable Health Care Coverage
‘‘Sec. 59B. Tax on individuals without acceptable health care coverage.
That is kind of a big deal, because, there are going to be those folks that will state, "I don't want health insurance." The problem is will the Supreme Court actually hold them responsible for having such insurance, and it is my estimation they will. Why? Because, the people that are 'non-compliant' with their health insurance coverage put burdens on the rest of the citizens that seek to be law abiding with the intent of containing and even lowering health care costs to garner lower insurance costs. I believe, unless a citizen can provide proof of enough personal wealth whereby they can be exempt from having health insurance, the promise of a better health insurance premium to the nation will have more legal weight than someone who simply 'dumps' responsibility on society for their health care costs.
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