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Originally Posted by The_Dunedan
In regards to The Plan itself, the quotations below are from HR 3200, my own commentary is in bold.
Section 102: prevents ensureres from changing rates, or enrolling new policy-holders as of the date the prospective Law went into effect. This will put private insurance companies out of business.
(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:
(1) LIMITATION ON NEW ENROLLMENT-
(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.
(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.
(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.
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Bullshit, either generated by lack of reading comprehension or willful distortion. It doesn't say private companies will not be able to enroll new people, nor that companies can't change rates. This section simply means that current health insurances can continue to exist exempt from the coming new regulations, but that it can't enroll new people under the old policies after the regulations go into effect. It in no way prevents insurance companies from enrolling people in new policies under the new guidelines. It takes a considerable amount of spin to turn something that is essentially making a whole set of policies immune to the new regulations as some sort of new draconian regulation
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Section 123: provides for an "advisory committee" to decide who gets what, composed mostly of career bureaucrats beholden to the President. Historically, such persons have been most reluctant to give The Man the Bad News, and so things like Walter Reed or Romanian orphanages persisted.
(1) IN GENERAL- There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
(2) CHAIR- The Surgeon General shall be a member and the chair of the Health Benefits Advisory Committee.
(3) MEMBERSHIP- The Health Benefits Advisory Committee shall be composed of the following members, in addition to the Surgeon General:
(A) 9 members who are not Federal employees or officers and who are appointed by the President.
(B) 9 members who are not Federal employees or officers and who are appointed by the Comptroller General of the United States in a manner similar to the manner in which the Comptroller General appoints members to the Medicare Payment Advisory Commission under section 1805(c) of the Social Security Act.
(C) Such even number of members (not to exceed 8) who are Federal employees and officers, as the President may appoint.
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Bullshit. The text itself already contains language that debunks the "career bureaucrats" spin, given that the number of "federal employees and officers" cannot exceed 8, and given how 9 members are nominated by the Comptroller General, who is not in any way under the president. Add to that the missing part ("duties") and the whole notion of career bureaucrats deciding "who gets what" is ludicrous. The "advisory committee" doesnt even make decisions, but advises the secretary of health and human services what the standard benefits should be like.
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Section 163 amends the Social Security Act to provide for real-time Federal-level access to all personal medical and financial data, including but not limited to bank-account information and credit ratings. It also provides for a machine-readable national ID card system, at least for those who are utilizing the system
SEC. 163. ADMINISTRATIVE SIMPLIFICATION.
(a) Standardizing Electronic Administrative Transactions-
(1) IN GENERAL- Part C of title XI of the Social Security Act (42 U.S.C. 1320d et seq.) is amended by inserting after section 1173 the following new section:
`SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS.
`(a) Standards for Financial and Administrative Transactions-
`(1) IN GENERAL- The Secretary shall adopt and regularly update standards consistent with the goals described in paragraph (2).
`(2) GOALS FOR FINANCIAL AND ADMINISTRATIVE TRANSACTIONS- The goals for standards under paragraph (1) are that such standards shall--
`(A) be unique with no conflicting or redundant standards;
`(B) be authoritative, permitting no additions or constraints for electronic transactions, including companion guides;
`(C) be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications;
`(D) enable the real-time (or near real-time) determination of an individual's financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;
`(E) enable, where feasible, near real-time adjudication of claims;
`(F) provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;
`(G) describe all data elements (such as reason and remark codes) in unambiguous terms, not permit optional fields, require that data elements be either required or conditioned upon set values in other fields, and prohibit additional conditions; and
`(H) harmonize all common data elements across administrative and clinical transaction standards.
Shall we continue? This thing is a monstrosity.
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bullshit. I wonder why you stopped quoting it there, and did not include the following sections:
"(b) Limitations on Use of Data- Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual.
‘(c) Protection of Data- The Secretary shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to subsection (a) are--
‘(1) used and disclosed in a manner that meets the HIPAA privacy and security law (as defined in section 3009(a)(2) of the Public Health Service Act), including any privacy or security standard adopted under section 3004 of such Act; and
‘(2) protected from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.’."
This is what pisses me off. People want to be against it because they don't like the merits? Fine. People want to mislead others, selectively quoting and spinning the legislation to make a false claim? That is bullshit.
The first section basically says that none of the new regulations and standards affect the old policies. It doesn't prevent any insurance companies from selling new policies, it simply prevents them from selling the old policies to new clients, which is a given when any new regulations come into effect.
The second section basically means that there is an advisory committee that makes recommendations on what the basic level of coverage should be. The advice is non binding, is not individualized, and does not stop anyone from getting additional health coverage if the public system has insufficient benefits for a given condition.
The third section coded simply says that the new public system should be constructed in a way as to reduce paperwork and increase efficiency by creating an electronic database. It does not allow anyone to collect any additional data, or any of the data that the government is currently not allowed to have.