Wednesday, March 31, 2010

Today's health care bill update:

For a collection of all health care bill readings, see sidebar on the right side of the page.

Here is this morning's reading of the new health care law. Feel free to clarify or post corrections to anything I write as I'm definitely not an expert on this but rather an ignorant layman trying to make sense of it.

Page 20. Section 2713: Coverage of preventive health services. The law mandates insurance plans "shall at a minimum provide coverage for and shall not impose any cost sharing requirements for-" (That means no copays or deductibles.) services that have a rating of A or B in the current recommendations of the U.S. Preventative Task force." Don't know what that is? Well, go to this link to see if the service is covered under this section. By the way, there is not a list under "A" or a list under "B" but instead you have to click on each service to check the rating. How convenient. This section also covers child immunizations, preventative care and screenings for women and breast cancer screenings. A new recommendation does not have to be covered by the insurer until one year after its creation.

Page 22. Section 2714: Extension of Dependent Coverage. Here it is. Read it and weep if you are a parent: "A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child (who is not married) until the child turns 26 years of age." But don't worry, the law does state in the next sentence that the plan does not have to cover the child of the child covered so if your 24 year-old single daughter has a baby, don't worry, your insurance will not cover her kid. Thank goodness for the tough cost containment measures in this law.

Page 23. Section 2715: Development and Utilization of Uniform Explanation of Coverage Documents and Standardized Definitions. Within one year after this bill became law, the government will issue "standards" for use by health insurers and provide to enrollees a summary of benefits and coverage. Wow, it even mandates how the standards shall be described: summary can't be more than four pages. Yup, four. Print can't be smaller than 12-point font. Damned if they aren't meticulous in looking out for our interests. Language MUST be understandable. The rest of the section deals with notice requirements. Failure to comply will result in a fine of $1,000 for each failure. Each failure is obviously a separate offense.

Page 29. Section 2716: Prohibition of discrimination based on salary. Can't offer plans that "are based on the hourly or annual salary of the employee or otherwise establish eligibility rules that have the effect of discrimination in favor of higher wage employees." However, it DOES allow employees making less money to contribute less than those with higher salaries. Translation: Everyone gets the same plan. No more Mercedes plans for upper management who pay little for them while factory workers get plans with smaller coverage.

Question: Will section 2716 apply to state and local governments since too often politicians get much better benefits packages than do the actual employees. Then there are colleges and universities. Some local private ones known for being cheapskates on employee pay and benefits while giving sweet deals to their presidents immediately come to mind.

That's it for today. You're going to looooove the next section, which will be covered tomorrow. Copy of bill.

33 comments:

Anonymous said...

Is anyone else getting as dizzy as I am trying to read this bill?? Now I need to drink some tequila. Hmmmm... perhaps we are on to something here. Maybe that is what they were drinking when they wrote this bill.

paul mitchell said...

Oddly, Kingfish, the bill says the exact opposite of what the Clarion Ledger said on the twenty-SEVEN year old thing. The C-L stated that you CAN, instead of MUST.

Also, I use 27 because parents are FORCED to cover their children until their 27th birthday. I am certain this is not going to be a problem with my son finishes his stint in the Navy and comes home to find there are no jobs left because of the horrendous government that we have.

While reading through this law, have you found a single thing that will reduce costs or increase quality? Yeah, me neither.

And have you found the reconciliation bill online, yet? From all accounts that I have read, the reconciliation bill takes out some of the provisions of the primary legislation and does even more to increase costs and regulations.

Kingfish said...

This is the reconciliation bill. Its going to be easier if I just go through the Senate bill first, then go back and deal with this one.

paul mitchell said...

It would have been easier if the Democrats had not had to employ so many procedural tactics and so much under the table to ram this crap down our throats.

I find it hard to believe that there can ever be a full understanding of all they have done. Well, before the year 3000, anyway.

Anonymous said...

Does this bill apply to the President and members of Congress?

paul mitchell said...

^^HAHAHAHAHAHAHA!!!!^^

Kaptain Kangaroo said...

I'm gonna take it by page...

Page 20: I've always been for preventative health services. Fortunately for the HC industry not a lot of people take advantage of "wellness" programs. Unfortunately, a lot of procedures got lumped under "wellness" it appears. I guess they want us to live longer.

Page 22: The kid is going to college. So, I'll be covering until they are out. After that, will they need coverage b/c they are un- under-employed? Probably. I like the no coverage for dependents of dependents, but, guess who is picking up the birthing tab?

Page 23: I actually agree with this. I watched a very educated person "gotten" by the very fine print on a very lengthy document, despite the assurances that the fine print said "nothing, just disclaimers". How soon we forget the predatory practices of the Mortgage industry.

Page 29: Don't get this. I hope, as mentioned before, this will include "all members of Congress and POTUS" are beholden to the same level of healthcare as our poorest citizen.

You know the more I think about this, I have to wonder, what happens to Workers Compensation Inusrance, coverage limits, and pay discrimination under this bill?

paul mitchell said...

KK, all Executive Branch, Legislative Branch, and Judicial Branch officials, along with their aides, full time or part time, PAID and UNPAID are exempted from participation.

Unless that was changed with the reconciliation law. Chances of that are nil in my opinion, but I have not had the opportunity to read the reconciliation law.

Kaptain Kangaroo said...

Did I mention, I'm gonna suffer through this too. I'm thinking I might just start a daily meeting to discuss with my peers. Nice approach. And already, I'm very confused. I'm hoping to at least get the gist of the important segments of the legislation. Or, understand where I best come out on this and work to get there now, rather than later.

Kingfish said...

Don't know. We are taking this page by page.

NOW here is a question based on page 29: Will it apply to the MISSISSIPPI LEGISLATURE?

Kingfish said...

Then there are universities and colleges which give their presidents sweet benefits packages. What about those plans? Seems they go out the window.

Kaptain Kangaroo said...

GREAT Question! Does this impact state government, quasi-government, public organizations...and how? Interesting. We need to keep a running list of questions somehow to make sure we are answering the very issues most impactful in a meaningful day-to-day life of an ordinary citizen.

Kingfish said...

Over the weekend I'm going to start a post that is constantly updated that will be a fact sheet. One sentence blurb and page number as I come across them. Probably would've had two today, one yesterday.

Anonymous said...

OK...
I am at a loss about the objections to PARENTS WITH HEALTH INSURANCE PAYING UNTIL SUCH TIME AS THAT CHILD HAS COVERAGE AS AN EMPLOYEE.

NOW WE TAXPAYERS PAY FOR ALL CHILDREN OVER 18 AND NOT IN SCHOOL WHOSE PARENTS RAISED THEM TO BE BUMS!

My kids had 6 and 1 year before coverage though IMMEDIATELY hired after graduation. I would have LOVED to just continue coverage on our policy.

It's either Medicaid or "free" ER care for the shiftless kid or their parents' responsibility. I'm ALL for making it the parents' responsibility!

paul mitchell said...

Anon 5:53, just out of curiosity, why did you not just buy the kids a new policy if you wanted to pay for them? That seems strange.

Anonymous said...

YEAH for 2716! That's the closest thing to a flat tax we can get!

Of course, those of you who find it fairer to let upper management pay , say, 10% of six figures for their health insurance and some poor slob making 5 figures paying a greater percentage for less coverage, please stand up!

Those standing, put down the tequila, you are too drunk to make intelligent decisions.

PAUL, PLEASE..could you object to the 4 sections rather than what's NOT under discussion?

Anonymous said...

Please look up actuarial tables for health care for those 18-26. Where's the cost? I only see a guaranteed profit to insurance companies on those collected rates.

Where's the cost to the taxpayer on the next section? So, a CEO getting big bonuses has less ? I'm weeping with pity.

So , far...where's the COST to the taxpayer? PLEASE be specific.

We'll get to some, but not yet...

paul mitchell said...

Sorry, I was unaware that Page 22. Section 2714 was NOT under discussion now.

Anonymous said...

Please look up actuarial tables for health care for those 18-26. Where's the cost? I only see a guaranteed profit to insurance companies on those collected rates.

Where's the cost to the taxpayer on the next section? So, a CEO getting big bonuses has less ? I'm weeping with pity.

So , far...where's the COST to the taxpayer? PLEASE be specific.

We'll get to some, but not yet...

Anonymous said...

PAUL, PLEASE..could you object to the 4 sections rather than what's NOT under discussion?

Are you the moderator here?

Anonymous said...

PAUL, I DID BUY A NEW POLICY

My costs doubled...$360 with a $1000 deductible for the first and 3years later $490 for the second grad. That's per MONTH.
NO WAY either would or did need it, but IN CASE one of them ran into the Irbys and lived, I had to cover my bets.

Kingfish said...

I would prefer if possible we kept it to the sections discussed in the post or previous sections covered. We'll have plenty of time for the others when we get to them.

Anonymous said...

My costs doubled...$360 with a $1000 deductible for the first and 3years later $490 for the second grad. That's per MONTH.
NO WAY either would or did need it, but IN CASE one of them ran into the Irbys and lived, I had to cover my bets.


So why should we help you pay your bills? Why should anyone be forced to subsidize your finances?

paul mitchell said...

Kingfish, will you add a label to this series of posts for ease of linking to other sites?

Anonymous said...

Ah, I see the entitled rich folks showed up. Good to see. Let me begin with you make too much money to be entitled to anything other than what you earn. And, for those "poor slobs" you make money off of (those that tea-baggers would rather the insurance companies not cover and subject them to "death penalties"); I say, sir, do unto yourself as you do unto them.

Kaptain Kangaroo said...

Shout out to State Street Posts!

Anonymous said...

6:15, you shouldn't help me pay.
The insurance industry forced me to buy NEW coverage that was more expensive.
Neither child's risk or costs changed from the day of graduation from college to the day after graduation. Nor did their employers WITH our contribution have to pay that much for our coverage.

You will STILL not be paying anything.

The only thing different is that your child's coverage will continue until they have a job that covers them or they can buy their own or until age 26, whichever comes first.

THINK. If my child goes to college, that child is covered until age 22 anyway. If your child graduates from high school and gets a job, their coverage stops at 18. If we work for the same company and make have the same premiums, then a secretary whose child doesn't go to college is paying for coverage for her boss' child to go to college as they are on the same plan.

This section is ONLY about continued insurance coverage.

IF there is any cost to the taxpayer, it will be in premiums increasing and THAT'S where you start looking at other sections.

One of things I DON'T like about this bill is that while it stops sleazy insurance practices that developed over the last several decades that were based ONLY on profit and NOT on risk, it doesn't do enough ( thanks to lobbying) to make sure the insurance industry doesn't just gouge.

Sorta like all the credit card companies that made things worse for the consumer in anticipation of that new law. Congress didn't make it apply to existing accounts.

Anonymous said...

If your children are healthy young adults then why are you insuring their health at all? You could have taken that $850 monthly and set it aside (banked) only for the rare event (per you) that they became ill. $1000 deductible? Big deal. You act as if insurance is some kind of piggy bank.

Anonymous said...

PAUL, do you not know how insurance works?

My children couldn't be covered under our employer's plan anymore once they finished school. I stayed with the same insurance company as choices were limited to plans available in this state.

INDIVIDUAL coverage cost more than GROUP coverage. The larger the GROUP , the less the premium. Mom and Pops get screwed on this as do professional groups. IF they could ever have POOLED...like all clothing stores pooled into one group, it'd have been cheaper. But, the industry had fought THAT or going across state lines for years.


That is a why a large corp like GE has better coverage for it's employees than a Mom and Pop and pays LESS for each employee and each employee pays LESS for better coverage. Since GE operates in every state, it can also buy coverage in a state with the cheapest rates and best coverage.

You are also limited in what insurance companies operate in your state. I am a member of USAA but couldn't buy their HEALTH plan, only their AUTO and LIFE plans.

I am now on BC/BS with a larger company. Same supposed level of policy ( best offered) and yet my copays are lower and my coverage MUCH greater , including airflight home from any place I become ill.

I'm surprised so many people don't seem to know about their insurance policies.

Mississippians have always been screwed on insurance of all types, including health, because we always elected an Insurance Commissioner who was a part of the industry. Alabama had a consumer oriented commissioner who got them better deals.

We keep electing Insurance Commissioners based on how fun they are at parties or their politic party . There is never a discussion of INSURANCE or competence to negotiate on our behalf.

Paul, I can't believe you missed knowing this stuff...leave it to the wife or secretary or your buddy the insurance agent?

Anonymous said...

This bill gets us closer to having coverage to consumers that is available to government employees because FINALLY, small gruops will be able to POOL together. THAT has been a huge advantage these guys had that we did not.

There's stuff NOT there. Unfortunately, a side effect of all the " agin it" folks who keyed in on the wrong stuff, led to " compromises" to get support that were favorable to the insurance industry.

Between lobbying and political games, YOU the taxpayer gets screwed OVER AND OVER because the lobbyists and politicians DEPEND on YOU not doing your homework. They DEPEND on being able to use slogans and catch phrases to PLAY YOU.

Anonymous said...

You are so convinced of your own expertise you've become delusional.

paul mitchell said...

Anon 8:03, thanks for the lesson in "insurance." I have made it to 45 years old and running my own business, "insuring" others without knowing all that.

By the way, I still do not consider your pre-paid medical program to be insurance.

But, leftists always think that others are too stupid to know what those leftists "know." And those leftists are always wrong in everything they believe.

FORCED to cover your children until they TURN 27? Only an dimbulb would think that is a good idea.

Anonymous said...

Oh, you are just a racist Paul. ;-)

Suscribe to latest on JJ.

Recent Comments

Search Jackson Jambalaya

Subscribe to JJ's Youtube channel

Archives

Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).


Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.


In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.


Note: Security provided by INS.

Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS
.