Tuesday, March 30, 2010

Let's talk about the health care reform bill

Ok, here's the deal. The health care debate was not much of a debate. It's hard to debate something when there are umpteen versions of a bill floating around, countless amendments, talking points, sound bites and the fact that almost NO ONE actually READ the bill. Well guess what we are going to do here on Jackson Jambalaya? We are going to read the damn bill. I'm going to start reading and posting up here. Might be five pages a day, might be fifty pages. There is no set pace here but we are going to read through it if it takes six months. It's 2400 pages so it's going to take us a while. I am reading from this bill when I study the bill. Let's get started.

Pages 1-18: Table of contents.

Page 19: No annual or lifetime limits on benefits. "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 1 of 1986) on the dollar value of benefits for any participant or beneficiary." Link to section 223.

What exactly is reasonable? Whatever a court or the government says it is. If no limit can be placed on services at all, what will happen to demand for said services? Better yet, what will happen to insurer if said demand rises and it can't raise revenue (through premium increases or other sources) enough to pay for the increased expenses? However, section b does say that a plan that is not required to provide "health benefits under section 1302(b) of the PPACA from placing limits." SO what is 1302(b)? Let's go find out. Section 1302(b) is on page 105: "Essential Health Benefits Requirements". Only plan referred to as not facing such a requirement in (b) is stand-alone dental plans. There are other plans mentioned in Section 1302 such as catastrophic but they are not in section b. However, section 223 of the IRS code does provide some limits, depending on the type of plan. (Usually health savings accounts or high-deductible plans).

Page 19: Section 2712: Prohibition on Rescissions. Health insurer can not "rescind" a "plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved" unless fraud or material misrepresentation occurs.

That is enough for one day. Feel free to comment or point out relevant facts. I'm not an expert, not pretending to be one, just want to read the bill and see what is in it. This is going to be a long discussion as I point out what is in the bill and ask for comments. Clarifications are definitely welcome.


Anonymous said...

You are a brave man, Kingfish. This will require a lot of whiskey.

Kingfish said...

Tequila baby, tequila.

Milagro Silver Tequila. chilled.

Anonymous said...

To get through this mess it will require a tanker truck of tequila.

Kingfish said...

That is a bad thing?

Anonymous said...

Kingfish, I applaud you for doing this, and I think it will be extremely enlightening. I posted on NMC's site this morning, but the debate on his post dried up about the time I posted. Before we get too mired in the details, there is one thing I would like to hear your and your readers opinion on.

The cost of this bill is being touted as decreasing the deficit by approximately $200 billion over 10 years. Further, if it was not deficit neutral or better, it could not have become law.

So, here is a simple question that needs to be addressed by our leaders. Is the $200 billion in deficit reductions fair and accurate?

Let's forget the fact that it requires assumptions and future cuts to existing programs and then an actual application of those savings to pay for this bill. While all of that is a valid debate, there is an obvious pink elephant in the room in these novice eyes.

We start collecting revenues now and significantly ramp up the new revenues in 2013. While there a few benefits (expenditures) starting now, the very large majority of them do not kick in until 2014.

So, we tested the bill with 10 years of revenues collected but only 7 years of major expenditures. Those revenues collected early are not endowing any future benefits, so aren't we being extremely dishonest by accepting OMB's numbers that this will decrease the deficit in future years? Or, am I totally missing the point on this?

We should demand that OMB start in 2014 and analyze this bill for ten years from that date. Further, I would ask them to not factor in the revenues collected early UNLESS we endow those funds and apply only the revenues from earnings on the endowment.

My humble opinion is that you will see a bill that will not pay for itself and could possibly be a government obligation that cost our government more than SS and Medicare/Medicaid once they are completely bankrupt.

Anonymous said...

Not advocating this person's website, but this came out in Aug 2009, someone had sent it to me, I found it interesting. This guy is an insurance lawyer and he went through the bill back in 2009 in one section. Take a moment and look at what he wrote. He did what you are doing. He was careful to check legal definitions and codes that were referenced in the bill.


Anonymous said...

If you all don't see what this is for what it is...the shortfall in Healthcare for an aging population...you have your blinders on. You actually think SSI will be enough? Dems just picked up a lot of Baby Boomers.

Anonymous said...

Not as voters they didn't.

Anonymous said...

Obama said today that this bill is "only the first step". Gee, I can't wait for more, can you?

Kingfish, thank you for doing this. I've read the bill, too, but am way too lazy to analyze it the way you are doing. This should be enlightening.

Anonymous said...

So we don't want to talk about entitlements of the past disappearing under the new health care entitlements huh? Lets just color the page a different color folks. If you are 55+, I bet you are pissed. Its kinda like a 30 something wondering if he's gonna get SSI. What do you old folks think? I bet I get to pay your SSI and collect nothing. But I don't see you posting that you are willing to give it up to prevent HCR.

KaptKangaroo said...


Good morning Captain!

Anonymous said...

But I don't see you posting that you are willing to give it up to prevent HCR.

Give what up?

Anonymous said...

Regrettably, it's no longer a bill - it's the damn LAW...

Anonymous said...

KF, this will be enlightening only to you and a very few if your readers are going to address the content of the section posted.

IF there are sections of the bill that should be changed, would it be more effective to have a position on what change is needed, that to just bitch?

Let's deal with the reality that those generally opposed didn't win. NOW the task is to persuade your elected representatives propose changes.

What is the objection to these sections specifically people?

Do you anti-bill folks support annual and yearly limits on the insured? Or is this section acceptable?

If you don't and believe the insurance companies SHOULD place annual or yearly limits ( regardless of past health history as exists now), please explain why .

Anonymous said...

If you don't care for the conversation then you are free not to read and comment.

Anonymous said...

Got some info yesterday at my job - in 2011 the "value" of your employer health insurance will be on your W-2. Who is going to decide the value? Are we going to pay income tax on that amount? Why else would it be on your W-2? Lots of questions I know but I am scared to death of this thing. Is there any caps on how much our premiums can be? I would appreciate any info on these things.

Anonymous said...

So, no limits. Hmmm. What is the reason for no limits? It sounds like there may be a belief by some that the limits encourage doctors vis-a-vis insurance limits, to decide the "best" care is not affordable and a "death panel" type decision occurs. Sorry, the money ran out, you have to make due with what you got. Anyone want to argue this?

As to the exceptions, this appears to me to be a loophole for continuing other insurance policies in lieu of GHC (Gubment' HC). Not sure. I could use help on this one. I'm sure it is woven throughout the bill somehow.

Anonymous said...

10:19 Give up your current entitlements...SSI/Medicare/Medicaid.

Anonymous said...

Some groups are exempt from the mandate to buy insurance. One of those groups is "THOSE NOT HERE LEGALLY". Plus there is no provision requiring health care providers or insurers to verify citizenship.
I swear, if Obama fed his supporters a crap sandwich they would say MMMMMM! MMMMMM! MMMMMM! gimee more!

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