Friday, April 9, 2010

Today's Health Care Bill reading

The Senate bill and the reconciliation bill were consolidated, so the page numbers have changed but the sections haven't, so I will pick up where I left off in the last post.

Page 25: Section 1102. Reinsurance for Early Retirees.
The government will establish ninety days after the law is enacted, a program to reimburse employer-based plans for part of the cost of insuring early retirees and their dependents. The program ends on January 1, 2014. An individual must be 55 years old and not eligible for Medicare to be considered an early retiree.

Interesting. Employer-based plan must "(2)(A)implement programs and procedures to generate cost-savings with respect to participants with chronic and high-cost conditions." What are these programs and procedures to be? Doesn't say as it only requires the employer to document the actual cost of of the medical claims.

The end result of this section is the government will pay 80% of claims that exceeds $15,000 and less than $90,000. The payment is to be used for reducing costs, premiums, co-pays, deductibles and other out of pocket expenses, not for general revenue. Section (5) is explicit: Payments "shall not be included in determining the gross income..".

Government will conduct annual audits (Section d, p. 27) of all claims data. Five billion dollars is appropriated for this program (Section e, p. 27). The government also has the authority to stop taking applications for this reimbursement.

Page 28. Section 1103: Immediate Information That Allows Consumers to Identify Affordable Coverage Options. The government must establish by JULY 1, 2010, (get that?) 90 days from last week a website for residents of each state to "identify affordable health insurance coverage options in that State". Um, that should be fun to watch. Create a website in less than 90 days that happens to do all that?

What should the website do? The website should "provide ways for residents of any State to receive information on at least the following coverage options:" health insurance coverage, Medicaid, Medicare, State high risk pool, and the high risk pool offered in this bill under section 1101. (We covered this a few days ago.) The Government will also issue, no more than 60 days after the bill becomes law, a "standardized format" for the information provided on the websites.
Page 28: Section 1104: Administrative Simplification. Yes, the government actually uses that term. Such simplification is seven pages of gobbledygook that covers information systems, data exchanges, and converting health care system to a paperless standard. If you are currently a health care provider reading this post, you will probably want to read this section in more detail.

Copy of Bill


Paul Mitchell said...

Well, I can only assume that Mississippi is hiring at the IT department. The government would need at least six thousand people to even figure out the url of the website. This IS good employment news!

Anonymous said...

The first section is to end the practice where corporations or businesses rid themselves of older employees as the employees cost more and thus leaving them with no affordable health insurance options.

If you put in all the implementation details in a bill, every bill would more than 1000 pages. Can't have it both ways, unfortunately, as those details can be important.

As for the second section. Each state should already have that information and are likely have it on their computers for their access.

Since the feds and members of Congress have many websites, I would have imagined that if this were impossible, someone would catch it, but maybe not.

As a consumer, I'd like to know my options, but if the timeline is unrealistic, that's a legitmate concern.

Anonymous said...

This is going to require a lot of tequila.

Anonymous said...

I tried to find the final version of the bill that was signed on March 23rd. Wasn't able to That one was reportedly over 2000 pages. However, the link provided led me to the January 907 page version. This is bothersome since it seems like they're trying to hide something. Can you provide us with a link to the final version? Thx!

Anonymous said...

Anonymous said...

How is the employer going to keep up with cost of claims for each employee? Doesn't that violate hippa insome way? Who is going to give the employer that info? The ins companies or the insured or the provider? Ugh. What a mess.

Anonymous said...


Anonymous said...

Thanks for posting the link to the final bill. Readers should reach each section if they want to confirm what is being stated in the many interpretations out there. It is easy to get confused over legislative language.

For example, a first read may lead you to think section 1103 requires every state to create a website by July 1, 2010.

However, the actual language of section 1103 is "Not later than July 1, 2010, the Secretary, in consultation with the States, shall establish a mechanism, including an Internet website, through which a resident of any State may identify affordable health insurance coverage options in that State."

This calls for a national website, not individual sites for each state. Thoughout the section "website" is singular. States will be given the format by which to submit info.

So don't worry about MS government having to create a website.

Kingfish said...

Corrected. Thanks.

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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