What a hybrid mess. What we truly need is a single payer system.
But the insurance companies have far too much power.
Physicians for single payer
But the insurance companies have far too much power.
Physicians for single payer
Originally posted by: TheSkinsFan
The moment a single change is made to your plan by your insurance provider, *BAM* you lose your "Gradfathered" status and you must immediately choose an HIE option to remain covered. -- paragraph (a)(2)Originally posted by: Athena
Bear with me here, I haven't had time to study the complete bill to see how these things fit together but as I read sections 101-102, they say:Originally posted by: TheSkinsFan
By the way, for those who may have missed the highlights above, the real kick in the balls arrives in paragraph (c)(1).
Welcome to 100% Government-controlled healthcare.
1. Employers have 5 years to get their plans into conformance. That is pretty much the way all legislation that affects companies works . I haven't read of a single employer that has any problem with any of that; companies change their plans every year or so anyway.
If you join a new company on or after January 1st, 2010? -- paragraph (a)(1)(A) -- sorry buddy, the list on the HIE is your only option and no private insurance companies have had time to add their plans since we're all still waiting on the The Commissioner to publish the criteria... so, please choose between "public option" or "public option." What's covered in this so-called "public-option," you ask? WE DONT KNOW YET! But please enjoy the music while The Commissioner figures that out too.
lack of specifics FTL.
Exactly! The list will be entirely Government-controlled and at the whim of "The Commissioner." But, given the multitude of ways it can be lost, you'll be VERY lucky if your "Grandfathered" status lasts that entire five years.2. The individual insurance plans must conform immediately. Current subscribers can keep what they have while the insurance companies rearrange their plans. After 5 years, everyone will be in "Exchange" participating programs.
It's not merely regulated, it's completely Government-controlled. At any time, the Government can add or remove private companies on the HIE, at will.As I understand it, the purpose of this Insurance Exchange is to offer the benefits of risk pooling to individuals and small businesses. The Insurance is still offered by private, for-profit companies.
So what part of this is "Government controlled"? What is your objection to having a regulated insurance market?
Imagine what would happen if the NYSE or NASDAQ become government entities rather than the private competitive businesses they are today. So, instead of them being merely regulated by the likes of the SEC, membership on each exchange would become entirely Government-controlled.
Understand the difference now?
Will my current bullet-proof plan be on the list? Well, that's the fun part, NOBODY KNOWS! The qualification criteria is TBD at some time AFTER the bill is passed.
What if their standards suck? What if they're too stringent? Too lax? Why won't they list those requirements now?
Now, if they were merely proposing a House Insurance Commission of some sort to regulate some new private Health Insurance Exchange businesses -- as with the SEC and NYSE relationship -- then I'd probably give such a proposal a thumbs up!
But, sadly, that's not what they're doing here... they're reaching for total control.
Originally posted by: TheSkinsFan
The moment a single change is made to your plan by your insurance provider, *BAM* you lose your "Gradfathered" status and you must immediately choose an HIE option to remain covered. -- paragraph (a)(2)
If you join a new company on or after January 1st, 2010? -- paragraph (a)(1)(A) -- sorry buddy, the list on the HIE is your only option and no private insurance companies have had time to add their plans since we're all still waiting on the The Commissioner to publish the criteria... so, please choose between "public option" or "public option." What's covered in this so-called "public-option," you ask? WE DONT KNOW YET! But please enjoy the music while The Commissioner figures that out too.
I don't get it. What is "controlled" about this. How is it any different than dealing with "qualified" retirement savings programs?The list will be entirely Government-controlled and at the whim of "The Commissioner." But, given the multitude of ways it can be lost, you'll be VERY lucky if your "Grandfathered" status lasts that entire five years.
What list? It's not a matter of someone adding or removing plans from a master list -- the plan either qualifies or it doesn't. It's no different from a bank seeking a a charter from the OCC or a state. They know what the requirements are and organize around that.It's not merely regulated, it's completely Government-controlled. At any time, the Government can add or remove private companies on the HIE, at will.
Imagine what would happen if the NYSE or NASDAQ become government entities rather than the private competitive businesses they are today. So, instead of them being merely regulated by the likes of the SEC, membership on each exchange would become entirely Government-controlled.
Understand the difference now?
Will my current bullet-proof plan be on the list? Well, that's the fun part, NOBODY KNOWS! The qualification criteria is TBD at some time AFTER the bill is passed.
I think you should talk with reps from your company's HR about the implications for your plan.What if their standards suck? What if they're too stringent? Too lax? Why won't they list those requirements now?
I'm sorry but I think that you are obsessing about overreaching that just isn't there.But, sadly, that's not what they're doing here... they're reaching for total control.
Originally posted by: Carmen813
I'm calling BS here. We know exactly what the public options will require, it's the exact same as any other exchange program.
Wrong. Your current plan's "Grandfathered" status will be lost instantly, and you will be forced to re-select a plan from the list. That could be your old plan with the new changes, but we still don't know the process for getting such changes approved by the new Government bureaucracy responsible for doing so.Originally posted by: Athena
Actually, what will happen is that your insurance carrier will be making no changes except those that will conform to the requirements of the exchange. You won't actually have to do anything if you want to continue in the same plan
That's absolutely false. Please re-read paragraph (a)(1). You will need to select a a plan listed on the Government-controlled HIE.What do you mean if you join a new company? If you change employers, you will be covered by their plan immediately.
Listings on the HIE, and the criteria for each, will be completely Government controlled. The exchange itself will be a Government entity. The requirements are still TBD by "The Commisioner" AFTER the bill is signed.I don't get it. What is "controlled" about this. How is it any different than dealing with "qualified" retirement savings programs?The list will be entirely Government-controlled and at the whim of "The Commissioner." But, given the multitude of ways it can be lost, you'll be VERY lucky if your "Grandfathered" status lasts that entire five years.
Wrong, see above. The "list" I'm referring to is the HIE itself.What list? It's not a matter of someone adding or removing plans from a master list -- the plan either qualifies or it doesn't. It's no different from a bank seeking a a charter from the OCC or a state. They know what the requirements are and organize around that.It's not merely regulated, it's completely Government-controlled. At any time, the Government can add or remove private companies on the HIE, at will.
See above. The Health insurance Exchange is a Government entity, while the NYSE is not. THEY would be injecting unnecessary government involvement, not I.Imagine what would happen if the NYSE or NASDAQ become government entities rather than the private competitive businesses they are today. So, instead of them being merely regulated by the likes of the SEC, membership on each exchange would become entirely Government-controlled.
Understand the difference now?
No I do not. You are injecting a level of government involvement that simply is not present in any of the bills under disussion.
Wrong again. See above. List = HIE.Will my current bullet-proof plan be on the list? Well, that's the fun part, NOBODY KNOWS! The qualification criteria is TBD at some time AFTER the bill is passed.
Again, there is no "list". Employer-paid plans either conform to the requirements or they don't. Companies have 5 years to add any necessary improvements.
I think you should ask your Congressional reps what the requirements for HIE listings are. Don't be surprised by their stunned silence...I think you should talk with reps from your company's HR about the implications for your plan.What if their standards suck? What if they're too stringent? Too lax? Why won't they list those requirements now?
See above.I'm sorry but I think that you are obsessing about overreaching that just isn't there.But, sadly, that's not what they're doing here... they're reaching for total control.
Originally posted by: Carmen813
No, there are not other options out there.
I'm on Family Health Plus, which is a type of Medicaid. However, the income requirements are more stringent than I think you realize. It is in part the reason why our income is kept low, there is a "cliff" where we aren't making enough to afford insurance (even through an employer) and are simultaneously making to much money for public options. There is no private insurance available to us, it does not exist in any sort of reasonable payment platform.
Here's the problem. I'm moving in a week to a new county. In NYS, the County pays for medicaid, even though its managed by an HMO (in my case bluecross/blue shield). Since I'm moving to a new county, I need to re-apply, you can't transfer it (apparently, I'm working on that). So that means for about 2 months (60 days for application to go through) my wife and I wouldn't have coverage. HealthyNY, the next step above FPH, costs about $450 a month for 2 people. It's out of our budget range.
My wife requires prescription medications to manage chronic pain. Without them, she is basically bed-ridden and disabled. With them, she can maintain a somewhat normal life, including holding down a full time job. They cost about $200 a month without insurance.
If you are curious as to why we are moving, it was because I worked hard and received a full scholarship (worth about $28,000 a year) to get a Master's degree. I am not lazy, and neither is my wife. I could buy graduate student insurance, but the plan my university offers is not adequate for someone with my medical history. I have a CT scan scheduled for September, a requirement to make sure my cancer hasn't come back. The idea is to catch it early if it does, so I have a chance to survive. Of course, these scans cost $4,000 or so, well out of my ability to pay without some type of assistance.
So, put on my shoes for five minutes and tell me what to do. Find me the free market solution you've advocated throughout this thread. The problem I have is not with the health coverage I've received with FHP, it's in fact been fantastic, but rather the difficulties in the way NYS has setup its payments (something my friend in Ohio tells me he doesn't have to worry about).
I think perhaps this will help you understand why I cannot tolerate the status quo.
Originally posted by: Athena
Originally posted by: TheSkinsFan
The moment a single change is made to your plan by your insurance provider, *BAM* you lose your "Gradfathered" status and you must immediately choose an HIE option to remain covered. -- paragraph (a)(2)
Actually, what will happen is that your insurance carrier will be making no changes except those that will conform to the requirements of the exchange. You won't actually have to do anything if you want to continue in the same plan.
If you join a new company on or after January 1st, 2010? -- paragraph (a)(1)(A) -- sorry buddy, the list on the HIE is your only option and no private insurance companies have had time to add their plans since we're all still waiting on the The Commissioner to publish the criteria... so, please choose between "public option" or "public option." What's covered in this so-called "public-option," you ask? WE DONT KNOW YET! But please enjoy the music while The Commissioner figures that out too.
What do you mean if you join a new company? If you change employers, you will be covered by their plan immediately. If you are talking about changing insurance carriers, done of them will be offering anything but qualified plans to new subscribers.
I don't get it. What is "controlled" about this. How is it any different than dealing with "qualified" retirement savings programs?The list will be entirely Government-controlled and at the whim of "The Commissioner." But, given the multitude of ways it can be lost, you'll be VERY lucky if your "Grandfathered" status lasts that entire five years.
What list? It's not a matter of someone adding or removing plans from a master list -- the plan either qualifies or it doesn't. It's no different from a bank seeking a a charter from the OCC or a state. They know what the requirements are and organize around that.It's not merely regulated, it's completely Government-controlled. At any time, the Government can add or remove private companies on the HIE, at will.
Imagine what would happen if the NYSE or NASDAQ become government entities rather than the private competitive businesses they are today. So, instead of them being merely regulated by the likes of the SEC, membership on each exchange would become entirely Government-controlled.
Understand the difference now?
No I do not. You are injecting a level of government involvement that simply is not present in any of the bills under disussion.
Will my current bullet-proof plan be on the list? Well, that's the fun part, NOBODY KNOWS! The qualification criteria is TBD at some time AFTER the bill is passed.
Again, there is no "list". Employer-paid plans either conform to the requirements or they don't. Companies have 5 years to add any necessary improvements.
I think you should talk with reps from your company's HR about the implications for your plan.What if their standards suck? What if they're too stringent? Too lax? Why won't they list those requirements now?
I'm sorry but I think that you are obsessing about overreaching that just isn't there.But, sadly, that's not what they're doing here... they're reaching for total control.
How's the koolaid today? Fresh? Cold?Originally posted by: Pens1566
I was going to respond in kind to SkinsFan ... but you beat me to it.
Anyone reaching his conclusions from the text of the proposed bill isn't comprehending what the sections he's referring to are trying to accomplish.
No, it is your reading that is incorrect. You seem to be conflating employment-based and individual insurance. Health Insurance Exchanges are irrelevant to large companies that provide employer-paid coverage and optional for small businesses. An employer that provides coverage can self-insure or buy coverage from an insurance carrier. Either way, those companies have 5 years to meet the requirements for a qualified plan. If you change companies, you get whatever acceptable coverage that company has.Originally posted by: TheSkinsFan
That's absolutely false. Please re-read paragraph (a)(1). You will need to select a a plan listed on the Government-controlled HIE.What do you mean if you join a new company? If you change employers, you will be covered by their plan immediately.
1. Financial barriers should not stand between Americans and preventive or acute health care that they sincerely believe will address concerns over a troubling medical condition, in a timely manner, before that condition grows into a critically serious illness.
2. Having received needed health care, no American family should be so financially devastated by medical bills that it cannot meet routine daily living expenses ? for example, make utility or mortgage payments on time or finance the education of the family?s children.
3. The future growth in national health spending should be constrained to fall significantly below currently projected spending growth, which has the United States devoting about 40 percent of its G.D.P. to health care by midcentury.
Riddle me these questions three...Originally posted by: Pens1566
Thats your opinion, reinforced by your pre-determined goals. The sections of the bill you keep harping on merely require insurance plans to meet a certain set of standards, which were listed in I believe section 121. Those standards listed were very very reasonable. Any plan not meeting those deserves to be terminated. Whole point of the section as others have already said. You and your "all plans can be cancelled" or "complete government control" rants are not based on anything.
Your interpretations of this are as solid as those you had on income tax.
perhaps.Originally posted by: Pens1566
Are you really this dense?
Originally posted by: TheSkinsFan
perhaps.Originally posted by: Pens1566
Are you really this dense?
Now, answer the three questions. I made them real easy for ya.
Originally posted by: Pens1566
Originally posted by: TheSkinsFan
perhaps.Originally posted by: Pens1566
Are you really this dense?
Now, answer the three questions. I made them real easy for ya.
The reason I asked if you were dense is because Athena already corrected you on them. Now you're just trying to deflect away from your obvious errors. Seems to be a common practice of yours.
Originally posted by: Hayabusa Rider
Originally posted by: Pens1566
Originally posted by: TheSkinsFan
perhaps.Originally posted by: Pens1566
Are you really this dense?
Now, answer the three questions. I made them real easy for ya.
The reason I asked if you were dense is because Athena already corrected you on them. Now you're just trying to deflect away from your obvious errors. Seems to be a common practice of yours.
What limits in the legislation are there on what the criteria can be?
Athena did nothing of the sort. My interpretation of the language in the bill stands.Originally posted by: Pens1566
Originally posted by: TheSkinsFan
perhaps.Originally posted by: Pens1566
Are you really this dense?
Now, answer the three questions. I made them real easy for ya.
The reason I asked if you were dense is because Athena already corrected you on them. Now you're just trying to deflect away from your obvious errors. Seems to be a common practice of yours.
So, the "Secretary," not the Commish, will have a year and half AFTER the signing of the bill to come up with standards.(b) ADOPTION OF STANDARDS.?
(1) INITIAL STANDARDS.?Not later than 18 months after the date of the enactment of this Act, the Secretary shall, through the rulemaking process consistent with subsection (a), adopt an initial set of benefit standards.
Originally posted by: TheSkinsFan
Athena did nothing of the sort. My interpretation of the language in the bill stands.Originally posted by: Pens1566
Originally posted by: TheSkinsFan
perhaps.Originally posted by: Pens1566
Are you really this dense?
Now, answer the three questions. I made them real easy for ya.
The reason I asked if you were dense is because Athena already corrected you on them. Now you're just trying to deflect away from your obvious errors. Seems to be a common practice of yours.
Why are you so afraid to answer the questions? Weird...
I'm sure that you're "convinced" that you're just like all the other little boys too, but that doesn't make it true. The helmet is on your head for a reason.Originally posted by: Pens1566
Originally posted by: TheSkinsFan
Athena did nothing of the sort. My interpretation of the language in the bill stands.Originally posted by: Pens1566
Originally posted by: TheSkinsFan
perhaps.Originally posted by: Pens1566
Are you really this dense?
Now, answer the three questions. I made them real easy for ya.
The reason I asked if you were dense is because Athena already corrected you on them. Now you're just trying to deflect away from your obvious errors. Seems to be a common practice of yours.
Why are you so afraid to answer the questions? Weird...
Your "interpretation" is your opinion. And it's wrong. Again. Just like taxes, just like how #s of Representatives to the US House are assigned based on census population and not #s of voters.
1) No. Its a set of standards put forth in the bill.
2) No. As Athena already showed you, its for individual plans, not all.
3) The criteria are set forth by the legislation. Whether a plan falls into that is up to the company selling the plan.
This "control" you speak of is nothing more than bottom line standards that anyone should hope their plan would meet. And I'm convinced you really are dense.