BREAKING NEWS: Appeals court rules part of President Obama’s health care law unconsti

[Intense]

This may or may not be cleared up. Bring a Weegie Board to decipher and maybe you can clear the matter up for me. Let's do a before and after. Before, the original red flag on the proposed legislation. The after, from what I believe to be from the Current Bill. I have to comment on the use of the term "ADMINISTRATIVE SIMPLIFICATION", touching and eye opening. .
_____________________________________________________________
Before:

Correcting the Record on ObamaCare's Access to Individuals' Bank Accounts

From Justin Quinn, About.com Guide August 20, 2009
Nevertheless, the language is unclear enough to create fear and loathing that is legitimate. Recalling that this is falling under the category of "Definition of Services" and "Medical and Other Services" in Medicare, it raises the questioned about why this language was included at all. There's really only one reason that makes sense. Consults every five years are going to be required (mandatory) if patients want to receive Medicare reimbursement for associated services, and when end-of-life decisions become imminent, more consultations will be required if reimbursements are to be made regarding end-of-life treatment. It may not mean "death panels," but the language is obscure enough to raise the question about the participatory nature of the consults. The bottom line: if they're not mandatory, why are these consults included in the bill at all?

Back to the bank account stuff.

This article at CNN.com uses the news network's so-called "truth-squad" to dispel the notion that the House bill provides the federal government with real-time access to the bank accounts of "individuals." Their verdict (False. The provision cited doesn't affect individuals, but companies involved in medical billing.),is reckless in its misinformation.

For the sake of clarity, it is important to note that this part of the bill updates Title XI of the Social Security Act, and once again cite the page number, section and subsection of the ObamaCare plan that spells this out. It is called "Administrative Simplification" (Section 163) and Subsection 1173A of this measure, "Standardize Electronic Transactions" has a provision (a)(2)(B) that ensures that this new governmental power:

"be authoritative, permitting no additions or constraints for electronic transactions ..." (C) "be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications;" and, finally, (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 ..." (Emphasis added)

According to President Barack Obama, there are several versions of the bill now in existence. If this is indeed the case, (so far, I've only been able to find and read one) it is possible that this language has been clarified to strike out all references to the individual. As it stands, however, the language in the current version of the House bill clearly indicates that the authority of the government pertains to "individuals" not providers, physicians or insurers.

In fact, this is so clearly defined in the bill, that on page 64, the language for "operating rules" (which regulate the "using and processing [of] transactions") is changed in a related section to add the phrase "on behalf of an individual." Combine the two, and you have the government paying for services on behalf of an individual from the individual's account.

The most disturbing aspect of this part of the bill, as I've mentioned before is the lack of language outlining any sort of authorization on the part of the individual.

In my previous post (linked to above), I mentioned that the Democrats and Obama would scoff off any notion of the federal government dipping into individual's accounts without permission. This is indeed what has happened. If the bill had some sort of measure in it that explicitly describes the authorization process, perhaps conservatives wouldn't feel quite so paranoid about what this legislation has in store for them.

Correcting the Record on ObamaCare's Access to Individuals' Bank Accounts


--------------------------------------------------------------------------------------
Current Bill:
111TH CONGRESS
1ST SESSION H. R. 3200
3 SEC. 163. ADMINISTRATIVE SIMPLIFICATION.
4 (a) STANDARDIZING ELECTRONIC ADMINISTRATIVE
5 TRANSACTIONS.—
6 (1) IN GENERAL.—Part C of title XI of the So7
cial Security Act (42 U.S.C. 1320d et seq.) is
8 amended by inserting after section 1173 the fol9
lowing new section:
10 ‘‘SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE
11 TRANSACTIONS.
12 ‘‘(a) STANDARDS FOR FINANCIAL AND ADMINISTRA13
TIVE TRANSACTIONS.—
14 ‘‘(1) IN GENERAL.—The Secretary shall adopt
15 and regularly update standards consistent with the
16 goals described in paragraph (2).
17 ‘‘(2) GOALS FOR FINANCIAL AND ADMINISTRA18
TIVE TRANSACTIONS.—The goals for standards
19 under paragraph (1) are that such standards shall—
20 ‘‘(A) be unique with no conflicting or re21
dundant standards;
22 ‘‘(B) be authoritative, permitting no addi23
tions or constraints for electronic transactions,
24 including companion guides;
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58
•HR 3200 IH
1 ‘‘(C) be comprehensive, efficient and ro2
bust, requiring minimal augmentation by paper
3 transactions or clarification by further commu4
nications;
5 ‘‘(D) enable the real-time (or near real6
time) determination of an individual’s financial
7 responsibility at the point of service and, to the
8 extent possible, prior to service, including
9 whether the individual is eligible for a specific
10 service with a specific physician at a specific fa11
cility, which may include utilization of a ma12
chine-readable health plan beneficiary identi13
fication card;
14 ‘‘(E) enable, where feasible, near real-time
15 adjudication of claims;
16 ‘‘(F) provide for timely acknowledgment,
17 response, and status reporting applicable to any
18 electronic transaction deemed appropriate by
19 the Secretary;
20 ‘‘(G) describe all data elements (such as
21 reason and remark codes) in unambiguous
22 terms, not permit optional fields, require that
23 data elements be either required or conditioned
24 upon set values in other fields, and prohibit ad25
ditional conditions; and
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•HR 3200 IH
1 ‘‘(H) harmonize all common data elements
2 across administrative and clinical transaction
3 standards.
4 ‘‘(3) TIME FOR ADOPTION.—Not later than 2
5 years after the date of implementation of the X12
6 Version 5010 transaction standards implemented
7 under this part, the Secretary shall adopt standards
8 under this section.
9 ‘‘(4) REQUIREMENTS FOR SPECIFIC STAND10
ARDS.—The standards under this section shall be
11 developed, adopted and enforced so as to—
12 ‘‘(A) clarify, refine, complete, and expand,
13 as needed, the standards required under section
14 1173;
15 ‘‘(B) require paper versions of standard16
ized transactions to comply with the same
17 standards as to data content such that a fully
18 compliant, equivalent electronic transaction can
19 be populated from the data from a paper
20 version;
21 ‘‘(C) enable electronic funds transfers, in
22 order to allow automated reconciliation with the
23 related health care payment and remittance ad24
vice;
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•HR 3200 IH
1 ‘‘(D) require timely and transparent claim
2 and denial management processes, including
3 tracking, adjudication, and appeal processing;
4 ‘‘(E) require the use of a standard elec5
tronic transaction with which health care pro6
viders may quickly and efficiently enroll with a
7 health plan to conduct the other electronic
8 transactions provided for in this part; and
9 ‘‘(F) provide for other requirements relat10
ing to administrative simplification as identified
11 by the Secretary, in consultation with stake12
holders.
13 ‘‘(5) BUILDING ON EXISTING STANDARDS.—In
14 developing the standards under this section, the Sec15
retary shall build upon existing and planned stand16
ards.
17 ‘‘(6) IMPLEMENTATION AND ENFORCEMENT.—
18 Not later than 6 months after the date of the enact19
ment of this section, the Secretary shall submit to
20 the appropriate committees of Congress a plan for
21 the implementation and enforcement, by not later
22 than 5 years after such date of enactment, of the
23 standards under this section. Such plan shall in24
clude—
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61
•HR 3200 IH
1 ‘‘(A) a process and timeframe with mile2
stones for developing the complete set of stand3
ards;
4 ‘‘(B) an expedited upgrade program for
5 continually developing and approving additions
6 and modifications to the standards as often as
7 annually to improve their quality and extend
8 their functionality to meet evolving require9
ments in health care;
10 ‘‘(C) programs to provide incentives for,
11 and ease the burden of, implementation for cer12
tain health care providers, with special consid13
eration given to such providers serving rural or
14 underserved areas and ensure coordination with
15 standards, implementation specifications, and
16 certification criteria being adopted under the
17 HITECH Act;
18 ‘‘(D) programs to provide incentives for,
19 and ease the burden of, health care providers
20 who volunteer to participate in the process of
21 setting standards for electronic transactions;
22 ‘‘(E) an estimate of total funds needed to
23 ensure timely completion of the implementation
24 plan; and
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•HR 3200 IH
1 ‘‘(F) an enforcement process that includes
2 timely investigation of complaints, random au3
dits to ensure compliance, civil monetary and
4 programmatic penalties for non-compliance con5
sistent with existing laws and regulations, and
6 a fair and reasonable appeals process building
7 off of enforcement provisions under this part.
8 ‘‘(b) LIMITATIONS ON USE OF DATA.—Nothing in
9 this section shall be construed to permit the use of infor10
mation collected under this section in a manner that would
11 adversely affect any individual.
12 ‘‘(c) PROTECTION OF DATA.—The Secretary shall en13
sure (through the promulgation of regulations or other14
wise) that all data collected pursuant to subsection (a)
15 are—
16 ‘‘(1) used and disclosed in a manner that meets
17 the HIPAA privacy and security law (as defined in
18 section 3009(a)(2) of the Public Health Service
19 Act), including any privacy or security standard
20 adopted under section 3004 of such Act; and
21 ‘‘(2) protected from all inappropriate internal
22 use by any entity that collects, stores, or receives the
23 data, including use of such data in determinations of
24 eligibility (or continued eligibility) in health plans,
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63
•HR 3200 IH
1 and from other inappropriate uses, as defined by the
2 Secretary.’’.
3 (2) DEFINITIONS.—Section 1171 of such Act
4 (42 U.S.C. 1320d) is amended—
5 (A) in paragraph (7), by striking ‘‘with
6 reference to’’ and all that follows and inserting
7 ‘‘with reference to a transaction or data ele8
ment of health information in section 1173
9 means implementation specifications, certifi10
cation criteria, operating rules, messaging for11
mats, codes, and code sets adopted or estab12
lished by the Secretary for the electronic ex13
change and use of information’’; and
14 (B) by adding at the end the following new
15 paragraph:
16 ‘‘(9) OPERATING RULES.—The term ‘operating
17 rules’ means business rules for using and processing
18 transactions. Operating rules should address the fol19
lowing:
20 ‘‘(A) Requirements for data content using
21 available and established national standards.
22 ‘‘(B) Infrastructure requirements that es23
tablish best practices for streamlining data flow
24 to yield timely execution of transactions.
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64
•HR 3200 IH
1 ‘‘(C) Policies defining the transaction re2
lated rights and responsibilities for entities that
3 are transmitting or receiving data.’’.
4 (3) CONFORMING AMENDMENT.—Section
5 1179(a) of such Act (42 U.S.C. 1320d–8(a)) is
6 amended, in the matter before paragraph (1)—
7 (A) by inserting ‘‘on behalf of an indi8
vidual’’ after ‘‘1978)’’; and
9 (B) by inserting ‘‘on behalf of an indi10
vidual’’ after ‘‘for a financial institution.’’
11 (b) STANDARDS FOR CLAIMS ATTACHMENTS AND
12 COORDINATION OF BENEFITS .—
13 (1) STANDARD FOR HEALTH CLAIMS ATTACH14
MENTS.—Not later than 1 year after the date of the
15 enactment of this Act, the Secretary of Health and
16 Human Services shall promulgate a final rule to es17
tablish a standard for health claims attachment
18 transaction described in section 1173(a)(2)(B) of the
19 Social Security Act (42 U.S.C. 1320d–2(a)(2)(B))
20 and coordination of benefits.
21 (2) REVISION IN PROCESSING PAYMENT TRANS22
ACTIONS BY FINANCIAL INSTITUTIONS.—
23 (A) IN GENERAL.—Section 1179 of the So24
cial Security Act (42 U.S.C. 1320d–8) is
25 amended, in the matter before paragraph (1)—
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•HR 3200 IH
1 (i) by striking ‘‘or is engaged’’ and in2
serting ‘‘and is engaged’’; and
3 (ii) by inserting ‘‘(other than as a
4 business associate for a covered entity)’’
5 after ‘‘for a financial institution’’.
6 (B) EFFECTIVE DATE.—The amendments
7 made by paragraph (1) shall apply to trans8
actions occurring on or after such date (not
9 later than 6 months after the date of the enact10
ment of this Act) as the Secretary of Health
11 and Human Services shall specify.

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf

 

[Greenbeard]

This may or may not be cleared up.

I'm seeing three problems here.

First, figuring out whether something is in the law would best be done before you reference it and cite it as a pillar of your opposition.

Second, you're producing sources about the wrong legislation, a House health care bill that never became law.

Third, the comprehension here is lacking. "Administrative simplification" refers to a process that began with HIPAA in the late '90s: namely, the development of uniform standards for health plans, health care clearinghouses, and health care providers who conduct standard health care transactions with each other electronically. The issue in that proposed legislation from 2009 is standards for electronic information sharing between your doctor and your insurer with regard to verifying eligibility for services, communicating prior authorizations for services when necessary, and transferring funds electronically (again, between the payer and the provider--that is, the insurer and the doctor).

None of that has anything to do with the government "dipping into individual's accounts without permission" or empowering anyone to "raid your savings and checking accounts when you have a problem paying medical expenses."

This hysteria is far past the point of absurdity.

 

[dblack]

First, figuring out whether something is in the law would best be done before you reference it and cite it as a pillar of your opposition.

Agreed. It should probably also have been done before our asshat congress critters voted on it.

 

[Immanuel]

First, figuring out whether something is in the law would best be done before you reference it and cite it as a pillar of your opposition.

Agreed. It should probably also have been done before our asshat congress critters voted on it.

Don't forget, they had to pass it so that we could know what was in it.

All of that was for our own good.

Immie

 

[Flopper]

And there has been something like 1500 different exemptions to obamacare so far.

Why so many?

It is a bad law and never should have been passed.

Anyone with half a brain knows it.

Some health insurance policies do not meet minimum standards set forth in the law. Their policies lacked coverage for major illnesses. In order that policy holders are not stuck having no insurance, the government has granted one year exemptions to give policy holders time to find other policies. 1500 out of millions of health insurance policies is not that many. These exemptions do not indicate any shortcoming in law, but rather the shortcomings in cheap near worthless health insurance policies some states have allowed companies to sell.

Yep, just ignore who is on the list and you sound credible. How many on that list supported it? How many knew what was in it before they supported it? How long would the phone call take to increase your coverage, relating to something important to you personally? I especially appreciate the new powers for government to raid your savings and checking accounts when you have a problem paying medical expenses. Government could not get anymore personal and caring than that huh.

These exemptions were given mostly to employers and unions with group plans that did not meet the minimum requirement. Increasing coverage of group plans, usually means replacing the whole plan often with a different company. Typically large group plans are covered by a yearly or longer contract.

 

[Immanuel]

Some health insurance policies do not meet minimum standards set forth in the law. Their policies lacked coverage for major illnesses. In order that policy holders are not stuck having no insurance, the government has granted one year exemptions to give policy holders time to find other policies. 1500 out of millions of health insurance policies is not that many. These exemptions do not indicate any shortcoming in law, but rather the shortcomings in cheap near worthless health insurance policies some states have allowed companies to sell.

Yep, just ignore who is on the list and you sound credible. How many on that list supported it? How many knew what was in it before they supported it? How long would the phone call take to increase your coverage, relating to something important to you personally? I especially appreciate the new powers for government to raid your savings and checking accounts when you have a problem paying medical expenses. Government could not get anymore personal and caring than that huh.

These exemptions were given mostly to employers and unions with group plans that did not meet the minimum requirement. Increasing coverage of group plans, usually means replacing the whole plan often with a different company. Typically large group plans are covered by a yearly or longer contract.

And if I am not mistaken they are not permanent exemptions. I believe they expire after a few years. Not 100% positive on that, but I thought I read that somewhere and I'm simply not willing to look it up tonight.

Immie

 

[Intense]

This may or may not be cleared up.

I'm seeing three problems here.

First, figuring out whether something is in the law would best be done before you reference it and cite it as a pillar of your opposition.

Second, you're producing sources about the wrong legislation, a House health care bill that never became law.

Third, the comprehension here is lacking. "Administrative simplification" refers to a process that began with HIPAA in the late '90s: namely, the development of uniform standards for health plans, health care clearinghouses, and health care providers who conduct standard health care transactions with each other electronically. The issue in that proposed legislation from 2009 is standards for electronic information sharing between your doctor and your insurer with regard to verifying eligibility for services, communicating prior authorizations for services when necessary, and transferring funds electronically (again, between the payer and the provider--that is, the insurer and the doctor).

None of that has anything to do with the government "dipping into individual's accounts without permission" or empowering anyone to "raid your savings and checking accounts when you have a problem paying medical expenses."

This hysteria is far past the point of absurdity.

First, figuring out whether something is in the law would best be done before you reference it and cite it as a pillar of your opposition. False.

Second, you're producing sources about the wrong legislation, a House health care bill that never became law. Well, that is good.
None of that has anything to do with the government "dipping into individual's accounts without permission" or empowering anyone to "raid your savings and checking accounts when you have a problem paying medical expenses." The fact that it was tried in the first place is reason for concern. At least one version of it did provide access to Individual Saving Accounts. Try reading the post and the link.
Third, the comprehension here is lacking. "Administrative simplification" refers to a process that began with HIPAA in the late '90s: namely, the development of uniform standards for health plans, health care clearinghouses, and health care providers who conduct standard health care transactions with each other electronically. The issue in that proposed legislation from 2009 is standards for electronic information sharing between your doctor and your insurer with regard to verifying eligibility for services, communicating prior authorizations for services when necessary, and transferring funds electronically (again, between the payer and the provider--that is, the insurer and the doctor).
True in the Amended version. Still, applied here is is an oxymoron.
This hysteria is far past the point of absurdity.
What is absurd every time it happens is signing legislation before even knowing what is in it.

 

[Foxfyre]

They are permanent waivers until 2014 when a government plan, which we were told was not in the works, will kick in. Right now they wanted to keep as many on board as possible and prevent companies from dropping coverage altogether which any company exec with a brain would almost certainly do faced with this boondoggle mishmash of a healthcare overhaul.

In the very first wave, just before the 2010 election, 29 large companies were exempted:

Nearly a million workers won't get a consumer protection in the U.S. health reform law meant to cap insurance costs because the government exempted their employers.
Thirty companies and organizations, including McDonald's (MCD) and Jack in the Box (JACK), won't be required to raise the minimum annual benefit included in low-cost health plans, which are often used to cover part-time or low-wage employees.

The Department of Health and Human Services, which provided a list of exemptions, said it granted waivers in late September so workers with such plans wouldn't lose coverage from employers who might choose instead to drop health insurance altogether.

Without waivers, companies would have had to provide a minimum of $750,000 in coverage next year, increasing to $1.25 million in 2012, $2 million in 2013 and unlimited in 2014.

"The big political issue here is the president promised no one would lose the coverage they've got," says Robert Laszewski, chief executive officer of consulting company Health Policy and Strategy Associates. "Here we are a month before the election, and these companies represent 1 million people who would lose the coverage they've got."

The United Agricultural Benefit Trust, the California-based cooperative that offers coverage to farm workers, was allowed to exempt 17,347 people. San Diego-based Jack in the Box's waiver is for 1,130 workers, while McDonald's asked to excuse 115,000.

The plans will be exempt from rules intended to keep people from having to pay for all their care once they reach a preset coverage cap. McDonald's, which offers the programs as a way to cover part-time employees, told the Obama administration it might re-evaluate the plans unless it got a waiver.

McDonald's and Jack in the Box didn't immediately respond to requests for comment.

The waiver program is intended to provide continuous coverage until 2014, when government-organized marketplaces will offer insurance subsidized by tax credits, says HHS spokeswoman Jessica Santillo. . . . .
McDonald's, 29 other firms get health care coverage waivers - USATODAY.com

Of course there have been many many other 'waivers' extended, mostly to Obama's union buddies and such as that, and no doubt many many more to come.

 

[Immanuel]

They are permanent waivers until 2014 when a government plan, which we were told was not in the works, will kick in. Right now they wanted to keep as many on board as possible and prevent companies from dropping coverage altogether which any company exec with a brain would almost certainly do faced with this boondoggle mishmash of a healthcare overhaul.

In the very first wave, just before the 2010 election, 29 large companies were exempted:

Nearly a million workers won't get a consumer protection in the U.S. health reform law meant to cap insurance costs because the government exempted their employers.
Thirty companies and organizations, including McDonald's (MCD) and Jack in the Box (JACK), won't be required to raise the minimum annual benefit included in low-cost health plans, which are often used to cover part-time or low-wage employees.

The Department of Health and Human Services, which provided a list of exemptions, said it granted waivers in late September so workers with such plans wouldn't lose coverage from employers who might choose instead to drop health insurance altogether.

Without waivers, companies would have had to provide a minimum of $750,000 in coverage next year, increasing to $1.25 million in 2012, $2 million in 2013 and unlimited in 2014.

"The big political issue here is the president promised no one would lose the coverage they've got," says Robert Laszewski, chief executive officer of consulting company Health Policy and Strategy Associates. "Here we are a month before the election, and these companies represent 1 million people who would lose the coverage they've got."

The United Agricultural Benefit Trust, the California-based cooperative that offers coverage to farm workers, was allowed to exempt 17,347 people. San Diego-based Jack in the Box's waiver is for 1,130 workers, while McDonald's asked to excuse 115,000.

The plans will be exempt from rules intended to keep people from having to pay for all their care once they reach a preset coverage cap. McDonald's, which offers the programs as a way to cover part-time employees, told the Obama administration it might re-evaluate the plans unless it got a waiver.

McDonald's and Jack in the Box didn't immediately respond to requests for comment.

The waiver program is intended to provide continuous coverage until 2014, when government-organized marketplaces will offer insurance subsidized by tax credits, says HHS spokeswoman Jessica Santillo. . . . .
McDonald's, 29 other firms get health care coverage waivers - USATODAY.com

Of course there have been many many other 'waivers' extended, mostly to Obama's union buddies and such as that, and no doubt many many more to come.

They are permanent waivers until 2014

Explain what that means. To me that says they are temporary i.e. not permanent.

Immie

 

[Greenbeard]

At least one version of it did provide access to Individual Saving Accounts.

I did. And there's nothing in the link or the legislative text posted to support that assertion. Which is because it was never true, even for that older bill (which, again, isn't the Affordable Care Act).

They are permanent waivers until 2014 when a government plan, which we were told was not in the works, will kick in.

There is no "government plan." You're confusing the concept of an Exchange with a public health insurance plan.

 

[Intense]

Here is something I came across that is up to your speed Greenbeard. What is your take on it?
-------------------------------------------------------------------------
Analysis
The finding that insurers have exited the child-only plan market, often leaving families
with no options to purchase insurance coverage for their children, is an entirely
predictable consequence of how the Administration drafted the new rule prohibiting
preexisting condition exclusions.
By redefining through regulation the definition of these exclusions, the Administration
created a new guaranteed issue requirement for child-only plans. This regulatory policy
change went beyond the scope of the language in section 2704 of the PHSA, and
created the problems that have caused insurance companies to no longer offer childonly
plans in several states.
Requiring carriers to sell child-only plans to anyone at any time allows individuals to wait
until a child is sick and then purchase coverage. This undermines one of the
fundamental principles of insurance, which allows individuals to manage risk by pooling
resources to help pay for future, unpredictable expenses. If an individual can avoid
paying premiums until they know they will incur an expense, it is impossible for such a
system of insurance to be financially sustainable.
6
This is not a hypothetical concern, but rather one that has already been documented in
the market. A recent study, commissioned by the Massachusetts Division of Insurance,
reported that after Massachusetts enacted its health care reform law (which included a
guaranteed issue requirement), there was a significant increase in the number of
individuals who purchased coverage for short periods of time and incurred high costs.5
The Administration has also previously acknowledged this reality. A January 31, 2011
White House blog post noted:
If insurance companies can no longer deny coverage to anyone who applies for
insurance – especially those who have health problems and are potentially more
expensive to cover – then there is nothing stopping someone from waiting until
they’re sick or injured to apply for coverage since insurance companies can’t say
no. That would lead to double digit premiums increases – up to 20% – for
everyone with insurance, and would significantly increase the cost health care
spending nationwide.
We don’t let people wait until after they’ve been in a car accident to apply for auto
insurance and get reimbursed, and we don’t want to do that with healthcare. If
we’re going to outlaw discrimination based on pre-existing conditions, the only
way to keep people from gaming the system and raising costs on everyone else
is to ensure that everyone takes responsibility for their own health insurance.”6
This statement indicates that the Administration understood how a stand-alone
guaranteed issue requirement could raise costs for everyone. Despite this
understanding, the Administration still chose to arbitrarily impose a guaranteed issue
requirement.
When confronted with the reality of this regulatory action, insurers in 39 states stopped
selling child-only plans to new enrollees. They indicated that to do otherwise would
likely expose them to significant, unsustainable financial losses and thereby jeopardize
their continuing ability to offer insurance coverage to current enrollees.
The October 13, 2010, Administration Questions and Answers document did not solve
the problems created by the initial rule. Insurers have asserted that absent a uniform
annual enrollment period applicable to all market participants, they would still face
potential competitive disadvantages created by plans with different open enrollment
periods, which in turn could create serious risks of adverse selection. For these
reasons, insurers have declined to return to the child-only plan market in many states.


http://help.senate.gov/imo/media/doc/Child-Only Health Insurance Report Aug 2, 2011.pdf

 

[Greenbeard]

Here is something I came across that is up to your speed Greenbeard. What is your take on it?

Their recommendation is to institute uniform open enrollment periods (similar to those that will be in effect in the Exchanges starting in 2014). That's fine, I don't have any objection to that. Even HHS has already indicated a willingness to take that step if necessary. There are other steps that can be taken by insurers or state regulators to deter adverse selection in child-only plans, however. But if that's the one that will be most effective (though, given the other options available, it doesn't strike me that it would be), by all means they can and should amend the regs.

Those are the kinds of productive discussions about salient policy issues in the ACA I'd love to see taking place between Congressional committees and executive branch officials, instead of the politicized, point-scoring tit-for-tats we've mostly seen so far.

 

[Foxfyre]

They are permanent waivers until 2014 when a government plan, which we were told was not in the works, will kick in. Right now they wanted to keep as many on board as possible and prevent companies from dropping coverage altogether which any company exec with a brain would almost certainly do faced with this boondoggle mishmash of a healthcare overhaul.

In the very first wave, just before the 2010 election, 29 large companies were exempted:

Nearly a million workers won't get a consumer protection in the U.S. health reform law meant to cap insurance costs because the government exempted their employers.
Thirty companies and organizations, including McDonald's (MCD) and Jack in the Box (JACK), won't be required to raise the minimum annual benefit included in low-cost health plans, which are often used to cover part-time or low-wage employees.

The Department of Health and Human Services, which provided a list of exemptions, said it granted waivers in late September so workers with such plans wouldn't lose coverage from employers who might choose instead to drop health insurance altogether.

Without waivers, companies would have had to provide a minimum of $750,000 in coverage next year, increasing to $1.25 million in 2012, $2 million in 2013 and unlimited in 2014.

"The big political issue here is the president promised no one would lose the coverage they've got," says Robert Laszewski, chief executive officer of consulting company Health Policy and Strategy Associates. "Here we are a month before the election, and these companies represent 1 million people who would lose the coverage they've got."

The United Agricultural Benefit Trust, the California-based cooperative that offers coverage to farm workers, was allowed to exempt 17,347 people. San Diego-based Jack in the Box's waiver is for 1,130 workers, while McDonald's asked to excuse 115,000.

The plans will be exempt from rules intended to keep people from having to pay for all their care once they reach a preset coverage cap. McDonald's, which offers the programs as a way to cover part-time employees, told the Obama administration it might re-evaluate the plans unless it got a waiver.

McDonald's and Jack in the Box didn't immediately respond to requests for comment.

The waiver program is intended to provide continuous coverage until 2014, when government-organized marketplaces will offer insurance subsidized by tax credits, says HHS spokeswoman Jessica Santillo. . . . .
McDonald's, 29 other firms get health care coverage waivers - USATODAY.com

Of course there have been many many other 'waivers' extended, mostly to Obama's union buddies and such as that, and no doubt many many more to come.

They are permanent waivers until 2014

Explain what that means. To me that says they are temporary i.e. not permanent.

Immie

Permanent meaning nobody will mess with them until 2014 when they'll be forced into the government organized system with everybody else. Probably could have picked a different word but I'm using government speak.

Like, make the Bush tax cuts 'permanent' until at least. . . . .

But when we think about how quickly that last two years have passed, 2014 is right around the corner. We had better start paying attention to this stuff and giving some serious backup to elected leaders that want to stop it now.

 

[Toddsterpatriot]

"He, however, didn't wring his hands about what a terrible and unmanageable mess he inherited. He set about working with Congress to restore fiscal sanity while assuring Americans that they were fixing it, what we could expect, and brighter days were ahead. We could look forward encouraged and expecting great things. And he delivered."

And quadrupled the debt. But he didn't have an opposition who obstructed EVERYTHING, with a fear mongering Propaganda machine bitching about EVERYTHING 24/7/365, and huge loudmouth brainwashed dupe 1/2 nation...

Bullshit!

 

[Flopper]

Yep, just ignore who is on the list and you sound credible. How many on that list supported it? How many knew what was in it before they supported it? How long would the phone call take to increase your coverage, relating to something important to you personally? I especially appreciate the new powers for government to raid your savings and checking accounts when you have a problem paying medical expenses. Government could not get anymore personal and caring than that huh.

These exemptions were given mostly to employers and unions with group plans that did not meet the minimum requirement. Increasing coverage of group plans, usually means replacing the whole plan often with a different company. Typically large group plans are covered by a yearly or longer contract.

And if I am not mistaken they are not permanent exemptions. I believe they expire after a few years. Not 100% positive on that, but I thought I read that somewhere and I'm simply not willing to look it up tonight.

Immie

Yes, they one year exemptions and can be renewed each year till 2024.

 

[emilynghiem]

Score is still in favor of the mandates. This will be decided by the SC.

How Antonin Scalia May Save The Individual Mandate

It should have been decided by Congress.

Shame so many care about what so many died for.

Down With The Tyrants!!

The article you linked seemed to point to the necessity of the mandate to meet the OTHER mandated condition that all people with preexisting conditions be covered.

So this is a self-perpetuating loop!

If the law did not attempt to mandate universal coverage on private insurance companies, then it would not need to require all people to purchase it!

This really seems like a case of no one wanting to admit that the
Emperor we are all staring at is butt naked.

This is totally blurring the lines between private industry and government taxation
to pay for public services. I think the only reason this went so far, is it did provide emergency means to save some lives in the meantime while this is debated
how to achieve greater coverage in a CONSTITUTIONAL way. This isn't it.
This is a mess.

If you cannot see this is unconstitutional, you have no business making
government decisions that are supposed to reflect the consent and interests
of the public.

The fastest way I see to fix this is
1. change Opt Out to Opt In and make this bill optional
so anyone who believes in following or funding it still has the right to do as they believe
without imposing on those who dissent
2. separate the health care policies and exchanges along the same party lines
that the votes indicate. so the liberal Democrats who vote for mandated policies can
run their own exchange based on that; the independents and conservative Republicans and Tea Party members who want free enterprise without mandates can set up and fund their own exchanges under that policy; and the Greens and single-payer supporters can set up their system. I see no problem with a public option as long as there is no manipulation by govt on the provision and pricing of supplies and services.

In general the Democrats who voted for this have to get real.
How can you argue for no government interference or regulation of abortion
and then argue for government mandates at the same time?

The only way I see to afford to pay for everyone's coverage is to MANDATE
health codes like no smoking or drinking or drug addictions, compel all people
to go through spiritual healing therapy to get rid of disease and causes of
ills to reduce the costs of more evasive or expensive treatments, and you
CANNOT mandate that!!! So you are asking to separate church and state
but then mandating people to pay the costs without responsibility for one's health.

What a mess. Which judge is going to be as brave as the little girl
in the story with the honesty to point out the Emperor is naked.
When are we going to snap out of this whole ruse, really!

 

[dblack]

This really seems like a case of no one wanting to admit that the Emperor we are all staring at is butt naked.

Well said.

 

[dblack]

Good article in the Nation:

The individual mandate was always a bad idea. Instead of recognizing that healthcare is a right, the members of Congress and the Obama administration who cobbled together the healthcare reform plan created a mandate that maintains the abuses and the expenses of for-profit insurance companies—and actually rewards those insurance companies with a guarantee of federal money.
...

While I think the discussion of health care as a 'right' badly misconstrues what rights are, it's good to see liberals who recognize the hypocrisy inherent in ACA.

 

[The Rabbi]

These exemptions were given mostly to employers and unions with group plans that did not meet the minimum requirement. Increasing coverage of group plans, usually means replacing the whole plan often with a different company. Typically large group plans are covered by a yearly or longer contract.

And if I am not mistaken they are not permanent exemptions. I believe they expire after a few years. Not 100% positive on that, but I thought I read that somewhere and I'm simply not willing to look it up tonight.

Immie

Yes, they one year exemptions and can be renewed each year till 2024.

What's going to change next year that will reverse the logic of the exemption?

The Health Care Act is a disaster. Every indicator says that it will be. It will result in rationed care and yes, death panels. Look at the statements of Donald Berwick and that is exactly what he is talking about.
The Democrats have managed to take the best health care system in the world and trash it. Obamacare needs to be repudiated wholesale. The individual mandate is essential to the program, as Democrats said repeatedly during the debates on it. It is unconstitutional. Therefore since there is no severability clause in the legislation the whole thing needs to go.

 

[SFC Ollie]

The simple fact that there had to be waivers and exemptions immediately after the bill was passed should have been enough to tell us that it is a piece of crap bill.

The fact that it had to be passed in backroom deals and bribes to certain congressmen should have told us it was a piece of crap bill.

Obamacare does not do what we needed it to do. Lower healthcare costs........