Wednesday, Sept 23, Republicans to unveil Health Care Plan and other policies

[DiveCon]

nevermind, found it myself
it was in INTERNAL grayson poll

 

[rdean]

Republican Plan includes:

1. Coverage can be denied for the following "pre-existing" conditions:

asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast including having had a mammogram regardless of the results, and any condition of the prostate

2. If a person becomes sick and can no longer pay premiums, coverage can be ended to keep costs down for others not sick.

3. No clause to cover children. They do not work. They do not need coverage.

4. Parents are no longer allowed to add their children to their health care plan while those children attend college or have passed 18 years of age.

5. An amendment to "protect marriage" will be back on the table.

6. A bill to repeal the "don't ask" part of "don't ask, don't tell".

7. Government intervention to end all abortions, including rape and incest.

8. A trillion-dollar tax cut for millionaires and billionaires.

9. Further deregulation of Wall Street.

10. Privatizing Social Security.

11. Ending Medicare and Medicaid.

12. Freedom of religion doesn't mean freedom from religion. Bill to include mandatory teacher led prayers in public schools.

13. A change in science curriculum to include the possibility of "occult" intervention.

14. An amendment to strip Hispanic children of their citizenship.

There you go. I think I've covered most of what they will present.

On #1: you got that one wrong. Here is what is does: " Insurance companies will no longer be able to deny children coverage for pre-existing conditions."

On #2: You missed it on that one too. Here is what it does: " Insurance companies will be forbidden from terminating coverage for any other reason than customer fraud."

On #3: Partially wrong again. Here is what it does: "Children of parents with insurance will be allowed to remain covered under those policies until the age of 26." I am not sure about if they cen be covered on insurance. I do believe they can. It would be crazy not to have insurence on your children.

On #4: I don't know if they can be addede while they are in college, but if they are already covered they can remain covered. (See #3)

Other coverage will include the following: "4. Insurance companies will no longer be able to cap the amount of benefits and treatment a person can receive in a lifetime.

5. Insurers can no longer charge customers for preventive services like mammograms and colonoscopies.

6. High-risk pools are mandated to cover those who have been denied coverage because of pre-existing conditions."

The problem is that none of these is actually able to be used at least until 1-1-11, and some even at a later date. Most of the rest will be waiting until 2014.

While I have not read the details of these changes, I have to say that I believe they will be cause for worry. They will cause an increase in coverage cost. They will cause overloads for medical professionals. They will mosy likely have so many exceptions that in fact they will be ineffective for the most part. It is not a gift. Because of who pushed it, I do not personally trust it.

However, I will use it to the fullest extent since I am older and don't have time to take advantage of anything that MIGHT be good.

rdean is so crazy the lefties thing he is wrong.

And then "whoops", turns out I was right all along.

 

[DiveCon]

On #1: you got that one wrong. Here is what is does: " Insurance companies will no longer be able to deny children coverage for pre-existing conditions."

On #2: You missed it on that one too. Here is what it does: " Insurance companies will be forbidden from terminating coverage for any other reason than customer fraud."

On #3: Partially wrong again. Here is what it does: "Children of parents with insurance will be allowed to remain covered under those policies until the age of 26." I am not sure about if they cen be covered on insurance. I do believe they can. It would be crazy not to have insurence on your children.

On #4: I don't know if they can be addede while they are in college, but if they are already covered they can remain covered. (See #3)

Other coverage will include the following: "4. Insurance companies will no longer be able to cap the amount of benefits and treatment a person can receive in a lifetime.

5. Insurers can no longer charge customers for preventive services like mammograms and colonoscopies.

6. High-risk pools are mandated to cover those who have been denied coverage because of pre-existing conditions."

The problem is that none of these is actually able to be used at least until 1-1-11, and some even at a later date. Most of the rest will be waiting until 2014.

While I have not read the details of these changes, I have to say that I believe they will be cause for worry. They will cause an increase in coverage cost. They will cause overloads for medical professionals. They will mosy likely have so many exceptions that in fact they will be ineffective for the most part. It is not a gift. Because of who pushed it, I do not personally trust it.

However, I will use it to the fullest extent since I am older and don't have time to take advantage of anything that MIGHT be good.

rdean is so crazy the lefties thing he is wrong.

And then "whoops", turns out I was right all along.

only in your delusional fucking ridiculous mind

 

[Quantum Windbag]

That is not how I read the law

No offense, but it doesn't matter how you read it. None of this is mysterious or ambiguous to anyone who knew about it before last night. All of this is well-established stuff.

The contortions you're going through here to find some fatal flaw are amusing. First you accuse RDD of spreading "obvious disinformation and bullshit lies about Obamacare" for pointing out that the law provides for enrollment periods for the exchanges. Then when it's pointed out that not only does the law do exactly that, it defuses your hypothetical situation of someone losing coverage by allowing for special enrollments (as in HIPAA) for those people, you move on to claiming there's no such thing as enrollment periods. It's just a steady march toward absurdity.

And it's not just you, this happens with so many people in so many of these health care threads. Someone says something that reveals they haven't bothered to read any of this law ("there's nothing about workforce!" or "why doesn't it address fraud and abuse!" or "states can't opt out!"), the simple truth is pointed out and instead of conceding that it's a good thing that X is in the law, they just keep falling back to progressively more absurd positions. usually contradicting their own earlier post. It's okay to like a provision. It's okay. It's okay.

[ame="http://www.youtube.com/watch?v=GtkST5-ZFHw"]It's not your fault[/ame]

It is a lie, because the law clearly allows people to apply for insurance whenever their status changes for some reason. Even you admit that. I am not saying that there are no enrollment periods, I am saying that lawyers will be able to use the language of the law to argue that enrollment periods do not prohibit a person from purchasing insurance outside those enrollment periods. I do not know why you refuse to admit the truth, but I have come to expect that from supporters of this law, so I am not surprised. You are quite adept at pointing at the provisions of the law, yet refuse to admit how they work in the real world.

The parts of this law that supposedly address fraud and abuse are going to be totally ineffective, because people will just find other ways to commit it. The only way to eliminate fraud and abuse in a human system is to eliminate the humans, and this law does not come anywhere accomplishing that. Any honest person would admit that is impossible, and instead of getting political mileage out of going after fraud and abuse would simply step up enforcement of the existing laws, and making the checks that already exist work better. Instead they pile on new regulations that simply make it harder on honest people.

I also love the way supporters of this law want to lump everyone together and tar them with the same brush. I admit I have not read the whole law, but then again, neither did anyone that voted for it. What makes me smarter than they are is that I know a good idea is not enough to make a difference. The proper way to approach health care reform would to be to take small, incremental, steps. By lumping everything together in one law no one will be able to tell what is working, and what is not working. When the inevitable problems pop up, like insurers refusing to sell new policies for individuals, sell child only policies, and raise rates to cover the new new required benefits all they can do is issue vague threats and threaten to exclude the companies that say things they do not like from participating in future gimmies to their industry.

If this law is half what supporters claim for it, why is every single thing that is happening as a result making things worse?

 

[Quantum Windbag]

Couldn't have said it any better. Quantum - please just concede that you didn't understand this portion of the bill, but now it makes a little more sense. This is not some conspiracy against you.

If you want me to admit the law does contain enrollment periods, I have no problem with that. Why do you have a problem admitting that people, including some of the people who wrote this law, are going to argue that these enrollment periods do not prohibit people from signing up for insurance outside of those periods. That is what I was looking for when I read the language of the law, and it is not there.

 

[Quantum Windbag]

On #1: you got that one wrong. Here is what is does: " Insurance companies will no longer be able to deny children coverage for pre-existing conditions."

On #2: You missed it on that one too. Here is what it does: " Insurance companies will be forbidden from terminating coverage for any other reason than customer fraud."

On #3: Partially wrong again. Here is what it does: "Children of parents with insurance will be allowed to remain covered under those policies until the age of 26." I am not sure about if they cen be covered on insurance. I do believe they can. It would be crazy not to have insurence on your children.

On #4: I don't know if they can be addede while they are in college, but if they are already covered they can remain covered. (See #3)

Other coverage will include the following: "4. Insurance companies will no longer be able to cap the amount of benefits and treatment a person can receive in a lifetime.

5. Insurers can no longer charge customers for preventive services like mammograms and colonoscopies.

6. High-risk pools are mandated to cover those who have been denied coverage because of pre-existing conditions."

The problem is that none of these is actually able to be used at least until 1-1-11, and some even at a later date. Most of the rest will be waiting until 2014.

While I have not read the details of these changes, I have to say that I believe they will be cause for worry. They will cause an increase in coverage cost. They will cause overloads for medical professionals. They will mosy likely have so many exceptions that in fact they will be ineffective for the most part. It is not a gift. Because of who pushed it, I do not personally trust it.

However, I will use it to the fullest extent since I am older and don't have time to take advantage of anything that MIGHT be good.

rdean is so crazy the lefties thing he is wrong.

And then "whoops", turns out I was right all along.

Then respond to the points I made.

 

[Greenbeard]

It is a lie, because the law clearly allows people to apply for insurance whenever their status changes for some reason. Even you admit that.

No, it isn't a lie. RDD said "How will that be possible if there are only certain times during the year when you can purchase that insurance?" in response to someone who sarcastically suggested remaining uninsured until you have some kind of accident. Open enrollment periods don't allow for that (in fact, that's why they'll exist). There will be special enrollments for people who lose other coverage and want to immediately buy new coverage through an exchange. Special enrollments don't allow you to game the system by remaining outside it until you want to draw resources from it, they allow us to avoid the "conundrum for some people" that you were so concerned about only a few pages ago.

I am not saying that there are no enrollment periods, I am saying that lawyers will be able to use the language of the law to argue that enrollment periods do not prohibit a person from purchasing insurance outside those enrollment periods.

HIPAA has been law for 15 years. This is not new language, nor is anyone confused by it.

Moreover, your grand loophole seems to rely on the notion of a "late enrollee" which doesn't apply in ACA. ACA requires the HHS Secretary to ensure the exchanges provide for "special enrollment periods specified in section 9801 of the Internal Revenue Code of 1986." Which means it's referring explicitly and exclusively to subsection f of that part of federal law ("Special enrollment periods"). The concept of a late enrollee applies to a preexisting condition exclusion period which doesn't exist in an exchange. You can verify that just by reading the definition ("The term 'late enrollee' means, with respect to coverage under a group health plan, [note: this explicitly means you couldn't possibly be talking about an exchange] a participant or beneficiary who enrolls under the plan other than during"...) In short, this isn't a coherent argument--ACA doesn't refer to that subsection, nor could it since that definition has no relevance.

I can't tell whether you're grasping at straws or you really don't get this.

I do not know why you refuse to admit the truth, but I have come to expect that from supporters of this law, so I am not surprised. You are quite adept at pointing at the provisions of the law, yet refuse to admit how they work in the real world.

Implementation is foremost of my mind. But make no mistake--and this is key--your concerns here are idiotic. But instead of realizing that, you can continue to dig your heels in deeper. But you're not the only one who's not surprised here.

The parts of this law that supposedly address fraud and abuse are going to be totally ineffective, because people will just find other ways to commit it.

Very persuasive, thanks.

Any honest person would admit that is impossible, and instead of getting political mileage out of going after fraud and abuse would simply step up enforcement of the existing laws, and making the checks that already exist work better. Instead they pile on new regulations that simply make it harder on honest people.

You've really got to read this thing at some point. I'm constantly baffled how people like you can have such strong opinions about it while have some glaring gaps in your knowledge of its content.

I also love the way supporters of this law want to lump everyone together and tar them with the same brush. I admit I have not read the whole law, but then again, neither did anyone that voted for it.

Riveting defense.

By lumping everything together in one law no one will be able to tell what is working, and what is not working. When the inevitable problems pop up, like insurers refusing to sell new policies for individuals, sell child only policies, and raise rates to cover the new new required benefits all they can do is issue vague threats and threaten to exclude the companies that say things they do not like from participating in future gimmies to their industry.

Your examples contradict your message. The reason the guaranteed issue law for children is causing problems is that it was done in isolation. They wanted to implement that one, relatively small, change (no pre-existing conditions for kids under 19) as soon as possible, without waiting for the infrastructure of the exchanges to be built. But without companion pieces of subsidies, an individual mandate, and risk adjustment, insurers can make the argument that it's financially dangerous for them to issue new policies ("Insurers are worried that children — or, more likely, their parents — might apply for coverage literally on the way to the hospital or doctor's office and cancel it once treatment is complete.").

The same would be true of state premium oversight, if it weren't in the law. If states don't have the infrastructure and authority in place to scrutinize premium increases, there would be little to stop insurers from engaging in price gouging and simply blaming it on the new law. That's why states and directed and funded to enhance their premium oversight capabilities.

As critics are eager to point out, provisions have consequences. Increasing access requires attention to primary care workforce expansion. Expanding Medicaid requires attention to combating fraud in public programs. Guaranteed issue and community rating laws require, at minimum, risk adjustment and an individual mandate. Do you mean to tell me now that you're not a part of the crowd that has a shit-fit every time it thinks it identifies something that logically or pragmatically ought to be included in the law but (as far as they know) is not?

 

[rdean]

rdean is so crazy the lefties thing he is wrong.

And then "whoops", turns out I was right all along.

Then respond to the points I made.

I think you missed this part:

Republican Plan includes:

 

[Quantum Windbag]

No, it isn't a lie. RDD said "How will that be possible if there are only certain times during the year when you can purchase that insurance?" in response to someone who sarcastically suggested remaining uninsured until you have some kind of accident. Open enrollment periods don't allow for that (in fact, that's why they'll exist). There will be special enrollments for people who lose other coverage and want to immediately buy new coverage through an exchange. Special enrollments don't allow you to game the system by remaining outside it until you want to draw resources from it, they allow us to avoid the "conundrum for some people" that you were so concerned about only a few pages ago.

We shall see. My guess is that the law will be interpreted as not preventing this, you disagree. Argue all you want, but the only thing that will actually prove me wrong is time. The language of the law does not specifically say that a person has to buy insurance immediately. Indeed, the law specifically makes a provision for people who do not buy insurance, that tax, or penalty, or whatever it is going to end up being called legally. Where does it specifically state that anyone who elects to not buy insurance has to wait for an open enrollment period.

Funny thing, even at work, where we have an open enrollment every year, that is not the only time a person can buy insurance. The HR department prefers that all employees buy it then, because it makes their paperwork easier, but we are allowed to buy it at any point, even if they had the option during the open period. Why should I believe that this law will work differently?

HIPAA has been law for 15 years. This is not new language, nor is anyone confused by it.

Moreover, your grand loophole seems to rely on the notion of a "late enrollee" which doesn't apply in ACA. ACA requires the HHS Secretary to ensure the exchanges provide for "special enrollment periods specified in section 9801 of the Internal Revenue Code of 1986." Which means it's referring explicitly and exclusively to subsection f of that part of federal law ("Special enrollment periods"). The concept of a late enrollee applies to a preexisting condition exclusion period which doesn't exist in an exchange. You can verify that just by reading the definition ("The term 'late enrollee' means, with respect to coverage under a group health plan, [note: this explicitly means you couldn't possibly be talking about an exchange] a participant or beneficiary who enrolls under the plan other than during"...) In short, this isn't a coherent argument--ACA doesn't refer to that subsection, nor could it since that definition has no relevance.

I can't tell whether you're grasping at straws or you really don't get this.

How will this work when insurers are required to cover preexisting conditions? That is what I am asking about, and you continually go off on tangents about how things work now. Your arguments about how it works has nothing to do with how it will work.

Implementation is foremost of my mind. But make no mistake--and this is key--your concerns here are idiotic. But instead of realizing that, you can continue to dig your heels in deeper. But you're not the only one who's not surprised here.

Exactly my point. When insurers are required to sell policies to anyone, even if they have preexisting conditions, will the enrollment periods prevent someone from not buying insurance until they need it? Why do you keep insisting that it will somehow do the impossible? The most that will happen, assuming everything works exactly the way you think it will, is that they will be forced to wait until the next enrollment period before they can stiff the insurance companies.

Am I right or am I wrong?

You've really got to read this thing at some point. I'm constantly baffled how people like you can have such strong opinions about it while have some glaring gaps in your knowledge of its content.

So far the glaring gaps have not been bad enough to convince me that I have to wade through it. Your arguments here are certainly not shaking my understanding that everyone is trying to feed me lies about this abomination.

I also love the way supporters of this law want to lump everyone together and tar them with the same brush. I admit I have not read the whole law, but then again, neither did anyone that voted for it.

Riveting defense.

Your examples contradict your message. The reason the guaranteed issue law for children is causing problems is that it was done in isolation. They wanted to implement that one, relatively small, change (no pre-existing conditions for kids under 19) as soon as possible, without waiting for the infrastructure of the exchanges to be built. But without companion pieces of subsidies, an individual mandate, and risk adjustment, insurers can make the argument that it's financially dangerous for them to issue new policies ("Insurers are worried that children — or, more likely, their parents — might apply for coverage literally on the way to the hospital or doctor's office and cancel it once treatment is complete.").

The same would be true of state premium oversight, if it weren't in the law. If states don't have the infrastructure and authority in place to scrutinize premium increases, there would be little to stop insurers from engaging in price gouging and simply blaming it on the new law. That's why states and directed and funded to enhance their premium oversight capabilities.

As critics are eager to point out, provisions have consequences. Increasing access requires attention to primary care workforce expansion. Expanding Medicaid requires attention to combating fraud in public programs. Guaranteed issue and community rating laws require, at minimum, risk adjustment and an individual mandate. Do you mean to tell me now that you're not a part of the crowd that has a shit-fit every time it thinks it identifies something that logically or pragmatically ought to be included in the law but (as far as they know) is not?

States do not have the laws in place to study rate increases?

Perhaps that is because, until now, the major concern of lawmakers was the demonstrated fact that insurers routinely undercharge for policies, thus leaving themselves exposed to the danger of not having enough assets to cover potential losses. Which makes the assertion that insurers routinely gouge customers a bit hard to justify.

 

[Quantum Windbag]

And then "whoops", turns out I was right all along.

Then respond to the points I made.

I think you missed this part:

Republican Plan includes:

Nope, I saw that. I am still waiting for you to repond to my points.

 

[rdean]

I propose that when you wreck your car, then go buy insurance and demand that they fix your car.

Awesome.

asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast including having had a mammogram regardless of the results, and any condition of the prostate

So you agree that if you get sick and you had one of these "pre-existing" conditions, then you should lose your insurance? We want to be clear. That is what you are defending.

If you had an allergy or a tonsillectomy (got your tonsils removed), then you should lose your insurance if you get sick. So tell us that you agree with this.

Weird thing.

The policy you quoted does not deny coverage based on those conditions, it just advises people that they are not covered during the first six months of the policy. After that period all of those conditions are covered, and paid for to the degree the policy specifies. That is what is known as a business contract, something very few progressives understand. They all think that contracts only apply if they benefit the 'little guy', and that any company is obligated to pay through every possible orifice if the 'little guy' is even mildly inconvenienced, even the company is completely clear of any and all legal responsibility.

Even Louisiana Gov. Bobby Jindal (R) spoke an unintentional truth when he said of his parents: “When they arrived in Baton Rouge, my mother was already four-and-a-half-months pregnant. I was what folks in the insurance industry now call a pre-existing condition.”

She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.

Think Progress Health Insurers Consider A Caesarean-Section Pregnancy A Pre-Existing Condition

Ms. Greenberger acknowledged that insurance companies were masters at protecting their bottom line, but said she did not see an obvious way around the new rules. “I never want to underestimate what a creative mind might be able to come up with,” she said, “but I believe this is pretty straightforward.”

http://www.nytimes.com/2010/03/30/health/30women.html?_r=1&ref=health

I don't know what else to say.

If you are protecting insurance companies, you will never find anything they do as "wrong".

 

[Quantum Windbag]

asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast including having had a mammogram regardless of the results, and any condition of the prostate

So you agree that if you get sick and you had one of these "pre-existing" conditions, then you should lose your insurance? We want to be clear. That is what you are defending.

If you had an allergy or a tonsillectomy (got your tonsils removed), then you should lose your insurance if you get sick. So tell us that you agree with this.

Weird thing.

The policy you quoted does not deny coverage based on those conditions, it just advises people that they are not covered during the first six months of the policy. After that period all of those conditions are covered, and paid for to the degree the policy specifies. That is what is known as a business contract, something very few progressives understand. They all think that contracts only apply if they benefit the 'little guy', and that any company is obligated to pay through every possible orifice if the 'little guy' is even mildly inconvenienced, even the company is completely clear of any and all legal responsibility.

Even Louisiana Gov. Bobby Jindal (R) spoke an unintentional truth when he said of his parents: “When they arrived in Baton Rouge, my mother was already four-and-a-half-months pregnant. I was what folks in the insurance industry now call a pre-existing condition.”

She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.

Think Progress Health Insurers Consider A Caesarean-Section Pregnancy A Pre-Existing Condition

Ms. Greenberger acknowledged that insurance companies were masters at protecting their bottom line, but said she did not see an obvious way around the new rules. “I never want to underestimate what a creative mind might be able to come up with,” she said, “but I believe this is pretty straightforward.”

http://www.nytimes.com/2010/03/30/health/30women.html?_r=1&ref=health

I don't know what else to say.

If you are protecting insurance companies, you will never find anything they do as "wrong".

Thank you for making my point.