Health care plan makes for interesting reading

I like to read important proposed legislation. Actually, I don't so much like it — the text is often mind-numbing — but I make myself do it because I think that it is important.
AUG 16, 2009
I like to read important proposed legislation. Actually, I don't so much like it — the text is often mind-numbing — but I make myself do it because I think that it is important. Last week, I spent a few nights reading the health care reform bill, HR 3200, and now I can tell you why it is receiving such a skeptical reception. First, it is a 1,200-page bill that the Democratic administration wanted to vote on before the August recess. What is the rush? My guess is that most people in Congress did not read it before the recess began, and many won't have read it when they return from the recess, because of all their travels. Perhaps the administration didn't want to give anyone time to read what Congress had drafted and find things in it to object to. Not that I was surprised, but the very lengthy bill is filled with bureaucratic legalese. I had to read most sections several times, and refer to definitions, to understand exactly what the bill said. Ironically, Section 133 of the bill requires qualified-health-benefit plans to disclose plan terms and conditions, claims-payment policies and practices, periodic financial disclosure, etc., “in plain language.” It is a real pity that plain language wasn't required for the bill itself. Second, some parts of the bill seem to conflict with President Obama's promises. For example, the president repeatedly has stated that everyone who is satisfied with their health insurance will be able to keep that insurance. But then there is Section 102, “Protecting the choice to keep current coverage.” It states: (a) Grandfathered Health Insurance Coverage Defined — Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term “grandfathered health insurance coverage” means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met: (1) LIMITATION ON NEW ENROLLMENT — (A) IN GENERAL — Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1. (B) DEPENDENT COVERAGE PERMITTED — Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day. (2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS — Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1. (3) RESTRICTIONS ON PREMIUM INCREASES — The issuer cannot vary the percentage in-crease in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all en-rollees in the same risk group at the same rate, as specified by the Commissioner. That seems to state that no existing plan can enroll new members without losing its grandfathered status. Likewise, it can't change any terms or conditions, and there are severe restrictions on premium increases. Perhaps Mr. Obama hasn't actually had time to read the 1,200-page bill. Even if I am misunderstanding the intent of this section, I have to believe that I'm not alone here. It immediately raises suspicions and concerns about the intent of Congress. Likewise, Mr. Obama has pooh-poohed fears that the public plan option would have advantages that would allow it to outcompete the existing private plans and drive them out of existence, leaving the country with a single-payer plan. Yet under Section 222, the Department of the Treasury would provide the public plan with $2 billion in seed capital, interest-free. Private companies have to raise their capital in the financial markets, and it isn't free. That is a distinct advantage for the public plan. I am still slogging through the bill. Perhaps my fears will be allayed in other sections — or perhaps they will be heightened. All citizens should read the bill for themselves and decide whether they like the plan. But I warn you, it is hard slogging.

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