Page 16 states:Page 16: States that if you have insurance at the time of the bill becoming law and change, you will be required to take a similar plan. If that is not available, you will be required to take the gov option!
16SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
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.So, what does that mean? It means that except for the exceptions put forth in this paragraph, if an insured individual (or family) already has health insurance through a private insurer, they may keep that plan with that insurer. However, if the effective date of that private plan will be after the date of Y1 (in other words, this bill), the private insurer is not allowed to insure that individual (or family).
Part 2 addresses change in coverage by the current plan:
(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.
What this means is that your insurer can not change the terms and conditions of the plan as long as the beneficiary is enrolled. Including, but not limited to, raising premiums, changing copays, deductible and out of pocket costs, as well as lowering copays, premiums and out of pocket costs. When your plan changes its provisions, you are no longer locked into your plan. And if you are not locked into your plan, and you can not opt for another private plan....
Since I am reading the plan in progressive order, and this section has not requied that I go to another section and subsection, I interpret this to be a fairly straight forward section.
It is impossible to "grandfather" in something that hasn't started yet.
ReplyDeleteThis is a section meant only to define what "grandfathered coverage" means. It does not mean that "if the effective date of that private plan will be after the date of Y1 (in other words, this bill), the private insurer is not allowed to insure that individual (or family)." That is a complete non-sequitor.
It just means that a plan that doesn't start until after the date the bill takes effect is not a grandfathered policy. It is a new policy.
Plesae read page 20. Under this bill, insurance companies will still be able to sell new insurance to people.
Where'd you find the website that you took your original assertion from? Is he a friend of yours?
ReplyDeleteI'll read page 20 tomorrow morning. I'm beat this evening.
ReplyDeleteI found the website through Google just looking for some sort of list with page numbers. That was the first one I saw, and I thought it would be a fun one since some of his claims seem a bit silly. Don't know him, don't care to know him.
Page 20 reads:
ReplyDeleteSEC. 112. GUARANTEED ISSUE AND RENEWAL FOR INSURED PLANS.
The requirements of sections 2711 (other than subsections (c) and (e)) and 2712 (other than paragraphs (3),and (6) of subsection (b) and subsection (e)) of the Public Health Service Act, relating to guaranteed availability and renewability of health insurance coverage, shall apply to individuals and employers in all individual and group health insurance coverage, whether offered to individuals or employers through the Health Insurance Exchange, through any employment-based health plan, or otherwise, in the same manner as such sections apply to employers and health insurance coverage offered in the small group market, except that such section 2712(b)(1) shall apply only if, before nonrenewal or discontinuation of coverage, the issuer has provided the enrollee with notice of nonpayment of premiums and there is a grace period during which the enrollees has an opportunity to correct such nonpayment. Rescissions of such coverage shall be prohibited except in cases of fraud as defined in sections 2712(b)(2) of such Act.
This doesn't really tell us much of anything without also reading the noted subsections and paragraphs of sections 2711 and 2712. I have not been able to locate these sections by scanning through the document nor with the document's find function.
If I can read these exclusions, then I can understand this part of the bill better.
To be honest, you had me at:
ReplyDelete‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
19 HEALTH CARE COVERAGE.
20 ‘‘(a) TAX IMPOSED.—In the case of any individual
21 who does not meet the requirements of subsection (d) at
22 any time during the taxable year, there is hereby imposed
23 a tax equal to 2.5 percent of the excess of—
1 ‘‘(1) the taxpayer’s modified adjusted gross in2
come for the taxable year, over
3 ‘‘(2) the amount of gross income specified in
4 section 6012(a)(1) with respect to the taxpayer.
I don't think any bill should be passed that forces everyone to pay for an insurance plan.
That said, there are any number of exemptions, including the Religious exemption. I wonder if the Christian Scientists will have a big boost in membership this year.
I hadn't gotten to that part yet.
ReplyDeleteSorry to jump ahead. It just seems like the biggest and most unconstitutional obstacle--the one from which all others flow, so to speak.
ReplyDeleteBut back to the subject at hand:
ReplyDeleteHR 3200 only goes up to section 2541. I think they are referring to sections 2711 and 2712 of the Public Health Service Act:
Section 2711 of the Public Health Service Act provides that -- with certain exceptions:
"[E]ach health insurance issuer that offers health insurance coverage in the small group market in a State --
(A) must accept every small employer (as defined in section 300gg-91(e)(4) of this title) in the State that applies for such coverage; and
(B) must accept for enrollment under such coverage every eligible individual (as defined in paragraph (2)) who applies for enrollment during the period in which the individual first becomes eligible to enroll under the terms of the group health plan and may not place any restriction which is inconsistent with section 300gg-1 of this title on an eligible individual being a participant or beneficiary.
Section 2712 provides that -- with certain exceptions:
[A] group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
(A) Health status.
(B) Medical condition (including both physical and mental illnesses).
(C) Claims experience.
(D) Receipt of health care.
(E) Medical history.
(F) Genetic information.
(G) Evidence of insurability (including conditions arising out of acts of domestic violence).
(H) Disability."
Source: http://mediamatters.org/print/research/200907290061
Now as far as what it means, that will take some cogitating...
One reader on OpenCongress.org interprets the passage on page 20 thusly:
ReplyDeleteRight now, employer-offered group plans must accept every employee of that employer, regardless of pre-existing conditions. This clause extends that rule to individual plans as well. There are only two reasons they can cancel your policy: 1) If you don't pay your premiums--in which case your insurer must notify you that you didn't pay and give you a grace period in which to pay, before canceling your policy; and 2) They can cancel your policy if they find fraud on your part.