The tea parties woke me up. We
had better hope that they succeed in saving this country in November. They
caused me to read the health care bill and after I read it the first time, it
was cause for me to read it the second time. After reading all 2409 pages for
the third time, I became convinced that I should write a book ObamaCare by
Chris Cozby. The pages of the book will describe to you what I think it means.
I felt the tea parties needed the information. I will challenge any attorney or
group of attorneys to read the bill and tell me what’s in it. I will be happy
to debate the subject anytime, anyplace. In short, the bill says one thing;
there is a dictator in our midst. I can assure you it is the Secretary of
Health and Human Services. She will control every aspect of our health care.
We are now insuring an extra 45
million people of which a great portion pay no taxes. If you live at or below
the poverty level, you pay no insurance premium. It is my opinion that our
national debt will increase by at least one trillion dollars in the next four
years. The country is already thirteen trillion dollars in debt.
The National Inflation Association
(NIA) that I respect just made the following statement and I quote:
We are now at a point where if the U.S.
government taxed Americans 100% of their income, the tax receipts generated
would not be enough to balance the budget. Likewise, if the U.S. government cut
100% of spending including defense, but kept paying Social Security, Medicare
and Medicaid, we would still have a budget deficit. NIA believes that it will
be impossible for the U.S. to have a balanced budget ever again.
Can we now understand why the
tea parties exist? If the NIA is right, this country is bankrupt. How is it we
could elect anyone that would drive this country further in debt by passing the
health care bill? And if you think the health care bill is bad, try Cap and
Trade on for size.
The tea parties are
appropriately named. The Boston Tea Party was the first to say “enough is enough”.
I see history repeating itself. This time we can win in the voting booth not on
the battlefield, but if and only if the tea parties gain the momentum that it
will take to stop the insanity in Washington in November.
After reading the pages of the
book I think that you will agree that we, the middle class of America,
will pay for the entire health care bill. It will not affect the wealthy or the
poverty stricken, the entire burden will be on our backs. I can guarantee that
your taxes will skyrocket and there is absolutely no doubt that your insurance
premiums will go through the roof.
A former Secretary of Treasury
made the statement that the only person that he believes has actually read the
entire health care bill was the type setter. He made this statement on national
television and he is probably correct; except for me.
Every doctor’s office will have
to report to the Secretary of Health and Human Services every aspect of his or her
relationship with their patients which will triple their administrative costs.
Every doctor will have to report to the Secretary every aspect of their
personal investments or anything else the Secretary deems appropriate. If you
are an immediate family member of a doctor, you will also be reporting to the
Secretary any and all investment dealings. I assume that every doctor would
deem this a tremendous invasion of his or her privacy. Anything of value that
is deemed to be of value at 100 dollars USD or more must be reported to the
Secretary.
Every doctor should have his
professionals, whether an attorney or an accounting firm, read the entire
health care bill. This bill is so far reaching into the privacy of the doctor,
his spouse, his children all immediate family members that it must be repealed.
Every insurance provider that
offers group or individual coverage for health care will be totally controlled
in every aspect by the Secretary of Health and Human Services. The reporting
required by each and every insurance provider will triple the administrative
expense of an insurance company and most certainly drive up premiums. Free
enterprise and capitalism is no longer in existence when it comes to health
care. This is not only socialistic, but the government now controls every
aspect including doctors, hospitals, drug manufacturers, medical device
manufacturers, etc. The insurance companies, drug companies and medical device
companies must pay an annual fee to operate within the United States. Could
this fee be a hidden tax? Is there anyone that would be inclined to believe
that these fees will not drive insurance premiums into the stratosphere? Or at
least on all middle class Americans?
The most important aspect of the
health care bill is it creates a reporting scenario in which all entities must
report on all other entities or there will be a fine imposed. For instance, a
landlord who is leasing property to a hospital or doctor must report those
dealings to the Secretary of Health and Human Services. Where have we heard
this before; where everyone has to tell on everyone else?
In the book written by Newt
Gingrich To Save America, he states that H.R.3590 creates 159 new federal
agencies. I will tell you that over 200 times in this bill it states “whatever
the Secretary deems appropriate”. This is the reason that I make the
statement that there is a dictator in our midst. How can any bill be a law that
allows a single person to change any law in any way she deems appropriate?
I did not believe that any
elected official would vote on any bill without reading what is contained
therein. After reading this bill three times, I can assure everyone that they
did not read it or it would not have passed. When I heard Nancy Pelosi say we
will have to pass this bill so we can find out what’s in it, I knew that I
would be reading this bill in its entirety. There is no way of knowing how many
secret backroom deals had to be cut in order to purchase the votes needed to
pass a travesty such as this. A couple of examples would be the $100 million to
Nebraska, $300 million to Louisiana; how many more? Let’s us not forget that
the dollars used for these bribes are our tax dollars.
QUALITY,
AFFORDABLE HEALTH CARE FOR ALL AMERICANS
H.R.3590
“The
harsh fact of the matter is when you're going to pass legislation that will
cover 300 [million] American people in different ways it takes a long time to
do the necessary administrative steps that have to be taken to put the
legislation together to control the people”
— Rep. John Dingell
(D-MI)
May
12, 2010
Associated Press: "President
Barack Obama's new health care law could potentially add at least $115 billion
more to government health care spending over the next 10 years, congressional
budget referees said Tuesday," to beyond $1 trillion. "The
Congressional Budget Office said the added spending includes $10 billion to $20
billion in administrative costs to federal agencies carrying out the law, as
well as $34 billion for community health centers and $39 billion for Indian
health care" (Alonso-Zaldivar, 5/11).
May 2010
Congressional Budget Office: Rising health costs will put tremendous
pressure on the federal budget during the next few decades and beyond. In CBO’s
judgment, the health legislation enacted earlier this year does not
substantially diminish that pressure.
Here is a taste of what we have been force fed with
this bill:
‘‘(F)
The cost of providing uncompensated
14 care to the
uninsured was $43,000,000,000 in
15 2008. To pay
for this cost, health care providers
16 pass on the
cost to private insurers, which pass
17 on the cost to
families. This cost-shifting in18
creases
family premiums by on average over
19 $1,000 a year.
By significantly reducing the
20 number of the
uninsured, the requirement, to21
gether
with the other provisions of this Act, will
22 lower health
insurance premiums.
This sounds
great! I guess the insurance companies must have not received this news yet. My
insurance company has made the statement in writing that premiums are going up;
get ready! We have been hearing for more than a year now that this bill would
stop the health care insanity, guarantee value for your health care dollars,
create competition between health care providers, reduce premiums, cover all
Americans, etc. This has been a pretty good marketing scheme for most people.
When I say most people, I’m referring to the majority of people I have talked
with regarding their thoughts on what the health care bill means to them.
Strangely, there are people who believe that they are about to receive much
more from their insurance companies and government in the form of financial
help. Yes, health care costs are rising, the economy is on shaky ground at
best, people are losing or have lost their jobs, families have been removed
from their homes, taxes are rising, the atmosphere is warming up, food prices
are up….you know, you have heard all of this for awhile now. Some help would be
greatly appreciated, but do not believe for a moment that this bill, our
government or the insurance companies are offering any help of any kind for
someone like myself and I consider myself to be a middle class taxpaying American.
I would love to have Nancy Pelosi and Harry
Reid sit down in front of me so that I might ask them some questions.I would like to know who wrote this bill and
please don’t tell me it was our elected officials because I don’t believe it; I
have this funny feeling that some of them might not be able to read. If the
insurance companies really have to report to the Secretary all of the
information the Secretary asks for, it will be very costly to the insurance
companies and believe me when I say “your premiums are going up”. The Secretary
of Health and Human Services is about to become the most powerful person in
your life. She will wield more power over you and everything that you do than
the president of the United States. The Secretary will have the IRS handle the
collection of all the taxes, fees, fines, penalties, interest and whatever else
the Secretary deems appropriate that is hidden within H.R.3590. I have read
nothing in this bill that will be of any assistance in reducing our insurance
premiums, they are going to skyrocket. You know, I’m surprised that there is
not more screaming about this bill as I do believe that health care is better
than 1/6 of our economy and it touches every American; well all of the “Qualified
Individuals” anyway.
It is my opinion that this is a blatant
socialistic attempt at covering millions of Americans that could work, but
elect not to. There are millions of people on welfare, are happy to be there
and intend to stay. This bill should have been named The Robin Hood Bill as it
will take from the middle class and give to the poor. We all remember that
Robin Hood stole from the rich and gave to the poor; this bill does not accomplish
the same. The bill steals from everybody and gives to the poor. Don’t believe
me, read the bill. The wealthy are not affected much as the increase will not
be felt. The poor will not have to pay as they can’t. So who is left? I believe
it is the middleclass. When the government says that they are going to help
with funding, remember that funding consists of the taxes we pay. Federal
Funding = Tax Receipts and the government has said that only 50% of Americans
pay taxes.
I know this chapter seems long, but it is
worth every word. You need to read and understand this as time for action is
coming to a close. Our chance to stop the insanity is quickly approaching.
Midterm elections are in November and, in my opinion, our last chance to
fundamentally change our nation back to what it was before we started down the
socialistic path. America may not be the best place to be, just better than any
other on this planet.
As you will notice, I’ve pulled certain
sections from the bill and commented on each. My understanding and explanation
may not be correct; probably the case. If I am wrong, and no expert explanation
is offered, I will assume that I am correct. If I am correct, I fear that we as
a nation are headed into the abyss for which we will emerge on the other side,
but will be drastically different from anything we would recognize; we will not
like it! Once implemented, a law is almost impossible to repeal. Here is an
expert explanation where I think we are headed:
so·cial·ism
/ˈsoʊʃəˌlɪzəm/ Show Spelled[soh-shuh-liz-uhm] Show
IPA
–noun
1.
a
theory or system of social organization that advocates the vesting of the
ownership and control of the means of production and distribution, of capital,
land, etc., in the community as a whole.
2.
procedure
or practice in accordance with this theory.
3.
(in
Marxist theory) the stage following capitalism in the transition of a society
to communism, characterized by the imperfect implementation of collectivist
principles.
We
have all heard that none of our elected officials have read this bill and yet
voted to pass it. I can guarantee each and every one of you that they did not
and even if a few did, those individuals did not understand it. After reading
any part or the entire bill, I suggest that you get a second opinion from an
attorney. It is my opinion that, if you asked ten different attorneys to
comment, you will get ten different answers. Believe me when I say, your representative
did not understand what he or she was voting on.
I wish to apologize up front if I did not
include an issue that might be important to you. I pulled from this bill what I
deemed important to me as an individual. I can assure you that there are a
multitude of very, very important issues in H.R.3590 that I did not comment on.
is added 47 to 50
million new enrollees into health care plans they cannot afford.Who is going to pay for these new enrollees?After reading all and understanding some of
the new health care bill, it appears that the middle class will be the ones
paying.I cannot imagine that all of the
extra work involved will not equate to higher premiums for everyone.I for one do not believe that the federal
government has the wherewithal to pull this off.I for one, would like to know what type of
insurance policy is protecting the Secretary.Just a note, the Secretary is: The Secretary of Health And Human
Services.There is text in the health
care bill that refers to electronic funds transfers and I am not sure who it is
that this text refers to.As you will
notice most of the text in the health care bill seems vague and very open
ended. If you elect to read the bill, you too will glean this.
When the Secretary speaks of fair health
insurance premiums for all, it sounds good, but I can find very little
substance in the text.For the unaware
this would be a statement of profound consequence.One would have to assume that, without due
diligence, the federal government will play a leading role in the reduction of
health insurance premiums; I do not find this to be the case.Perhaps if there were more explanation within
this bill my conclusions would be different.It seems strange to me that magically, overnight, the 47 million
uninsured in this country could, with the passage of this bill, possess the
ability to afford any health insurance at any price.If an individual does not possess health
insurance it is probably because they can't afford it.
The competition the federal government speaks
of will be created through an exchange system.This exchange system is not a requirement as much as I understand it;
just a really strong suggestion.If an
insurance company elects to be a member of the exchange, then the Secretary
will dictate rate schedules for broker commissions paid by health benefit plans
offered through an exchange.So, let me
see if I understand this, The Secretary of Health And Human Services will set
the commission schedule for insurance brokers within the exchange.I have not met an insurance agent yet that I
believe would wish to be a part of a program such as this.It would be my suggestion that if you are an
insurance broker and are employed by an insurance company, that might be making
plans for becoming an exchange member, a commission structure breakdown might be
in order.I guess you could call the Secretary
the new “Insurance Broker Pay Czar”.
There is text in the bill that refers to
access being limited to lawful residents.With the ruckus now days about immigration it seems that a concrete
legal description of what a legal immigrant is would be appropriate at this
time. According to the news, there are
at least 12 million illegal immigrants in the United States.It seems funny to me that the federal
government would have an argument with the state of Arizona wanting glean proof
of citizenship status since within this bill it states that you must prove that
you are a citizen of the United States in order to become an eligible
individual for any health insurance plan.One of the things that is required as proof is a Social Security
number.I thought in order to acquire a
Social Security number that a person has to prove legal citizenship?It seems we have a conflict of interest!It is my belief that there are many more
illegal immigrants in the United States than the 12 million stated.In my mind I would think that an accurate
inventory of all illegal aliens would be justified at this time.I have formulated a very simple plan for such
an inventory and guaranteed control of movement across our border with Mexico,
in both directions, and not one penny of federal funding will be needed.Please don't misunderstand when I speak of
inventory and illegal aliens.Some of
the most trustworthy, hard-working, loyal and happy people I have ever encountered
are from the beautiful country of Mexico.I have spent quite a bit of time in Mexico and quite frankly the Mexican
people, as a whole, are happier than most of the people I encounter here in the
United States.
Reading further, it appears to me that HR
3590 relieves some individuals of the requirement to be enrolled in a health
insurance plan at all.An exemption
request can be made based on the individual's status as a member of an exempt
religious sect or division thereof, as a member of a health care sharing
Ministry, as an Indian, or as an individual eligible for a hardship
exemption.As I read it, a hardship
exemption can be acquired if an individual is seeking exemption based on the
lack of affordable coverage or the individual's status as a taxpayer with
household income less than 100% of the poverty line. Wait a minute, I thought
that I read at the beginning of this bill “Quality, Affordable Health Care for
All Americans”. It was my understanding that all Americans must be covered with
some form of health insurance.My
suggestion to each and every one is to acquire a list of all religious sects or
divisions to glean if you qualify as a member.That list would be an interesting read, would it not? The Secretary is
the one that will determine your status.
Another section of interest would be employer
liability.If you are an employer in the
United States, a good understanding of HR 3590 is imperative as there are legal
and financial obligations that you are now liable for.If I understand it correctly, you are
required to offer and pay a portion of an insurance policy for each and every
one of your employees.If the secretary
deems that you are not in compliance there can and probably will be hefty fees,
penalties and interest.It's states,
somewhere, that there are minimum requirements for policies that will be
acceptable to the Secretary. Along with these requirements, there is the
paperwork involved.The reporting
requirements mandated by the Secretary, in my opinion, will be inundating at
best.I believe that the lion's share of
the small businesses in this country do not possess the wherewithal to become
or stay in compliance.This will be
devastating to the already bleak employment picture in the United States.One of the most interesting descriptions in
this section is the non-elective contribution.I have a pretty good idea of what that means, but again, concrete
figures are not something that HR 3590 renders.Again, if you are an employer, you had better have a strong
understanding of what this Bill means.My suggestion, get an attorney!
As an employee, your employer is required, by
law, to offer an eligible qualified health insurance plan.Your employer is required, by law, to pay for
50% of that plan.On the surface and at
just a glance this would seem to be a good thing, but as the statistics will
show 35% or better of employees in America cannot afford health insurance at
any cost.Don't be fooled, as an
individual you are required, by law, to be covered under a health insurance policy
of some kind whether your employer offers one or not.There are penalties for an individual who is
found to be not covered.It is my
understanding that this penalty, tax, fee or whatever they want to call it, is
$750 per year.This penalty will be assessed
and collected by the IRS.If it is
deemed that you are not sufficiently covered by a qualifying health care plan
and a penalty is assessed, the IRS will start the collection process with your
tax refund check.Yes, it is my
understanding that if you owe a penalty, the IRS will deduct the amount of that
penalty from the refund owed to you.And
for those of you who are married, the spouse of such individual shall be
jointly liable for such penalty.According to the bill, married couples must file jointly.Advice from your CPA or tax attorney is
warranted.
With respect to fees, taxes, penalties and
interest the Secretary has stated that the Secretary shall not file notice of
lien with respect to any property of a taxpayer by reason of any failure to pay
the penalty imposed.There is nowhere in
this H.R.3590 that states that the IRS won't.The way I see it, the Secretary has handed marching orders to the IRS to
carry out the collection process; the dirty work if you will.As we all know the IRS can and will file
liens and levies to carry out the collection process.This is pretty ingenious if you ask me!I guess this would be the reason the IRS
needs 16,000 more employees; but just a guess.
Moving further into the bill I find it
intriguing that the Secretary has made a gallant attempt to leave no stone
unturned.The insurance companies, drug
manufacturers, medical device manufacturers, doctors or physicians, hospitals,
landlords and all other entities deemed appropriate by the Secretary are not
immune to this money-saving extravaganza. The reporting required by the Secretary for
all activity involved or construed to be appropriate by the Secretary will not,
under any circumstances, be of any cost saving value at all! If you are an insurance company, you are
required to report to the Secretary information regarding each and every one of
the individuals enrolled in health care plans that you offer.A premium increase will fall under extreme
scrutiny of the Secretary; she is going to want to know why.I personally find this to be an invasion of
our privacy as I do not believe that the federal government has any business
rooting around in anyone’s health care files.As it is with all other businesses, extra work equals a higher cost to
the end-user.In this case a higher
premium each month is probably to be expected.As I had mentioned before, it was my understanding that HR 3590 was
written, voted on and passed in an effort to reduce the out of pocket expense
for health insurance coverage.I do not
believe that the extra paperwork involved will help in this regard.
If you are a doctor or a physician, every
aspect of your life and the lives of your immediate family members, are about
to be put under the microscope.Your
ability to practice medicine is about to change forever.Your aptitude for healing the sick is not in
question, but your ability to run a business is, or so it seems.I would imagine that it is hard enough to
deal with the important things much less the meddling that is coming your
way.The federal government has
implemented rules and regulations that will require each and every entity that
you interact with report to the Secretary all interaction with you.I cannot imagine the grief that each and every
one of you is about to endure.This does
not bode well for any patient as the majority of your time will be required to
satisfy whatever the Secretary deems appropriate.With the strongest of suggestion I recommend
that you take the time and read HR 3590; it is of great significance to a
person in your profession.
The medical device and prescription drug
manufacturers have not been spared.There are significant annual fee's that you are required, by law, to pay
for the privilege of doing business in the United States. Could this be
construed as a tax? These fees are hefty.It is beyond me how an imposed fee can be instrumental in any way shape
or form for the purpose of reducing costs.Any increase in costs will be of great burden for our older population
as they are the most dependent on your services.No blame should be laid upon you for the
accelerated costs of your products as it is the federal government that has
imposed these rules, regulations, fees, taxes, penalties and interest.I am truly saddened for the elderly as much
of their wealth has been stolen.The
fact that a good portion of our retired population depends heavily on the help
of the federal government with health care costs is frightening to say the
least.
Let's talk about being retired in the United
States.When a person has reached the
age of 65 and has paid into the Social Security Fund, the assumption to date,
has been that there will be a little financial assistance available through the
Medicare program.To date, income has
not played a monumental role in an individual's eligibility for Medicare.You worked, you pay, and now it is time to
collect.Not anymore.It is my understanding that an individual's
income will be a significant determining factor of eligibility for Medicare
assistance.In other words, if the Secretary
deems that you make too much money, then no help for you!As to what that amount might be, it has not
been determined according to everything I have read in HR 3590.I am not a person that believes that Medicare
should be made available to an individual who can afford to pay their own
way.I do find it striking that we have
all been asked to pay in to a fund that was promised back to us at a certain
point in time and now we are being told that we are not eligible for what we
were promised.It seems that the
planet's largest Ponzi scheme is unraveling.The most troubling to me is the financial help that all but a few are or
were counting on might not be available.To add insult to injury, a revision to the Medicare improvement fund has
been made by striking $22,290,000,000.00 and inserting $0.00. Yes you read this
correctly, 22 billion is going somewhere, we are just not sure where.I strongly urge each and every person in this
country to ask their elected officials where these funds are disappearing
to.Remember, federal funding = tax
receipts = our money.
There seems to be great interest in the
health of the age group 55 to 64.Yep,
the baby boomers are about to retire!This will be the biggest influx of individuals into the Medicare market,
ever!If you think we have problems now;
hide and watch!The federal government,
you know, all of our elected officials, know that this system is about to come
crashing down around all of us and there is nothing that they can say or do to
keep this from happening.The concern
that the text in HR 3590 seems to portray about health and well-being of this
age group is ill-conceived.Our elected
officials are scared to death and they are hoping that we are not paying
attention.I for one am making a
concerted effort to educate myself so that I might be prepared for the onslaught
of the bad news that is coming.This
should not be construed as fear mongering or a doomsday thought process; just a
reality check.I happen to fall into
this age group and am quite concerned with all I see and think I understand.
A little further into HR 3590 I gleaned an
interesting section regarding federal workplace wellness requirements.It seems that there are certain federal work
establishments that are not subject to the same rules and regulations that the
rest of us are.It states, if I
understand it correctly, that an insurance provider that provides health
insurance coverage to certain federal establishments are not subject to the
same taxes, fees, penalties and interest as are the others.A logical assumption would be that these
insurance providers would not suffer from the same burden and therefore possess
the ability to offer a lower premium to their enrollees.And explanation of why I am wrong would be
greatly appreciated.
As a side note, but of particular interest to
me, is the fact that homeland security is mentioned in several locations of HR
3590.Remembering that I am a high
school dropout and I am not an attorney should not be reason to not question
this strange occurrence.Maybe it's just
me, but I cannot figure out why homeland security would be involved in any type
of health care bills.
I'd like to refer to section 1128G which begins
on page 1513.This section refers to
transparency reports and reporting of physician ownership and investment
interests.Please keep in mind that
receiving health care means that you need to see a doctor; period. We seem to
be short of doctors as it is and the following does not appear to being of any
assistance in keeping the ones we have. Let us corner the doctors and then dump
40 million new patients into their offices. If I were a doctor and had read
this bill, I would be quietly looking for another profession in this country or
looking at other countries. The intrusion into my personal and business life
would be so outrageous that there would be no choice.
I know it appears that I am jumping around a
bit, but that is the nature of HR 3590.This section starts out with, and I quote ”on March 31, 2013 and on the
90th day of each calendar year beginning thereafter, any applicable
manufacturer that provides a payment or other transfer of value to a covered
recipient or to an entity or individual at the request of or designated in
behalf of a covered recipient shall submit to the Secretary in such electronic
form as the Secretary shall require the following information with respect to
the preceding calendar year:
1 - The name of
the covered recipient
2 - The
business address of the covered recipient and, in the case of covered recipient
who is a physician, the specialty and national provider identifier of the
covered recipient
3 - The amount
of the payment or other transfer of value
4 - The dates
on which the payment or other transfer of value was provided to the covered
recipient
5 - A
description of the form of the payment or other transfer of value
as:
1 - Cash or
cash equivalent
2 - In-kind
items or services
3 - Stock, a
stock option, or any other ownership interest, dividend, profit, or other
return on investment
4 - Any other
form of payment or other transfer of value defined by the secretary
5 - A
description of the nature of the payment or other transfer of value
As in:
1 - Consulting fees
2 - Compensation for services other than
consulting
3 - Honoraria (whatever that is)
4 - Gift
5 - Entertainment
6 - Food
7 - Travel
8 - Education
9 - Research
10 - Charitable
contribution
11 - Royalty or
license
12 - Current or
prospective ownership or investment interest
13 - Direct
compensation for serving as faculty or as a speaker for a
14 - Medical
education program grant
15 - Or any
other nature of the payment or other transfer of value as defined by the
secretary
Do you still want to be a doctor? Is everyone
paying attention?This section is
referring to physicians.As I mentioned
earlier, if you are a physician, the Secretary and everyone else the Secretary
deems appropriate is about to know all about you, you have to send the
information and there are penalties for noncompliance.I have mentioned several times and I think it
bears repeating; know who your friends are!Every one that you conduct business with is required to report all
transactions to the Secretary that pertain to you.But all is not lost, the maximum penalty for
noncompliance for a purchasing organization that conducts business with you and
is found to be in noncompliance is only $150,000.00.All I can say is wow!The description of a covered recipient can be
found on page 1530 and reads as follows:
‘‘(6)
COVERED RECIPIENT.—
9 ‘‘(A) IN
GENERAL.—Except as provided in
10 subparagraph
(B), the term ‘covered recipient’
11 means the
following:
12 ‘‘(i) A
physician.
13 ‘‘(ii) A
teaching hospital.
I think I should touch on what the federal
government considers to be a health insurance policy that is too
expensive.We have all heard that there
will be a hefty fee, or tax, on health insurance plans that cost too much.If you're insurance plan is considered self
only coverage and it is reported to the Secretary that you paid more than
$8,500.00, there will be a fee imposed on that plan.If your plan is considered to be coverage
other than self only coverage and you pay more than $23,000.00 for this plan,
there will be a fee imposed on that plan.Now, it does not say if that plan might be your family plan.The fee imposed on either plan is staggering
and I cannot imagine a scenario in which an insurance provider would absorb
this extra cost and not pass it on to the enrollee in the form of higher
premiums.I know what you're thinking,
that seems a little expensive and I do not believe that my family plan costs
that much.Well, a second look at your
health insurance policies is in order.For a family of four, an expenditure of more than $479 per month, per
individual, will place you in the ”too expensive” category.Most decent insurance plans are just around
this cost.Don't believe me, go
look!Oh yeah, and if the Secretary
deems that your insurance provider is charging you too much, there is a fee for
that.
Buried inside HR 3590 is text pertaining to
our second amendment rights.Yes, our
right to own guns.I truly appreciate
our federal government reminding everyone that every American has the right to
own a gun.I just cannot figure out why
this type of rhetoric would be buried inside a health care Bill that is 2409
pages long? Or better yet, why it is there at all! After experiencing the
insanity of the last two years or so and a total disregard for the opinion of
the American populace, one would have to assume there to be a self seeking
purpose for this language.The list of
questions I am compiling for my meeting with Nancy Pelosi and Harry Reid is
growing exponentially!
HR 3590 is far reaching in an attempt to
squeeze financial assistance from the middle class for help in funding the cost
of health care.The middle class in
United States, in my opinion, are the only people that will experience real
fiscal burden when HR 3590 is fully implemented.Since no real pain has been felt yet there is
little concern that HR 3590 is a problem.I can assure you that the pain is coming and it is my opinion that the uninformed
are the ones that will be least prepared and scream the loudest!My suggestion to every American is to read
and understand HR 3590.If allowed to
mature unabated this bill will be an instrumental linchpin in the undoing of
this country.Please, do your homework,
ask a neighbor, talked to a friend, consult with your employer, asks an
attorney; this is important!
If, at the end of this short book, you do not
think that insurance premiums are going to rise, then please refer to this
letter that I received from my insurance company. This is not a small Mom and
Pop organization. I had to read this several times in order to digest what this
letter was trying to let me know. Actually, I consider this to be a warning and
the beginning of solid proof that this bill will not help reduce premiums;
premiums are going up. Please, do not let yourself be lulled into a coma with
the news you hear today, it is a lie.
‘‘SEC. 2711. NO LIFETIME OR
ANNUAL LIMITS.
3 ‘‘(a) IN GENERAL.—A group health plan and a health
4 insurance issuer offering group or
individual health insur5
ance coverage may not establish—
6 ‘‘(1) lifetime limits on the dollar value
of benefits
7 for any participant or beneficiary; or
8 ‘‘(2) unreasonable annual limits (within
the
9 meaning of section 223 of the Internal
Revenue Code
10 of 1986) on the dollar value of benefits
for any partic11
ipant or beneficiary.
12 ‘‘(b) PER BENEFICIARY LIMITS.—Subsection (a) shall
13 not be construed to prevent a group health
plan or health
14 insurance coverage that is not required to
provide essential
15 health benefits under section 1302(b) of
the Patient Protec16
tion and Affordable Care Act from placing
annual or life17
time per beneficiary limits on specific
covered benefits to
18 the extent that such limits are otherwise
permitted under
19 Federal or State law.
Where does it
state that an insurance company should not or will not or can’t raise premiums
between now and when this goes into effect; it doesn’t ! As with all other laws
passed lately, this is no different. Premiums are being raised as we read this.
As received from my insurance provider, if not grandfathered in, higher
premiums are on the way and their excuse; the health care legislation.
‘‘SEC. 2712.
PROHIBITION ON RESCISSIONS.
21 ‘‘A group health plan and a health insurance issuer
22 offering group or individual health insurance coverage shall
23 not rescind such plan or coverage with respect to an enrollee
24 once the enrollee is covered under such plan or coverage in25
volved, except that this
section shall not apply to a covered
26 individual who has performed an act or practice that con-
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1 stitutes fraud or makes an intentional misrepresentation of
2 material fact as prohibited by the terms of the plan or cov3
erage. Such plan or coverage
may not be cancelled except
4 with prior notice to the enrollee, and only as permitted
5 under section 2702(c) or 2742(b).
“Once
the enrollee is covered under such plan…” This mentions nothing about an
insurance provider being forced to accept an enrollee in the first place.
‘‘SEC. 2717.
ENSURING THE QUALITY OF CARE.
12 ‘‘(a) QUALITY REPORTING.—
13 ‘‘(1) IN GENERAL.—Not later than 2 years after
14 the date of enactment of the Patient Protection and
15 Affordable Care Act, the Secretary, in consultation
16 with experts in health care quality and stakeholders,
17 shall develop reporting requirements for use by a
18 group health plan, and a health insurance issuer of19
fering group or individual
health insurance coverage,
20 with respect to plan or coverage benefits and health
21 care provider reimbursement structures that—
22 ‘‘(A) improve health outcomes through the
23 implementation of activities such as quality re24
porting, effective case
management, care coordi25
nation, chronic disease
management, and medi-
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1 cation and care compliance initiatives, including
2 through the use of the medical homes model as
3 defined for purposes of section 3602 of the Pa4
tient Protection and
Affordable Care Act, for
5 treatment or services under the plan or coverage;
6 ‘‘(B) implement activities to prevent hos7
pital readmissions through a
comprehensive pro8
gram for hospital discharge
that includes pa9
tient-centered education and
counseling, com10
prehensive discharge planning,
and post dis11
charge reinforcement by an
appropriate health
12 care professional;
13 ‘‘(C) implement activities to improve pa14
tient safety and reduce
medical errors through
15 the appropriate use of best clinical practices, evi16
dence based medicine, and
health information
17 technology under the plan or coverage; and
18 ‘‘(D) implement wellness and health pro19
motion activities.
What
or who is a stakeholder? I am pretty sure I understand that one. So, the next
question would be “Why would a stakeholder be allowed to participate in this
exercise?” I think we’ve seen how “Stakeholders” conduct themselves in this and
most other markets.
‘‘SEC. 2718. BRINGING DOWN
THE COST OF HEALTH CARE
7 COVERAGE.
8 ‘‘(a) CLEAR ACCOUNTING FOR COSTS.—A health in9
surance issuer offering group or
individual health insur10
ance coverage shall, with respect to each
plan year, submit
11 to the Secretary a report concerning the
percentage of total
12 premium revenue that such coverage expends—
13 ‘‘(1) on reimbursement for clinical
services pro14
vided to enrollees under such coverage;
15 ‘‘(2) for activities that improve health
care qual16
ity; and
17 ‘‘(3) on all other non-claims costs,
including an
18 explanation of the nature of such costs,
and excluding
19 State taxes and licensing or regulatory
fees.
And
the cover up begins. I wonder if the insurance companies will have to report
all those conferences that they “have” to attend in Hawaii, Costa Rica, etc.?
Wait a minute, who’s paying for those? It seems to me that the insurance
companies have really good connections in the White House. Everyone has to be
covered, but no mention of rate regulation. All this “reporting” will cost
untold amounts of revenue. The accelerated cost will be passed down to the end
user; that is the way it works.
‘‘(1) REQUIREMENT TO PROVIDE VALUE
FOR
2 PREMIUM PAYMENTS.—A
health insurance issuer of3
fering group or individual health insurance coverage
4 shall, with respect to each plan year, provide an an5
nual rebate to each enrollee under such coverage, on
6 a pro rata basis, in an amount that is equal to the
7 amount by which premium revenue expended by the
8 issuer on activities described in subsection (a)(3) ex9
ceeds—
10 ‘‘(A) with respect to a health insurance
11 issuer offering coverage in the group market, 20
12 percent, or such lower percentage as a State may
13 by regulation determine; or
14 ‘‘(B) with respect to a health insurance
15 issuer offering coverage in the individual market,
16 25 percent, or such lower percentage as a State
17 may by regulation determine, except that such
18 percentage shall be adjusted to the extent the Sec19
retary determines that the application of such
20 percentage with a State may destabilize the ex21
isting individual market in such State.
22 ‘‘(2) CONSIDERATION IN SETTING
PERCENT23
AGES.—In determining the
percentages under para24
graph (1), a State shall seek to ensure adequate par25
ticipation by health insurance issuers, competition in
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1 the health insurance market in the State, and value
2 for consumers so that premiums are used for clinical
3 services and quality improvements.
4 ‘‘(3) TERMINATION.—The provisions of this sub5
section shall have no force or effect after December 31,
6 2013.
To
me, this reads like I will be receiving a bonus check from my insurance
company. The annual rebate they speak of will be included in your premium; I
guarantee it! I do not see that any state will have the political clout to wage
a value war against any insurance company; this is ludicrous! Wait a minute, The provisions of this sub5
section shall have no force or effect after December 31,
6 2013.
‘‘SEC. 2794.
ENSURING THAT CONSUMERS GET VALUE FOR
18 THEIR DOLLARS.
19 ‘‘(a) INITIAL PREMIUM REVIEW PROCESS.—
20 ‘‘(1) IN GENERAL.—The Secretary, in conjunc21
tion with States, shall
establish a process for the an22
nual review, beginning with
the 2010 plan year and
23 subject to subsection (b)(2)(A), of unreasonable in24
creases in premiums for health
insurance coverage.
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1 ‘‘(2) JUSTIFICATION AND DISCLOSURE.—The
2 process established under paragraph (1) shall require
3 health insurance issuers to submit to the Secretary
4 and the relevant State a justification for an unrea5
sonable premium increase prior
to the implementa6
tion of the increase. Such
issuers shall prominently
7 post such information on their Internet websites. The
8 Secretary shall ensure the public disclosure of infor9
mation on such increases and
justifications for all
10 health insurance issuers.
So,
the Secretary is the all knowing person who will be deciding what our insurance
premiums will be. I wonder how many lobbyists are following the Secretary
around? I do not believe that any government employee that is covered by an
insurance policy, paid for by the government, has a clue as to what an
affordable premium could possibly be. They do not have to pay for it and
everything is covered.
‘‘(2) MONITORING BY SECRETARY OF
PREMIUM
2 INCREASES.—
3 ‘‘(A) IN GENERAL.—Beginning with plan
4 years beginning in 2014, the Secretary, in con5
junction with the States and consistent with the
6 provisions of subsection (a)(2), shall monitor
7 premium increases of health insurance coverage
8 offered through an Exchange and outside of an
9 Exchange.
10 ‘‘(B) CONSIDERATION IN OPENING EX11
CHANGE.—In
determining under section
12 1312(f)(2)(B) of the Patient Protection and Af13
fordable Care Act whether to offer qualified
14 health plans in the large group market through
15 an Exchange, the State shall take into account
16 any excess of premium growth outside of the Ex17
change as compared to the rate of such growth
18 inside the Exchange.
19 ‘‘(c) GRANTS IN SUPPORT OF PROCESS.—
20 ‘‘(1) PREMIUM REVIEW GRANTS DURING
2010
21 THROUGH 2014.—The
Secretary shall carry out a pro22
gram to award grants to States during the 5-year pe23
riod beginning with fiscal year 2010 to assist such
24 States in carrying out subsection (a), including—
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1 ‘‘(A) in reviewing and, if appropriate under
2 State law, approving premium increases for
3 health insurance coverage; and
4 ‘‘(B) in providing information and rec5
ommendations to the Secretary under subsection
It
is the Secretary who will be deciding what our premiums will be! It would be
interesting to glean full disclosure of what insurance program she is covered
by and what she pays in monthly premiums. If she is going to mandate all this,
then we have a right to know.
SEC. 1101. IMMEDIATE
ACCESS TO INSURANCE FOR UNIN4
SURED INDIVIDUALS
WITH A PREEXISTING
5 CONDITION.
6 (a) IN GENERAL.—Not later than 90 days after
the
7 date of enactment of this Act, the Secretary shall establish
8 a temporary high risk health insurance pool program to
9 provide health insurance coverage for eligible individuals
10 during the period beginning on the date on which such pro11
gram is established and ending
on January 1, 2014.
12 (b) ADMINISTRATION.—
13 (1) IN GENERAL.—The Secretary may carry out
14 the program under this section directly or through
15 contracts to eligible entities.
16 (2) ELIGIBLE ENTITIES.—To be eligible for a
17 contract under paragraph (1), an entity shall—
18 (A) be a State or nonprofit private entity;
19 (B) submit to the Secretary an application
20 at such time, in such manner, and containing
21 such information as the Secretary may require;
22 and
23 (C) agree to utilize contract funding to es24
tablish and administer a
qualified high risk pool
25 for eligible individuals.
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1 (3) MAINTENANCE OF EFFORT.—To be eligible to
2 enter into a contract with the Secretary under this
3 subsection, a State shall agree not to reduce the an4
nual amount the State expended
for the operation of
5 one or more State high risk pools during the year pre6
ceding the year in which such
contract is entered into.
7 (c) QUALIFIED HIGH RISK
POOL.—
8 (1) IN GENERAL.—Amounts made available
9 under this section shall be used to establish a quali10
fied high risk pool that meets
the requirements of
11 paragraph (2).
12 (2) REQUIREMENTS.—A qualified high risk pool
13 meets the requirements of this paragraph if such
14 pool—
15 (A) provides to all eligible individuals
16 health insurance coverage that does not impose
17 any preexisting condition exclusion with respect
18 to such coverage;
19 (B) provides health insurance coverage—
20 (i) in which the issuer’s share of the
21 total allowed costs of benefits provided
22 under such coverage is not less than 65 per23
cent of such costs; and
24 (ii) that has an out of pocket limit not
25 greater than the applicable amount de-
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1 scribed in section 223(c)(2) of the Internal
2 Revenue Code of 1986 for the year involved,
3 except that the Secretary may modify such
4 limit if necessary to ensure the pool meets
5 the actuarial value limit under clause (i);
6 (C) ensures that with respect to the pre7
mium rate charged for health
insurance coverage
8 offered to eligible individuals through the high
9 risk pool, such rate shall—
10 (i) except as provided in clause (ii),
11 vary only as provided for under section
12 2701 of the Public Health Service Act (as
13 amended by this Act and notwithstanding
14 the date on which such amendments take ef15
fect);
16 (ii) vary on the basis of age by a factor
17 of not greater than 4 to 1; and
18 (iii) be established at a standard rate
19 for a standard population; and
20 (D) meets any other requirements deter21
mined appropriate by the
Secretary.
22 (d) ELIGIBLE INDIVIDUAL.—An individual shall be
23 deemed to be an eligible individual for purposes of this sec24
tion if such individual—
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1 (1) is a citizen or national of the United States
2 or is lawfully present in the United States (as deter3
mined in accordance with
section 1411);
4 (2) has not been covered under creditable cov5
erage (as defined in section
2701(c)(1) of the Public
6 Health Service Act as in effect on the date of enact7
ment of this Act) during the
6-month period prior to
8 the date on which such individual is applying for
9 coverage through the high risk pool; and
10 (3) has a pre-existing condition, as determined
11 in a manner consistent with guidance issued by the
12 Secretary.
If
I read this correctly, there is no mention of what my premium will be, and yes,
I have a pre-existing condition. Also, it seems that this set of rules ends
January 1, 2014. What happens after that? Every insurance agent I have spoken
with has told me that if, for some strange reason, I could find a policy that
would cover me even with exclusions, it will be extremely expensive.
(3) TERMINATION OF AUTHORITY.—
8 (A) IN GENERAL.—Except as provided in
9 subparagraph (B), coverage of eligible individ10
uals under a high risk pool in a State shall ter11
minate on January 1, 2014.
12 (B) TRANSITION TO EXCHANGE.—The Sec13
retary shall develop procedures to provide for the
14 transition of eligible individuals enrolled in
15 health insurance coverage offered through a high
16 risk pool established under this section into
17 qualified health plans offered through an Ex18
change. Such procedures shall ensure that there
19 is no lapse in coverage with respect to the indi20
vidual and may extend coverage after the termi21
nation of the risk pool involved, if the Secretary
22 determines necessary to avoid such a lapse.
23 (4) LIMITATIONS.—The Secretary has the au24
thority to stop taking applications for participation
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1 in the program under this section to comply with the
2 funding limitation provided for in paragraph (1).
Yep,
there it is in black and white. The Secretary deems the number of enrollees in
the government “High Risk Pool” and this pool coverage plan does not have to
accept me. What happens if I am not accepted? It doesn’t really explain that!
The way I read this bill so far, if I’m not covered, I get fined; even if no
coverage is made available to me at any cost. Transition into an eligible plan
offered by private insurance company is all smoke. I have not spoken with a
single insurance company that will accept me; period. This is written in a way
that would lead someone to think that the government will be forcing insurance
providers to accept high risk enrollees at a normal rate. Common sense would
tell you that this will never happen.
‘‘(i) ELIGIBILITY FOR A HEALTH PLAN
20 AND HEALTH CLAIM STATUS.—The
set of
21 operating rules for eligibility for a health
22 plan and health claim status transactions
23 shall be adopted not later than July 1,
24 2011, in a manner ensuring that such oper25
ating rules are effective not later than Jan-
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1 uary 1, 2013, and may allow for the use of
2 a machine readable identification card.
3 ‘‘(ii) ELECTRONIC FUNDS TRANSFERS
4 AND HEALTH CARE PAYMENT AND REMIT5
TANCE ADVICE.—The
set of operating rules
6 for electronic funds transfers and health
7 care payment and remittance advice trans8
actions shall—
9 ‘‘(I) allow for automated rec10
onciliation of the electronic payment
11 with the remittance advice; and
12 ‘‘(II) be adopted not later than
13 July 1, 2012, in a manner ensuring
14 that such operating rules are effective
15 not later than January 1, 2014.
I
am going to cordially invite anyone to explain, to me, what this section is
means. Electronic funds transfer and a National health I.D. Card? It is my
belief that this section will be taken way too far and exploitation should be
expected. This text is very disturbing as I do not like the idea of automatic
payments to any entity, much less the federal government.
(2)
ELECTRONIC FUNDS TRANSFER.—The
Sec6
retary
shall promulgate a final rule to establish a
7 standard for
electronic funds transfers (as described
8 in section
1173(a)(2)(J) of the Social Security Act, as
9 added by
subsection (b)(2)(A)). The Secretary may do
10 so on an
interim final basis and shall adopt such
11 standard not
later than January 1, 2012, in a man12
ner
ensuring that such standard is effective not later
13 than January 1,
2014.
More
concerning the “Electronic Funds Transfer” ! Everyone needs to pay attention.
This may not seem like an issue now, but it will be. I don’t know of one person
I have ever met that would cherish the idea of the government tapping their
checking account automatically for something the government forced upon them in
the first place. If given enough time, an auto pay system will be implemented
and that payment, fine, interest or penalty will be deducted from your personal
account “Electronically”. What happens if you don’t have the funds at the time
of deduction? Will the government cover all the NSF charges they created?
1 (d) EXPANSION
OF ELECTRONIC TRANSACTIONS
IN
2 MEDICARE.—Section 1862(a) of the Social Security
Act (42
3 U.S.C. 1395y(a)) is amended—
4 (1) in paragraph (23), by striking the ‘‘or’’
at
5 the end;
6 (2) in paragraph (24), by striking the
period
7 and inserting ‘‘; or’’; and
8 (3) by inserting after paragraph (24) the
fol9
lowing new paragraph:
10 ‘‘(25) not later than January 1, 2014, for
which
11 the payment is other than by electronic
funds transfer
12 (EFT) or an electronic remittance in a
form as speci13
fied in ASC X12 835 Health Care Payment
and Re14
mittance Advice or subsequent standard.’’.
Weird,
there it is again…….This is beginning to make me feel very uncomfortable.
‘‘SEC. 2701. FAIR
HEALTH INSURANCE PREMIUMS.
22 ‘‘(a) PROHIBITING DISCRIMINATORY PREMIUM
23 RATES.—
24 ‘‘(1) IN GENERAL.—With respect to the premium
25 rate charged by a health insurance issuer for health
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1 insurance coverage offered in the individual or small
2 group market—
3 ‘‘(A) such rate shall vary with respect to the
4 particular plan or coverage involved only by—
5 ‘‘(i) whether such plan or coverage cov6
ers an individual or family;
7 ‘‘(ii) rating area, as established in ac8
cordance with paragraph (2);
9 ‘‘(iii) age, except that such rate shall
10 not vary by more than 3 to 1 for adults
11 (consistent with section 2707(c)); and
12 ‘‘(iv) tobacco use, except that such rate
13 shall not vary by more than 1.5 to 1; and
14 ‘‘(B) such rate shall not vary with respect
15 to the particular plan or coverage involved by
16 any other factor not described in subparagraph
17 (A)
Now
I get it! This must be where it is mandated by law that I should receive a fair
and just insurance premium value. I feel better; not! Why would anyone believe
that the insurance companies would not find a good reason the raise premiums to
cover this (pass the extra cost down to the end user). Refer to the letter I
received from my insurance company. Premiums are going up!
‘‘SEC. 2705.
PROHIBITING DISCRIMINATION AGAINST INDI8
VIDUAL
PARTICIPANTS AND BENEFICIARIES
9 BASED ON HEALTH
STATUS.
10 ‘‘(a) IN GENERAL.—A group health plan and a
health
11 insurance issuer offering group or individual health insur12
ance coverage may not
establish rules for eligibility (includ13
ing continued eligibility) of
any individual to enroll under
14 the terms of the plan or coverage based on any of the fol15
lowing health status-related
factors in relation to the indi16
vidual or a dependent of the
individual:
17 ‘‘(1) Health status.
18 ‘‘(2) Medical condition (including both physical
19 and mental illnesses).
20 ‘‘(3) Claims experience.
21 ‘‘(4) Receipt of health care.
22 ‘‘(5) Medical history.
23 ‘‘(6) Genetic information.
24 ‘‘(7) Evidence of insurability (including condi25
tions arising out of acts of
domestic violence).
26 ‘‘(8) Disability.
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1 ‘‘(9) Any other health status-related factor deter2
mined appropriate by the
Secretary.
This
is awesome…..except it still hasn’t mentioned how the Secretary plans to hold
my premium down to a level I can afford or if I can get coverage at all. If I
read this correctly, everyone gets coverage, but at what cost? Who do they
think they are kidding? A forced acceptance of an enrollee will lead to much
higher premiums; at least for those fortunate individuals who actually pay for
their own insurance. Someone will have to make up the difference and it will
not be the people who receive free health care!
SEC. 1302.
ESSENTIAL HEALTH BENEFITS REQUIREMENTS.
18 (a) ESSENTIAL HEALTH BENEFITS PACKAGE.—In
19 this title, the term ‘‘essential health benefits package’’
20 means, with respect to any health plan, coverage that—
21 (1) provides for the essential health benefits de22
fined by the Secretary under
subsection (b);
23 (2) limits cost-sharing for such coverage in ac24
cordance with subsection (c);
and
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1 (3) subject to subsection (e), provides either the
2 bronze, silver, gold, or platinum level of coverage de3
scribed in subsection (d).
4 (b) ESSENTIAL HEALTH BENEFITS.—
5 (1) IN GENERAL.—Subject to paragraph (2), the
6 Secretary shall define the essential health benefits, ex7
cept that such benefits shall
include at least the fol8
lowing general categories and
the items and services
9 covered within the categories:
10 (A) Ambulatory patient services.
11 (B) Emergency services.
12 (C) Hospitalization.
13 (D) Maternity and newborn care.
14 (E) Mental health and substance use dis15
order services, including
behavioral health treat16
