Saturday, August 8, 2009

HR 3200, Section 102 (Part Deaux)

HR 3200: Section 102 (continued)

“(c) Limitation on Individual Health Insurance Coverage-
(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.
(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage.”

Translation:
1. You will not be able to get private insurance ever again after “the first day” on which this bill becomes law and goes into effect. The only insurance you will be allowed by your government to get will be the “Exchange-participating health benefit plan” – their code-word term for “The Public Option”, which is socialized medicine.
2. You will be permitted by your government (doesn’t that sound a little odd to anyone else?) to continue to have “excepted benefits”. What are “excepted benefits”? Well, for that, you have to go to yet another enormous Congressional document, the 1200+page Public Health Service Act, and look for Section 2791(c). Don’t worry. I’ve done this for you.

Public Health Service Act, Section 2791
(c) EXCEPTED BENEFITS.—For purposes of this title, the term ‘‘excepted benefits’’ means benefits under one or more (or any combination thereof) of the following:

(1) BENEFITS NOT SUBJECT TO REQUIREMENTS.—
(A) Coverage only for accident, or disability income insurance, or any combination thereof.
(B) Coverage issued as a supplement to liability insurance.
(C) Liability insurance, including general liability insurance and automobile liability insurance.
(D) Workers’ compensation or similar insurance.
(E) Automobile medical payment insurance.
(F) Credit-only insurance.
(G) Coverage for on-site medical clinics.
(H) Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.

(2) BENEFITS NOT SUBJECT TO REQUIREMENTS IF OFFERED SEPARATELY.—
(A) Limited scope dental or vision benefits.
(B) Benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof.
(C) Such other similar, limited benefits as are specified in regulations.

(3) BENEFITS NOT SUBJECT TO REQUIREMENTS IF OFFERED AS INDEPENDENT, NONCOORDINATED BENEFITS.—
(A) Coverage only for a specified disease or illness.
(B) Hospital indemnity or other fixed indemnity insurance.

(4) BENEFITS NOT SUBJECT TO REQUIREMENTS IF OFFERED AS SEPARATE INSURANCE POLICY.—Medicare supplemental health insurance (as defined under section 1882(g)(1) of the Social Security Act), coverage supplemental to the coverage provided under chapter 55 of title 10, United States Code, and similar supplemental coverage provided to coverage under a group health plan."

Okay. So what does this mean exactly? Let’s go back to the text of the bill…

The so-called “Public Option” will not include “excepted benefits”. So under your new government health insurance, you will not have any of the following benefits, and will have to buy them on your own or just not have them:
1. Dental
2. Vision
3. Accident or disability
4. Liability coverage
5. Workers’ compensation
6. Insurance for injuries sustained in automobile accidents
7. Long-term care
8. Nursing home care
9. Home health care

How does the Public Option sound so far to you? To me, it sounds like pretty lousy coverage. I mean, seriously. No dental? No vision? No long-term care, nursing home care, or home health care? Most private insurance includes stuff like this.

1 comment:

jennifer said...

Instead of listening to us about the government take-over, O'bama derides us, and it feels like he's yelling at me. Why does he have to demand what he knows is "radical reformation" at a time when we're ecomonomically sensitive? It isn't fair to insist that we do this without hardly even thinking about it. I'm already happy with my healthcare, and don't want his ideas treading on my God-given free will. If O'bama is trying to be this controlling now, what will happen if and when they have even more power very soon?