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Public option IS in the House Reconciliation Bill

ObamaCare 2010 Public Option

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#21 Balderdash

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Posted 18 March 2010 - 07:40 PM

View PostBad Wolf, on Mar 18 2010, 04:58 PM, said:

Baldy if you or anyone can point me to any specific language that imposes immediate restrictions on an insurer's ability to deny coverage based on a pre-existing condition (regardless of the economic circumstances of the applicant) I'd appreciate it.  It's not in the link you provided.


I'm pretty sure that Palisade found it.  That same area of the bill talks about a Health Insurance Exchange too.  I'm hoping that we haven't lost the damned public option again, hopefully they're just calling it something else.

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#22 Bad Wolf

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Posted 18 March 2010 - 07:41 PM

Wow.

I even SPEAK gobbledy gook and I can't make heads or tails of it.  I mean if I wanted to spend several hours with several different books looking up and cross referencing the multiple statutes reference there I might be able to determine if it actually does what I want it to do.

Maybe I'll try and tackle that tomorrow but I'll say that that doesn't inspire any confidence in me.
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#23 Bad Wolf

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Posted 18 March 2010 - 07:45 PM

One of the problems is that the Public Health Services act has been amended an RE NUMBERED so that the numbers in the proposed health care bill don't correspond with the Public Health Services Act which is idiotic and VERY typical of legislators trying to pass something off as something it really isn't.

Am I the only one around here who sees a problem?
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#24 Bad Wolf

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Posted 18 March 2010 - 07:47 PM

And you know me, the idea of relying on blogs (right or left wing) doesn't sit well at ALL.  But this one has a very nice analysis.

http://justifiedrigh...conditions.html
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#25 Palisades

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Posted 18 March 2010 - 08:23 PM

Personally, I find the better blogs, at least for financial stuff, to do a deeper and more honest analysis than the mainstream media.
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#26 Palisades

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Posted 18 March 2010 - 08:33 PM

View PostBad Wolf, on Mar 18 2010, 06:47 PM, said:

And you know me, the idea of relying on blogs (right or left wing) doesn't sit well at ALL.  But this one has a very nice analysis.

http://justifiedrigh...conditions.html

If that's a correct analysis, then wow, just wow.

From the conclusion:

Quote

I think it’s just a huge typographical error, so the only thing we can do is ignore section 701 and get back to paragraph 2 of Section 2702, which we were discussing above.

I know all of this is confusing, but let your trusty tour guide tell you where you stand:

Paragraph two in Part A does several things.

First, Paragrph two in Part A says that the prohibition against pre-existing condition exclusions DOES NOT APPLY to benefits offered in the policy in the "coverages" section, which means when the policy is written, pre-existing condition exclusions will be allowed to be written into the the sections defining coverage.  In short, insurers will still be allowed to exclude pre-existing conditions from coverage.

Second, paragraph two also says in Part A that policy writers for the government will be allowed to make the insurance you buy cover certain ailments, and not cover others (one of which may be a condition you happen to have, which is pre-existing).

What paragraph two says in Part B is that policy writers for the government will be allowed to limit the amount, level, extent, or nature of the treatment you get for certain ailments (one of which may be your pre-existing condition).

So who will be writing your insurance policy?  According to the President’s plan, a new bureaucracy known as the “Health Benefits Advisory Committee.”  It will be made up of 27 people, and guess how many have to be a treating doctor:  One.

So if you believe President Obama’s quote to the AMA means that if you sign up for government insurance your pre-existing condition will automatically be covered, - you’re wrong, and so is the President.  You’d better read the fine print on whether the gang of 26 bureaucrats plus one doctor is going to cover your pre-existing condition or not.  President Obama is giving them the power to not cover you.

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#27 Dev F

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Posted 18 March 2010 - 09:43 PM

View PostPalisade, on Mar 18 2010, 08:33 PM, said:

If that's a correct analysis, then wow, just wow.
It's hard for me to tell, because this kind of legalese is always baffling, but I don't think the analysis is correct.

The point of the cross-references is to provide the definition of the various terms being used: "pre-existing condition," "health status related factors," etc. So the blogger is right that you have to dig up the appropriate passage in the code and locate the definition to make sense of the new language. The problem is that he's not just pulling the definitions specified in the cross-references; he's trying to incorporate all of the text of the referenced passage, which is just making a muddle of things that are actually much simpler.

For instance, he finds the cross-cross-reference "The term 'health status-related factor' means any of the factors described in section 2702(a)(1)." To me, that suggests that you just have to look at whatever factors are listed and that particular section and ignore the rest of the text. And sure enough, there's a clearly labeled list of "factors" right in the middle:
". . . 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).
© 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."

But the blogger decides, for some reason, that's he's got to parse all the rest of the text of the section too -- even though it's part of a completely different law about health insurance discrimination, and even though the reference didn't tell him to. So he assumes that all the stuff about enrollment and exclusion applies to the new law, when I see no reason to assume that it does. That's just the way the old law happens to use the "factors described in section 2702(a)(1)"; it doesn't affect what those factors are. And what those factors are is the only thing the new law is concerned about.

Edited by Dev F, 18 March 2010 - 09:46 PM.


#28 Bad Wolf

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Posted 18 March 2010 - 10:07 PM

No the bill itself refers to that other law so I think the text DOES have to be taken as a part of the analysis.  It's a regular method lawmakers use to obfuscate.
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#29 Dev F

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Posted 18 March 2010 - 10:10 PM

View PostBad Wolf, on Mar 18 2010, 10:07 PM, said:

No the bill itself refers to that other law so I think the text DOES have to be taken as a part of the analysis.
That's my point -- the part of the law the bill refers to has to be taken into account, but not the whole thing. If the reference tells you to consult a particular element of a particular section, it doesn't make sense to assume that you have to take into account everything else in that section as well.

#30 Banapis

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Posted 18 March 2010 - 10:27 PM

View PostDev F, on Mar 18 2010, 10:43 PM, said:

But the blogger decides, for some reason, that's he's got to parse all the rest of the text of the section too -- even though it's part of a completely different law about health insurance discrimination, and even though the reference didn't tell him to. So he assumes that all the stuff about enrollment and exclusion applies to the new law, when I see no reason to assume that it does. That's just the way the old law happens to use the "factors described in section 2702(a)(1)"; it doesn't affect what those factors are. And what those factors are is the only thing the new law is concerned about.
I agree with your critique of the reasoning presented in that blog post.  The blogger represents that Sec. 2791(d)(9) of the PHSA specifies:

Quote

The term ‘‘health status-related factor’’ means any of the factors described in section 2702(a)(1).
If so, it would appear that the definition of the term only means "any of the factors" in Sec. 2702(a)(1).  That would signal to me that you can disregard everything else in Sec. 2702(a)(1) except the identified factors.   However, the blogger proceeds to analyze language in 2702(a)(1) that is in addition to the listed factors.

By discussing the rest of what is in Sec. 2702(a)(1) of the PHSA, and the "subject to paragraph (2)" loophole, he seems to be helping make the case for why the present system is broken and why we need new legislation.

Then again, that's just our reading of the proposed reform based on the information presented at that blog.  There could be other considerations that we simply don't know about from reading that post.  Lil is undoubtedly correct that it would have been a lot more clear to everyone if it would have avoided cross-referencing a completely different statute.  If the factors were directly listed it would go along way to avoid any confusion and posts like the one at that blog slogging through the statutes and trying to sort it out.  

Banapis

Edited by Banapis, 18 March 2010 - 11:52 PM.


#31 Bad Wolf

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Posted 19 March 2010 - 12:06 AM

View PostDev F, on Mar 18 2010, 08:10 PM, said:

View PostBad Wolf, on Mar 18 2010, 10:07 PM, said:

No the bill itself refers to that other law so I think the text DOES have to be taken as a part of the analysis.
That's my point -- the part of the law the bill refers to has to be taken into account, but not the whole thing. If the reference tells you to consult a particular element of a particular section, it doesn't make sense to assume that you have to take into account everything else in that section as well.

Unless the part they refer you to ITSELF refers to something else to be taken into consideration.
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#32 Captain Jack

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Posted 19 March 2010 - 12:21 AM

This bill is insanely over-complicated, and there is more fat in it than in a fast food menu.  All the grants and financial aid to college students should be in a seperate bill.  The amount of money needed to fund all the added clinics, grants, and aid will be immense.  The government will determine the quality of health care you'll be getting.  Just in ONE section alone, this is what it will cost:

Quote

...for carrying out subtitle D (Prevention and Wellness Research)—
‘‘(A) for fiscal year 2010, $100,000,000; ‘‘(B) for fiscal year 2011, $150,000,000; ‘‘© for fiscal year 2012, $200,000,000; ‘‘(D) for fiscal year 2013, $250,000,000; ‘‘(E) for fiscal year 2014, $300,000,000; ‘‘(F) for fiscal year 2015, $315,000,000; ‘‘(G) for fiscal year 2016, $331,000,000; ‘‘(H) for fiscal year 2017, $347,000,000; ‘‘(I) for fiscal year 2018, $364,000,000;
and
‘‘(J) for fiscal year 2019, $383,000,000. ‘‘(3) for carrying out subtitle E (Delivery of
Community Preventive and Wellness Services)— ‘‘(A) for fiscal year 2010, $1,100,000,000; ‘‘(B) for fiscal year 2011, $1,300,000,000; ‘‘© for fiscal year 2012, $1,400,000,000; ‘‘(D) for fiscal year 2013, $1,600,000,000; ‘‘(E) for fiscal year 2014, $1,700,000,000; ‘‘(F) for fiscal year 2015, $1,800,000,000; ‘‘(G) for fiscal year 2016, $1,900,000,000;
•J. 55–345
1 2 3 4 5 6 7 8 9
10 11 12 13 14 15 16 17 18 19 20 21 22 23
1989 ‘‘(H) for fiscal year 2017, $2,000,000,000; ‘‘(I) for fiscal year 2018, $2,100,000,000;
and
‘‘(J) for fiscal year 2019, $2,300,000,000. ‘‘(4) for carrying out section 3161 (Core Public Health Infrastructure and Activities for State and
Local Health Departments)— ‘‘(A) for fiscal year 2010, $800,000,000; ‘‘(B) for fiscal year 2011, $1,000,000,000; ‘‘© for fiscal year 2012, $1,100,000,000; ‘‘(D) for fiscal year 2013, $1,200,000,000; ‘‘(E) for fiscal year 2014, $1,300,000,000; ‘‘(F) for fiscal year 2015, $1,400,000,000; ‘‘(G) for fiscal year 2016, $1,500,000,000; ‘‘(H) for fiscal year 2017, $1,600,000,000; ‘‘(I) for fiscal year 2018, $1,800,000,000;
and
and
‘‘(J) for fiscal year 2019, $1,900,000,000;
‘‘(5) for carrying out section 3162 (Core Public Health Infrastructure and Activities for CDC), $400,000,000 for each of fiscal years 2010 through 2019.

Sorry, but we don't have that kind of $$$.  And this is just the tip of the iceberg in this bill.  This is just in prevention and wellness.  And there is an even bigger dollar amount in another section that dwarfs the figures above.  I've only skimmed through about 50 pages of the bill, and I can already see Big Brother spending way more than we can afford for this monster, and there are over 2,000 pages still to go through.  The Government wants to run and essentially own health care.  Sorry, but that bothers me.  And I have yet to find anywhere that demonstrates Health Care being more affordable.  This is all going to come out of our pockets.  It frightens me to see anyone even consider wanting this thing.  It's a disastter waiting to happen.  Keep it simple, and keep it free market.
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#33 Spectacles

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Posted 19 March 2010 - 06:15 AM

Sorry, Baldy. No public option. The Senate and White House didn't back one--too threatening to insurers and PhRMA.

And regarding pre-existing conditions, supposedly they cannot be used to deny new policies for children immediately, and for everyone by 2014. BUT there is supposed to be the immediate formation of a "high-risk pool" to provide coverage to adults who are presently uninsured because of pre-existing conditions.

http://www.huffingto...c_n_505128.html
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#34 Balderdash

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Posted 19 March 2010 - 07:08 AM

View PostSpectacles, on Mar 19 2010, 04:15 AM, said:

Sorry, Baldy. No public option. The Senate and White House didn't back one--too threatening to insurers and PhRMA.

And regarding pre-existing conditions, supposedly they cannot be used to deny new policies for children immediately, and for everyone by 2014. BUT there is supposed to be the immediate formation of a "high-risk pool" to provide coverage to adults who are presently uninsured because of pre-existing conditions.

http://www.huffingto...c_n_505128.html


That sucks about a public option.  The OMB is still saying that this bill will help pay down the deficit.

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#35 obsidianstorm13

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Posted 19 March 2010 - 08:37 AM

GRRRRR no public option.  Well, maybe in a few years.

And CJ I completely agree:  put it in plain ol' English so everyone can read it.

#36 Vapor Trails

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Posted 19 March 2010 - 10:20 AM

View Postobisidianstorm13, on Mar 19 2010, 08:37 AM, said:

GRRRRR no public option.  Well, maybe in a few years.

And CJ I completely agree:  put it in plain ol' English so everyone can read it.

Put it in plain English?? No-no-no-no-no!! People need to be kept confused-we don't want them analyzing and thinking for themselves. The more obfuscation, the better!! :p  :rolleyes:

Sarcasm aside-I'm not optimistic AT ALL. TOO many of these politicians (BOTH Dems and Republicans) have been bought off by special interests. These people are just gonna keep stringing us along with promises and distractions.

WHEN AND IF something is finalized, we'll see.  :suspect: And maybe, not even then.  :suspect:
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#37 Bad Wolf

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Posted 19 March 2010 - 10:26 AM

View PostSpectacles, on Mar 19 2010, 04:15 AM, said:

Sorry, Baldy. No public option. The Senate and White House didn't back one--too threatening to insurers and PhRMA.

And regarding pre-existing conditions, supposedly they cannot be used to deny new policies for children immediately, and for everyone by 2014. BUT there is supposed to be the immediate formation of a "high-risk pool" to provide coverage to adults who are presently uninsured because of pre-existing conditions.

http://www.huffingto...c_n_505128.html

High risk.

Great, so if I CONTRACT breast cancer maybe I'll get help but the mammogram that might help with early detection is out of the question.

Whatever.

My angst isn't directed at anyone here Specs it's just my frustration about the whole damned thing.
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#38 Vapor Trails

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Posted 19 March 2010 - 10:28 AM

View PostBad Wolf, on Mar 19 2010, 10:26 AM, said:

My angst isn't directed at anyone here Specs it's just my frustration about the whole damned thing.

I rest my case.

:headshake:
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#39 Vapor Trails

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Posted 19 March 2010 - 10:32 AM

View PostBad Wolf, on Mar 19 2010, 10:26 AM, said:

Great, so if I CONTRACT breast cancer maybe I'll get help but the mammogram that might help with early detection is out of the question.

Well, they have to thin the herd somehow.

And I'm not joking. I'm BRUTALLY serious. I've NEVER been more serious about that. I'd bet my life that there's a sizable number of folks out there who WANT those with pre-existing conditions to drop dead. It's the 10,000-pound gorilla no one wants to talk about. The sooner these folks die, the more money insurance companies can pocket.

Edited by Analog Kid, 19 March 2010 - 10:36 AM.

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#40 Spectacles

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Posted 19 March 2010 - 04:13 PM

Lil, as I understand it, if you currently are uninsured because you're repeatedly turned down because of a pre-existing condition, then you'll be eligible for coverage through the high-risk pool, which will be put into effect soon. That's all the "high-risk pool" means--that you're currently considered a high risk to insurers because of a pre-existing condition.

This is one of the things I actually like about this bill--as disappointing as it is for people like me who really prefer a single-payer health care plan. (I think I'm getting more "progressive" the older and more pissed off I get.)

I'm disappointed, but there are some good consumer protections in this bill--as long as the fine print doesn't provide loopholes for insurers. Frankly, given the wheeling and dealing, it's hard to imagine that there aren't loopholes for insurers. But we shall see. If the bill's consumer-protections fall apart when it hits the road, then there will be hell to pay. At this point, we just have to hope for the best and keep a skeptical eye on the provisions as they pass from theory to reality.

But it does look like there is some hope for you if the reason you don't have insurance is that you have a pre-existing condition that makes insurers balk at insuring you. So, as I say, we'll hope for the best.

The expansion of Medicaid will help a lot of struggling people right now, too, especially folks who have been hit hard by the recession and are underemployed without insurance. As disappointed as I am by the lack of a public option, I have to support the passage of this bill because it really does help a number of people to have insurance.
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