by LAS
The official language from Section 1312 of the Senate plan (HR 3590 ):
(D) MEMBERS OF CONGRESS IN THE EXCHANGE-
(i) REQUIREMENT- Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are--
(I) created under this Act (or an amendment made by this Act); or
(II) offered through an Exchange established under this Act (or an amendment made by this Act).
Some of us may be quite familiar with the fact that current members of Congress are covered under the Federal Employees Health Benefits Program. The program, which covers over 8 million employees of the federal government, is a private plan which is the envy of most non-governmental employees.
Congressional members may also choose to be treated at a military hospital or at the office of the Attending Physician of the U.S. Capitol for a fee.
Now when the provisions of the new law roll into effect, the Cadillac plan will be phased out and replaced with the same coverage given to the rest of America. You may read the notice posted at Congress dot org at http://www.congress.org/news/2010/03/25/how_will_lawmakers_insurance_change
Showing posts with label healthcare bill. Show all posts
Showing posts with label healthcare bill. Show all posts
Thursday, April 1, 2010
Amish and Mennonite Exempt from New Healthcare Reform Law
by LAS
The old order Amish and the Mennonite communities are exempt from the provisions of the new healthcare reform bill recently signed into law by President Obama. Their religious beliefs reject assistance from outsiders such as the government.
These churches typically take up collections to pay for any medical bills incurred by their members. These groups are defined, by the language of the bill, as nonprofit organizations whose "members share a common set of ethical or religious beliefs and medical expenses among members in accordance with those beliefs."
Like the Amish, members of these ministries believe that the teachings of Christ dictate a philosophy of giving and sharing rather than taking, in this case from the third-party insurance providers. Individuals can opt into a cost-sharing program where regular contributions are distributed to other members in the network to pay for various healthcare services.
Medi-Share , Christian Healthcare Ministries , and Samaritan Ministries International are three such networks. The only requirement for joining, aside from paying your share, is that you practice a lifestyle in strict adherence to Christian philosophy.
Congress dot org has posted a short article on this topic. http://www.congress.org/news/2010/03/24/which_religious_groups_are_exempt
The old order Amish and the Mennonite communities are exempt from the provisions of the new healthcare reform bill recently signed into law by President Obama. Their religious beliefs reject assistance from outsiders such as the government.
These churches typically take up collections to pay for any medical bills incurred by their members. These groups are defined, by the language of the bill, as nonprofit organizations whose "members share a common set of ethical or religious beliefs and medical expenses among members in accordance with those beliefs."
Like the Amish, members of these ministries believe that the teachings of Christ dictate a philosophy of giving and sharing rather than taking, in this case from the third-party insurance providers. Individuals can opt into a cost-sharing program where regular contributions are distributed to other members in the network to pay for various healthcare services.
Medi-Share , Christian Healthcare Ministries , and Samaritan Ministries International are three such networks. The only requirement for joining, aside from paying your share, is that you practice a lifestyle in strict adherence to Christian philosophy.
Congress dot org has posted a short article on this topic. http://www.congress.org/news/2010/03/24/which_religious_groups_are_exempt
Health Insurers Discussed Delaying Covering Children with Pre-Existing Conditions
by LAS
According to a March 28 story in the New York Times, and just days after President Obama signed the historic healthcare bill into law, insurance companies were insistent that they did not have to provide coverage to children with pre-existing conditions. President Obama called that element of the healthcare bill a 'centerpiece' of the new law.
President Obama, speaking at a rally in Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
This provision of the reform bill was meant to protect youngsters who suffer from conditions such as leukemia, cystic fibrosis, birth defects, sickle cell disease, etc from being denied coverage under current business practices.
But the insurance industry tries to redefine what 'is' is, and what 'coverage' and 'insurance' mean.
While insurers agree that if they write a policy for a child, that they must cover pre-existing conditions. However, they still feel that they are not compelled to write a policy for a given child, and that at any rate this provision does not go into effect until 2014.
A few days after expressing their reluctance to implement this provision of the healthcare reform bill, the industry was compelled to announce that they would, in fact, observe this feature of the new law. But that came only after public outrage at insurance industry statements, including criticism from Senator John D. Rockefeller, among others.
According to the New York Times: Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then. This is what ignited the firestorm of protest and criticism from those in Congress and the reform movement.
SOURCE:
Pear, Robert, Coverage Now for Sick Children? Check Fine Print, March 28, 2010, New York Times, http://www.nytimes.com/2010/03/29/health/policy/29health.html
According to a March 28 story in the New York Times, and just days after President Obama signed the historic healthcare bill into law, insurance companies were insistent that they did not have to provide coverage to children with pre-existing conditions. President Obama called that element of the healthcare bill a 'centerpiece' of the new law.
President Obama, speaking at a rally in Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
This provision of the reform bill was meant to protect youngsters who suffer from conditions such as leukemia, cystic fibrosis, birth defects, sickle cell disease, etc from being denied coverage under current business practices.
But the insurance industry tries to redefine what 'is' is, and what 'coverage' and 'insurance' mean.
While insurers agree that if they write a policy for a child, that they must cover pre-existing conditions. However, they still feel that they are not compelled to write a policy for a given child, and that at any rate this provision does not go into effect until 2014.
A few days after expressing their reluctance to implement this provision of the healthcare reform bill, the industry was compelled to announce that they would, in fact, observe this feature of the new law. But that came only after public outrage at insurance industry statements, including criticism from Senator John D. Rockefeller, among others.
According to the New York Times: Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then. This is what ignited the firestorm of protest and criticism from those in Congress and the reform movement.
SOURCE:
Pear, Robert, Coverage Now for Sick Children? Check Fine Print, March 28, 2010, New York Times, http://www.nytimes.com/2010/03/29/health/policy/29health.html
Monday, January 4, 2010
Things the Healthcare Reform Bill WON'T Fix, and a Handful of Things it WILL Fix and Quickly
by L.A.S.
The hard truth of the healthcare reform bill passed by the US Congress is that most of the provisions will not go into effect until 2014 (the House version would take effect in 2013).
The even harder truth is that even if it does become law, some things will still not be fixed. This is because the special interest groups lobbied hard and long so that their industry would not have to be the ones to pay for a national healthcare program.
As listed by economics writer Paul Zane Pilzer, these are the items that will still need reform. One wonders if the new bill is even worth all the paper and toner used to print it.
# The American Medical Association, representing doctors, was promised that nothing would be done to cut payments to physicians or tie doctor payments to performance.
# Trial lawyers were promised that no caps would be put on legal liability for medical mistakes.
#Big Pharma was promised that nothing would be done to their net revenues — even things like giving Medicaid patients generic vs. brand-name drugs were taken off the table.
# Local insurance companies were promised that they would not have to compete with larger national insurers over state lines.
# Medical network providers were promised that there would not be "transparency" — the varying charges medical providers give each patient would never be disclosed.
On the other hand, the bill does have the saving grace of offering consumers seven quick fixes that will go into effect almost immediately. My thanks to Congress dot org for posting this information.
1. Insuring high-risk citizens. Both bills would create a $5 billion fund for temporary insurance for citizens with pre-existing conditions who have not been insured for at least six months. The program would end once the insurance exchanges begin in 2013 or 2014.
2. Extending insurance for adult children. The House bill would allow parents to keep unmarried adult children on their health insurance until their 27th birthday; the Senate bill, until their 26th birthday. This would reduce the number of uninsured young adults.
3. Extending insurance for the recently unemployed. Under current law, laid-off workers are allowed to continue buying their existing insurance through the COBRA program for up to 18 months. The bills would extend that coverage until the insurance exchanges begin.
4. Ending lifetime limits on benefits. Both bills would end the lifetime caps on insurance coverage which have sometimes been used to deny payments to consumers with particularly expensive treatments. Both bills would also restrict annual limits on health-care benefits.
5. Ending rescission. Insurance companies often cancel policies for consumers who require expensive medical care because they made honest mistakes on their medical histories. Both bills would prohibit insurance plans from canceling coverage except in cases of fraud.
6. Starting to close the doughnut hole. Both bills would begin closing the so-called "doughnut hole" in Medicare Part D prescription drug coverage by providing an additional $500 in coverage starting in 2010. Over several years, the gap would be reduced until it was closed entirely.
7. Taxing plastic surgery. The Senate bill would include a new 5 percent tax on elective cosmetic surgery. The tax is estimated to raise $5.8 billion over the next 10 years. It does not apply to cosmetic surgery to fix problems caused by accidents, disease or birth defects.
So while the healthcare reform bill is far from perfect, it does have some redeeming value. Let us hope that this is only the beginning, and not the end, of healthcare reform.
The hard truth of the healthcare reform bill passed by the US Congress is that most of the provisions will not go into effect until 2014 (the House version would take effect in 2013).
The even harder truth is that even if it does become law, some things will still not be fixed. This is because the special interest groups lobbied hard and long so that their industry would not have to be the ones to pay for a national healthcare program.
As listed by economics writer Paul Zane Pilzer, these are the items that will still need reform. One wonders if the new bill is even worth all the paper and toner used to print it.
# The American Medical Association, representing doctors, was promised that nothing would be done to cut payments to physicians or tie doctor payments to performance.
# Trial lawyers were promised that no caps would be put on legal liability for medical mistakes.
#Big Pharma was promised that nothing would be done to their net revenues — even things like giving Medicaid patients generic vs. brand-name drugs were taken off the table.
# Local insurance companies were promised that they would not have to compete with larger national insurers over state lines.
# Medical network providers were promised that there would not be "transparency" — the varying charges medical providers give each patient would never be disclosed.
On the other hand, the bill does have the saving grace of offering consumers seven quick fixes that will go into effect almost immediately. My thanks to Congress dot org for posting this information.
1. Insuring high-risk citizens. Both bills would create a $5 billion fund for temporary insurance for citizens with pre-existing conditions who have not been insured for at least six months. The program would end once the insurance exchanges begin in 2013 or 2014.
2. Extending insurance for adult children. The House bill would allow parents to keep unmarried adult children on their health insurance until their 27th birthday; the Senate bill, until their 26th birthday. This would reduce the number of uninsured young adults.
3. Extending insurance for the recently unemployed. Under current law, laid-off workers are allowed to continue buying their existing insurance through the COBRA program for up to 18 months. The bills would extend that coverage until the insurance exchanges begin.
4. Ending lifetime limits on benefits. Both bills would end the lifetime caps on insurance coverage which have sometimes been used to deny payments to consumers with particularly expensive treatments. Both bills would also restrict annual limits on health-care benefits.
5. Ending rescission. Insurance companies often cancel policies for consumers who require expensive medical care because they made honest mistakes on their medical histories. Both bills would prohibit insurance plans from canceling coverage except in cases of fraud.
6. Starting to close the doughnut hole. Both bills would begin closing the so-called "doughnut hole" in Medicare Part D prescription drug coverage by providing an additional $500 in coverage starting in 2010. Over several years, the gap would be reduced until it was closed entirely.
7. Taxing plastic surgery. The Senate bill would include a new 5 percent tax on elective cosmetic surgery. The tax is estimated to raise $5.8 billion over the next 10 years. It does not apply to cosmetic surgery to fix problems caused by accidents, disease or birth defects.
So while the healthcare reform bill is far from perfect, it does have some redeeming value. Let us hope that this is only the beginning, and not the end, of healthcare reform.
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