In House Bill 3200 there is a provision that states your insurance company will have to re-imburse you if they made too much money (according to the government of course) in the premium Vs payout ratio. So what will they do in the years, currently paid for with those overruns, when the payout exceeds the premium? Nothing would be my guess. So here again we have the government dictating the profits that a private company can make.
This is from page 24 of bill.
A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.
It does specify that it is based on a benefit year so there is no provision for balancing the good years against the bad; nor does it say exactly who is going to be calculating this ratio or how.
This sounds an awful lot like government dictating privat industry profits to me. What do you think?
Showing posts with label H.R. 3200. Show all posts
Showing posts with label H.R. 3200. Show all posts
Friday, August 14, 2009
White House Misinformation
The largest bit of misinformation is what is coming out of the white house about being able to keep your coverage if you like it. All you have to do is read the text of the bill to find out that this is absolutely not true. Well, it's sort of true I guess, you can keep it for 5 years if it meets the government standard and your employer doesn't change a single thing in your benefits for those 5 years.
I found the text of the bill, one that didn't crash my computer when I tried to pull it up, at http://energycommerce.house.gov/Press_111/20090714/aahca.pdf and I encourage everybody to read it.
Sec 102 beginning on page 16 of the bill is laughingly titled "Protecting The Choice To Keep Current Coverage". Here's the rundown on this section.
subsection (a)describes individual coverage and defines grandfathered as any insurance in effect before year 1 of this new bill and which does not change.
subsection (b)defines the grace period for employer based health plans. If we get to keep it if we like it then why exactly is there a grace period? Here's what it says...
10 (1) GRACE PERIOD.—
11 (A) IN GENERAL.—The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
So this means that we get to keep the insurance we like for up to 5 years if, and only if, it meets the requirements set down by the government. They even define "acceptable coverage" and your plan has to meet their definition of this acceptable coverage in order for you to keep it, and then you can only keep it for 5 years before being forced off of it. Your employer may still be able to offer you a plan after that, but it will be whatever plan the government deems "acceptable".
The bill also includes information to determine whether your employer has the right to be "self insured" which means that they write the plan and absorb the costs while paying an insurance company to administer the benefits. So the government can come back and tell your employer that -- although your business has decided to self insure and your accountants are sure you can support it-- being self insured is just too risky and you can't do it. Gee, guess you better put your employees on that government plan. Nice!
So tell me again Mr President how I am going to be able to keep my coverage if I like it. Lie to me one more time.
I found the text of the bill, one that didn't crash my computer when I tried to pull it up, at http://energycommerce.house.gov/Press_111/20090714/aahca.pdf and I encourage everybody to read it.
Sec 102 beginning on page 16 of the bill is laughingly titled "Protecting The Choice To Keep Current Coverage". Here's the rundown on this section.
subsection (a)describes individual coverage and defines grandfathered as any insurance in effect before year 1 of this new bill and which does not change.
subsection (b)defines the grace period for employer based health plans. If we get to keep it if we like it then why exactly is there a grace period? Here's what it says...
10 (1) GRACE PERIOD.—
11 (A) IN GENERAL.—The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
So this means that we get to keep the insurance we like for up to 5 years if, and only if, it meets the requirements set down by the government. They even define "acceptable coverage" and your plan has to meet their definition of this acceptable coverage in order for you to keep it, and then you can only keep it for 5 years before being forced off of it. Your employer may still be able to offer you a plan after that, but it will be whatever plan the government deems "acceptable".
The bill also includes information to determine whether your employer has the right to be "self insured" which means that they write the plan and absorb the costs while paying an insurance company to administer the benefits. So the government can come back and tell your employer that -- although your business has decided to self insure and your accountants are sure you can support it-- being self insured is just too risky and you can't do it. Gee, guess you better put your employees on that government plan. Nice!
So tell me again Mr President how I am going to be able to keep my coverage if I like it. Lie to me one more time.
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