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Last Post Nov 10, 2009 7:14 AM by: cmybooksinc
Replies: 60
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cmybooksinc
Posts: 4,800

Are you ready for the new health Plan

Nov 5, 2009 8:14 PM
"What is even more alarming is that a monthly abortion premium will be charged of all enrollees in the government-run plan. It’s right there on line 16, page 96, section 213, under “Insurance Rating Rules.” The premium will be paid into a U.S. Treasury account – and these federal funds will be used to pay for the abortion services.

Section 213 describes the process in which the Health Benefits Commissioner is to assess the monthly premiums that will be used to pay for elective abortions under the government-run plan. The Commissioner must charge at a minimum $1 per enrollee per month."



just surfing and ran upon this
it is on the net do not know if true
But i do not need or want vending machines regs or paying for abortions in my health care plan


the congress people need to think and reform health slowly with well thought out plans not junk as this

alot of us are old but our kids will pay for this undisiregardless pile forever and ever .

reform do not destroy i am for almost all of the plans to fix health insurance but slowly and professionally .

not all this gobbly-gook
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obie_juan_cannoli
Posts: 777
(1 of 60)

Re: Are you ready for the new health Plan

Nov 5, 2009 8:20 PM
dam good way to keep conservatives from the public health roles, tho' ain't it?

~~~~~~~~~~the only trait that defines Americans historically is "descended from somebody willing to give up everything to live there".

-----------Col. Hyman Graff
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cavewoman22
Posts: 909
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Re: Are you ready for the new health Plan

Nov 5, 2009 9:31 PM
According to some, the section you are referring to is actually part of a safeguard in the bill to ensure that no federal money is used for funding abortions.

Link
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kbooks1
Posts: 3,001
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Re: Are you ready for the new health Plan

Nov 5, 2009 10:51 PM
cave-The link you provide seems to only be a summary. Last I heard the bill was nearly 2000 pages. Also, if the money is not to be used for abortions, why not just write it into the bill instead of just claiming it isn't in there? From nearly a 1000 pages to 1500 to almost 2000 pages can provide for a lot of obfuscation. Why can't a bill of this size spell out clearly an item of contention like abortion or medical services to any illegal alien who crosses our borders?
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cmybooksinc
Posts: 4,800
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Re: Are you ready for the new health Plan

Nov 6, 2009 5:35 AM
do not have time to read link now but why charge a premium for something that is not there.


still why not take a bill one step
at a time
instead of sending this pile to congress with special interest upon special interest PILED into this some might say a takeover by the federal government run by folks no one trusts very much .

either cover abortions are it doesn't
either covers illegal aliens or it doesn't ( tho they will still be admitted in emergency rooms and private clinics as now .

we need intelligent health insurance reform not political health reform.
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cmybooksinc
Posts: 4,800
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Re: Are you ready for the new health Plan

Nov 6, 2009 5:38 AM
our representatives both state and national have allowed insurance companies to do what they do

blame the government not allow them to do more harm.
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hpearl44
Posts: 2,123
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Re: Are you ready for the new health Plan

Nov 6, 2009 6:21 AM
CMY: Take up your criticisms with the AARP, the AMA and Consumer Reports that have recently endorsed the proposal.

I don't think anybody on the BSB, including your brilliant Right Wing Brethren have enough knowledge to fully understand the merits or demerits of the entire proposal. I sure don't. But as a member of the AARP , I feel a little more comfortable with it than I didn't a few weeks ago. Will there be areas that I am not happy with. You betcha.... But I'll tell you this I can live with a change to our present system, which is broken. And I'll trust in organizations with a lot more resources to read and judge the proposal.

Link

Pearl
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cavewoman22
Posts: 909
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Re: Are you ready for the new health Plan

Nov 6, 2009 6:24 AM
Apologies for the length :O

My GovSpeak is rusty so I'm gonna need help with this. Nowhere do I see any reference to abortion services or anybody being charged to provide such services, but it could be buried. Here is the relevant section:

SEC. 213. INSURANCE RATING RULES.
(a) In General- The premium rate charged for a qualified health benefits plan that is health insurance coverage may not vary except as follows:
(1) LIMITED AGE VARIATION PERMITTED- By age (within such age categories as the Commissioner shall specify) so long as the ratio of the highest such premium to the lowest such premium does not exceed the ratio of 2 to 1.
(2) BY AREA- By premium rating area (as permitted by State insurance regulators or, in the case of Exchange-participating health benefits plans, as specified by the Commissioner in consultation with such regulators).
(3) BY FAMILY ENROLLMENT- By family enrollment (such as variations within categories and compositions of families) so long as the ratio of the premium for family enrollment (or enrollments) to the premium for individual enrollment is uniform, as specified under State law and consistent with rules of the Commissioner.
(b) Actuarial Value of Optional Service Coverage-
(1) IN GENERAL- The Commissioner shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage under a basic plan of the services described in section 222(d)(4)(A).
(2) CONSIDERATIONS- In making such estimate the Commissioner--
(A) may take into account the impact on overall costs of the inclusion of such coverage, but may not take into account any cost reduction estimated to result from such services, including prenatal care, delivery, or postnatal care;
(B) shall estimate such costs as if such coverage were included for the entire population covered; and
(C) may not estimate such a cost at less than $1 per enrollee, per month.
(c) Study and Reports-
(1) STUDY- The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, shall conduct a study of the large-group-insured and self-insured employer health care markets. Such study shall examine the following:
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(A) The types of employers by key characteristics, including size, that purchase insured products versus those that self-insure.
(B) The similarities and differences between typical insured and self-insured health plans.
(C) The financial solvency and capital reserve levels of employers that self-insure by employer size.
(D) The risk of self-insured employers not being able to pay obligations or otherwise becoming financially insolvent.
(E) The extent to which rating rules are likely to cause adverse selection in the large group market or to encourage small and midsize employers to self-insure.
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(2) REPORTS- Not later than 18 months after the date of the enactment of this Act, the Commissioner shall submit to Congress and the applicable agencies a report on the study conducted under paragraph (1). Such report shall include any recommendations the Commissioner deems appropriate to ensure that the law does not provide incentives for small and midsize employers to self-insure or create adverse selection in the risk pools of large group insurers and self-insured employers. Not later than 18 months after the first day of Y1, the Commissioner shall submit to Congress and the applicable agencies an updated report on such study, including updates on such recommendations.


The GOP leader blog also cites section section 222, page 110 line 17 as containing similar language. Here it is with the relevant section (I think) highlighted (pay special attention to the last paragraph):

SEC. 222. ESSENTIAL BENEFITS PACKAGE DEFINED.
(a) In General- In this division, the term ‘essential benefits package’ means health benefits coverage, consistent with standards adopted under section 224, to ensure the provision of quality health care and financial security, that--
(1) provides payment for the items and services described in subsection (b) in accordance with generally accepted standards of medical or other appropriate clinical or professional practice;
(2) limits cost-sharing for such covered health care items and services in accordance with such benefit standards, consistent with subsection (c);
(3) does not impose any annual or lifetime limit on the coverage of covered health care items and services;
(4) complies with section 215(a) (relating to network adequacy); and
(5) is equivalent in its scope of benefits, as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services, to the average prevailing employer-sponsored coverage in Y1.
In order to carry out paragraph (5), the Secretary of Labor shall conduct a survey of employer-sponsored coverage to determine the benefits typically covered by employers, including multiemployer plans, and provide a report on such survey to the Health Benefits Advisory Committee and to the Secretary of Health and Human Services.
(b) Minimum Services To Be Covered- Subject to subsection (d), the items and services described in this subsection are the following:
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(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department services.
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician’s or a health professional’s delivery of care in institutional settings, physician offices, patients’ homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services, including behavioral health treatments.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well-baby and well-child care and oral health, vision, and hearing services, equipment, and supplies for children under 21 years of age.
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(11) Durable medical equipment, prosthetics, orthotics and related supplies.
(c) Requirements Relating to Cost-Sharing and Minimum Actuarial Value-
(1) NO COST-SHARING FOR PREVENTIVE SERVICES- There shall be no cost-sharing under the essential benefits package for--
(A) preventive items and services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention; or
(B) well-baby and well-child care.

(A) ANNUAL LIMITATION- The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B).
(B) APPLICABLE LEVEL- The applicable level specified in this subparagraph for Y1 is not to exceed $5,000 for an individual and not to exceed $10,000 for a family. Such levels shall be increased (rounded to the nearest $100) for each subsequent year by the annual percentage increase in the enrollment-weighted average of premium increases for basic plans applicable to such year, except that Secretary shall adjust such increase to ensure that the applicable level specified in this subparagraph meets the minimum actuarial value required under paragraph (3).
(C) USE OF COPAYMENTS- In establishing cost-sharing levels for basic, enhanced, and premium plans under this subsection, the Secretary shall, to the maximum extent possible, use only copayments and not coinsurance.
(3) MINIMUM ACTUARIAL VALUE-
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(A) IN GENERAL- The cost-sharing under the essential benefits package shall be designed to provide a level of coverage that is designed to provide benefits that are actuarially equivalent to approximately 70 percent of the full actuarial value of the benefits provided under the reference benefits package described in subparagraph (B).
(B) REFERENCE BENEFITS PACKAGE DESCRIBED- The reference benefits package described in this subparagraph is the essential benefits package if there were no cost-sharing imposed.
(d) Assessment and Counseling for Domestic Violence- The Secretary shall support the need for an assessment and brief counseling for domestic violence as part of a behavioral health assessment or primary care visit and determine the appropriate coverage for such assessment and counseling.
(e) Abortion Coverage Prohibited as Part of Minimum Benefits Package-
(1) PROHIBITION OF REQUIRED COVERAGE- The Health Benefits Advisory Committee may not recommend under section 223(b), and the Secretary may not adopt in standards under section 224(b), the services described in paragraph (4)(A) or (4)(B) as part of the essential benefits package and the Commissioner may not require such services for qualified health benefits plans to participate in the Health Insurance Exchange.
(2) VOLUNTARY CHOICE OF COVERAGE BY PLAN- In the case of a qualified health benefits plan, the plan is not required (or prohibited) under this Act from providing coverage of services described in paragraph (4)(A) or (4)(B) and the QHBP offering entity shall determine whether such coverage is provided.
(3) COVERAGE UNDER PUBLIC HEALTH INSURANCE OPTION- The public health insurance option shall provide coverage for services described in paragraph (4)(B). Nothing in this Act shall be construed as preventing the public health insurance option from providing for or prohibiting coverage of services described in paragraph (4)(A).
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2
(4) ABORTION SERVICES-
(A) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED- The services described in this subparagraph are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
1
(B) ABORTIONS FOR WHICH PUBLIC FUNDING IS ALLOWED- The services described in this subparagraph are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.

(f) Report Regarding Inclusion of Oral Health Care in Essential Benefits Package- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report containing the results of a study determining the need and cost of providing accessible and affordable oral health care to adults as part of the essential benefits package.


Section B looks and sounds damning, doesn't it? However, under current law the HHS Department does not have the authority to determine what abortions can be paid for with federal funds. That authority resides with congress. Since 1976, Congress has passed a law every year (the Hyde Amendment) that bans federal funds from being used for abortions except in cases of rape, incest, or when the life of the mother is at risk. This is the law being referenced in the section of the health care bill Boehner refers to in his article. It is fully upheld by the House health care bill. Congress would have to end the Hyde Amendment in order for any decisions regarding federal funds for abortions to be given to the HHS Secretary.
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keithwease
Posts: 13,397
(8 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 6:29 AM
Exactly what is wrong with Federally-funded abortions? It seems to me that those who are least able to afford an abortion are the very ones who will be producing offspring who will grow up to not be able to afford abortions. It would be a lot cheaper in the long run to fund abortions.





The true goal of the greatest democracy the world
has ever seen is to lift up the rest of the world to its
level, not to tear itself down to theirs.
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cavewoman22
Posts: 909
(9 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 6:44 AM
Exactly what is wrong with Federally-funded abortions? It seems to me that those who are least able to afford an abortion are the very ones who will be producing offspring who will grow up to not be able to afford abortions. It would be a lot cheaper in the long run to fund abortions.


I'm pretty sure you are engaging in sarcastic devil's advocacy here. If you are not, your reasoning is callous and evil. I am pro choice because I don't want to get in the face of anyone struggling with the decision. But pro choice is just that, to me. A choice you make for yourself, involving nobody else, not even the government--or the rest of us.
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ibesheshe
Posts: 17,362
(10 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 6:44 AM
Debunking John Boehner's "Monthly Abortion Premium" Claim (By Reading the Bill)
November 5, 2009 - by Donny Shaw

The Drudge Report is leading off today with an outrageous and false claim about the House health care bill from House Minority Leader John Boehner [R, OH-8]. “A monthly abortion premium will be charged of all enrollees in the government-run plan,” Boehner writes. It’s right there on line 16, page 96, section 213, under ‘Insurance Rating Rules.’ The premium will be paid into a U.S. Treasury account – and these federal funds will be used to pay for the abortion services."
But Boehner is either lying or completely misunderstanding what that section of the bill is all about. In fact, the section of the bill he is claiming would require a “monthly abortion premium” is actually part of a safeguard in the bill to ensure that no federal money is used for funding abortions.
The section, which you can read for yourself here, directs the Health Choices Commissioner to determine, on an actuarial basis, the per month cost of insurance coverage for elective abortions. The reason the government needs this information is because the bill requires federally-funded affordability credits to be segregated from individually-paid premiums for any insurance plan that covers elective abortions and is paid for in part by affordability credits. The government needs to know how much the abortion coverage portion of the plan costs so they can ensure that that that potion of the plan is fully paid for by private individuals, not by the government.
Read the section of the bill on segregating these funds here; you’ll see that it references the section directing the Commissioner to estimate the cost of abortion coverage. There is absolutely nothing in the section or anywhere else in the bill that says anything abortion premiums.
Boehner also makes another false claim in his article. “On line 17, p. 110, section 222, under ‘Abortions for which Public Funding is Allowed,’ the Health and Human Services Secretary is given the authority to determine when abortion is allowed under the government-run plan,” he writes.
This, also, is not true in any way. Read the actual text of that section:
(B) ABORTIONS FOR WHICH PUBLIC FUNDING IS ALLOWED- The services described in this subparagraph are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
Under current law, the Secretary of Health and Human Services does not have any authority to determine what abortions can be paid for with federal funds. That authority belongs to Congress. Since 1976, Congress has passed a law every year (the Hyde Amendment) that bans federal funds from being used for abortions except in cases of rape, incest, or when the life of the mother is at risk. This is the law being referenced in the section of the health care bill Boehner refers to in his article. It is fully upheld by the House health care bill. Congress would have to end the Hyde Amendment in order for any decisions regarding federal funds for abortions to be given to the HHS Secretary, as Boehner falsely claims.

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ibesheshe
Posts: 17,362
(11 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 6:51 AM
Boehner is an out and out bold faced liar - period.

He doesn't even know his Constitution from the Declaration of Independence. Or maybe he just can't read?

Drudge, Beck, Michelle Bachmann, Boehner...

Some epople will blindly follow anyone.
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frozencove
Posts: 2,852
(12 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 7:15 AM
I will soon have to delve into what health care coverages are available to me as I inch my way off medicaid. I stopped weekly visits to once a month when the economy went bad. I may have to rely on the board for therapy.


Smiley Face

_________________________
Sumtymes I donut cry
i jest weaps
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hpearl44
Posts: 2,123
(13 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 7:16 AM
Sheila: While channel surfing last night I caught the last 5 minutes of Rachel Maddow and her take on the Republican Tea Party led by Bachman. It was hysterical. What buffoons!!!


Drudge, Beck, Michelle Bachmann, Boehner...

Some epople will blindly follow anyone
.

That's todays Republican Party. But wait nobody's a Republican anymore. They're Conservatives, Libertarians, Mouseketeers, or whatever....

Pearl
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cmybooksinc
Posts: 4,800
(14 of 60)

Re: Are you ready for the new health Plan

Nov 6, 2009 7:39 AM
The AMA has about 13% of doctors as members ,,,,,I think
AARP is a insurance Shell corp in non profits clothing the sell medicare supplements through United Health services and Automobile Ins. through Hartford I imagine their high ups make nice salaries because of this


consumer reports i know nothing about so will not comment

so taking it up with them is bunch of a undisregardless pile


they do not speak for me .
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