For your reference, I will fact-checking the email against the draft form of HR 3200, which is what the email claims to be using as well.
Additionally, you can read the text of the full email, as it was sent to me, here.
Let's take a deep breath and dive right in.
Pg 22 of the HC Bill MANDATES the Govt will audit the books of ALL EMPLOYERS that self insure!!
Quite simply, no it doesn't. The section in question is about a nationwide study a newly created Health Commission would undertake to get an idea of what's available to the average insured citizen through their employers. This is a market study, not an audit. In fact, audit isn't even mentioned in this section. This is no different than when the government or any other group, just as a marketing agency for an insurance company, conducts a study
Pg 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get
Section 123 establishes a Health Benefits Advisory Committee which is tasked with making recommendations on plan structures and benefits under the overall section detailing how to guarantee access to essential benefits. It's structured similar to and even references the Medicare Payment Advisory Committee, which has existed since 1965 to offer recommendations for plan structure.
The membership, according to the text of the bill itself is:
T
he membership of the Health Benefits Advisory Committee shall at least reflect providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies. and at least one practicing physician or other health professional and an expert on children’s health and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee.
So, the summary is nothing at all like the email is describing. This isn't deciding what benefits you receive. It's making recommendations as to what constitutes essential services in keeping with their mandate to make sure everyone has access to them.
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!!
What's interesting here is that not only do lines 4 through 16 say nothing of the sort, they actually cross from previous and into later sections, which tells me this was just a random selection on the part of the author of the email. What mentions there are about restrictions have to do with cost-sharing. Cost-sharing is defined at the beginning of the bill (page 8, starting at line 11, if you are following along in the PDF version):
(4) COST-SHARING.—The term ‘‘cost-sharing’’ includes deductibles, coinsurance, copayments, and similar charges but does not include premiums or any network payment differential for covered services or spending for non-covered services.
In other words, the section being referenced in the email is describing limitations on what the limitations are things mentioned in the above definition. In fact, to further refute the FUD, skip backwards in the bill to page 26, starting at line 17:
A qualified health benefits plan may not impose any restriction (other than cost- sharing) unrelated to clinical appropriateness on the coverage of the health care items and services.(emphasis mine)
Pg 42 of HC Bill - The Health Choices Commissioner will choose your benefits for you. You have no choice!
The Commissioner doesn't choose benefits. The Commissioner sets standards for plans to meet. The plans themselves are determined by the respective insurers in keeping with, according to the bill, state insurance regulators, and the secretaries of Labor and Treasury.
(1) QUALIFIEDPLANSTANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
Pg 50 Section 152 in HC bill - HC will be provided to ALL non US citizens, illegal or otherwise
This is another boogeyman of the right, fearmongering that illegals might be getting something too. The section in question reads:
S
EC. 152. PROHIBITING DISCRIMINATION IN HEALTH CARE.
(a) INGENERAL.—Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.
Since illegal aliens are already not able to receive public benefits, such as Social Security or Medicaid/Medicare, it seem illogical that they would suddenly become qualified via this legislation. Given that our social security numbers will likely be used to handle reporting and record keeping, how would illegal aliens suddenly be able to qualify and get set up with paying premiums and receiving services?
No, this section instead is addressing things like pre-existing conditions, ethnicity, sexuality, etc. Also, it's worth noting that on page 143, section 246, we find this:
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
Pg 58HC Bill - Govt will have real-time access to individualâ finances & a National ID Health care card will be issued!
This one made me actually laugh. Here's the text of the bill:
‘
‘(D) enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;
Determining financial responsibility ≠ complete access to finances in real time.
This is the same as when a hospital or welfare agency runs a check of the individual's ability to pay and determines their qualifications for discounts a specific plan or level of service. This is most assuredly not looking at your list of written checks at your bank and asking you what you spent $26 on at Blockbuster last Thursday.
First of all, there is no central repository of your finances. Not even your bank knows what other banks you use. Thus, there would be no way for the government to access it either, especially in "real time". Second, the purpose of the health ID card is to expedite care for those who are found to be qualified for a specific plan being sought. Not a national health ID card, although I'm not sure why there would be anything wrong with that.
Pg 59 HC Bill lines 21-24 Govt will have direct access to your banks accts for electronic funds transfer.
An EFT is the same as running your debit card and entering your PIN. We all do it all the time at Wal-Mart without a second thought. So, why is it a bad thing if the health care provider now accepts your Visa check card? This isn't granting the government access to your account. An EFT is not a blank check. It's an agreed to amount you authorize via entering your PIN or signing your name.
Pg 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community orgs (ACORN).
First of all, this is a blatantly dishonest statement. The section says nothing about unions or community organizations and the word Acorn isn't in the bill....anywhere.
Instead, this section is detailing a method of providing temporary retirement benefit reimbursement to participating employer-based plans similar to how COBRA benefits work currently (also a publicly funded, temporary plan).
Pg 72 Lines 8-14 Govt is creating an HC Exchange to bring priv HC plans under Govt control.
This section indeed establishes the health care insurance exchange President Obama has openly stated he wants for the plan many times. However, it does not bring private insurance plans under government control. Private insurers apply to be part of the exchange and to qualify, they must meet the previously mentioned standards the Commission establishes. Private insurers can offer plans outside of the exchange as well.
Pg 84 Sec 203 HC bill - Govt mandates ALL benefit packages for private Health Care plans in the Exchange
Once again, this goes back to what has already been mentioned in how the Commission will establish standards for what plans are qualified to be offered through the health exchange. The plan divisions are Basic, Enhanced, Premium, and Premium Plus. The minimum benefits are established to meet the criteria of offering one or all of these plans. Private insurers can still offer whatever they want outside of the exchange.
Pg 85 Line 7 HC Bill - Specs for of Benefit Levels for Plans = The Govt will ration your Healthcare!
Here we go again. No, this section is more detail on the standards that each plan must meet to qualify for entry into the health exchange. These are minimum levels of acceptable standards. Health insurers are free to exceed these standards and can still offer private insurance outside of the exchange.
Pg 91 Lines 4-7 HC Bill - Govt mandates linguistic appropriate services. Example - Translation for illegal aliens.
It may come as a shock to some Republicans, but not everyone who cannot speak English is an illegal alien. And as it was earlier established that illegal aliens are not qualified for this government service, what remains is language-neutral healthcare, with translators and alternate language forms made available as needed.
Pg 95 HC Bill Lines 8-18 The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan
Once again, Acorn isn't mentioned anywhere in the document and neither is Americorps, which is a government established program already.
Pg 85 Line 7 HC Bill - Specs of Ben Levels 4 Plans. #AARP members - Your Health Care WILL be rationed
This repeats an earlier statement, above, and includes the dire warning to AARP members. And just as before, no, there is no rationing mentioned.
Pg 102 Lines 12-18 HC Bill - Medicaid Eligible Individual will be automat.enrolled in Medicaid. No choice.
This section is detailing how to handle health care costs for newborn babies not otherwise covered by an acceptable health care plan. In the event the newborn is determined to be unqualified for other plans, s/he is enrolled in Medicare.
Pg 124 lines 24-25 HC No company can sue Govt on price fixing. No judicial review against Govt Monopoly.
Rules governing administrative and judicial review of government agencies are already established. A government health care agency is no different and neither is it immune from lawsuit. To sue, a plaintiff has to show the rules of an agency are "arbitrary and capricious, an abuse of discretion, or otherwise not in accordance with the law." (Administrative Procedure Act)
In short, you will find statements like the section referenced in every published set of regulations of every government agency there is.
Pg 127 Lines 1-16 HC Bill - Doctors/ #AMA - The Govt will tell YOU what you can make.
This section is regarding doctors who work on the public option, provided by the government. If the doctors wish to provide coverage under the public option, they must agree to charge restrictions. This is no different than how your HMO or PPA governs the physicians in its network.
It also does not apply to physicians not under the public option.
Pg 145 Line 15-17 An Employer MUST auto enroll employees into public opt plan. NO CHOICE
This is something taken woefully out of context and deliberately, I believe, omitting contradictory passages to the interpretation.
The section in question reads as:
This section is in keeping with what an employer must do under the requirements of offering health care coverage to its employees. Note, there is no mention of the public option or any specific plan in the health exchange. Rather, it states that the employer must automatically enroll the employee into health coverage offered by the employer, BUT in accordance with restrictions which follow this passage.
Here is subsection C, as referenced in the bill:
So, the long story short, if hire an employee, you automatically put that employee into the lowest premium plan your company offers UNLESS the employee chooses not to be enrolled. It's really that simple.
Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.
No, the employer must pay a reduced contribution to the plan in effect at that company. This is not paying for health care but is paying a contribution towards the health care plan for those part time employees, based on how many hours the part time employee works. There is no mention of the employee's family either.
It's also worth noting this was on page 146, not page 126. The email was copied verbatim. Given the author's short shrift to fact checking, I guess it's not surprising there would be errors like the actual page number too.
Pg 149 Lines 16-24 ANY Emplyr w payroll 400k & above who does not prov. pub opt. pays 8% tax on all payroll
Pg 150 Lines 9-13 Biz w payroll btw 251k & 400k who doesnt provide public opt pays 2-6% tax on all payroll
No, the employer agrees to pay a contribution toward the health exchange trust fund if they don't offer coverage of any kind. That's it. No mention of required public option.
Pg 167 Lines 18-23 ANY individual who doesnt have acceptable HC according to Govt will be taxed 2.5% of income.
No, not any individual. Only those with incomes. That's the catch.
I think that's enough for one post. See as how this thing is jumping all the way through 1000 pages of legislation, it's going to be an effort to simply remain awake. Catch more in an upcoming post as I continue wading through the FUD.
Part 2
First of all, there is no central repository of your finances. Not even your bank knows what other banks you use. Thus, there would be no way for the government to access it either, especially in "real time". Second, the purpose of the health ID card is to expedite care for those who are found to be qualified for a specific plan being sought. Not a national health ID card, although I'm not sure why there would be anything wrong with that.
Pg 59 HC Bill lines 21-24 Govt will have direct access to your banks accts for electronic funds transfer.
An EFT is the same as running your debit card and entering your PIN. We all do it all the time at Wal-Mart without a second thought. So, why is it a bad thing if the health care provider now accepts your Visa check card? This isn't granting the government access to your account. An EFT is not a blank check. It's an agreed to amount you authorize via entering your PIN or signing your name.
Pg 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community orgs (ACORN).
First of all, this is a blatantly dishonest statement. The section says nothing about unions or community organizations and the word Acorn isn't in the bill....anywhere.
Instead, this section is detailing a method of providing temporary retirement benefit reimbursement to participating employer-based plans similar to how COBRA benefits work currently (also a publicly funded, temporary plan).
Pg 72 Lines 8-14 Govt is creating an HC Exchange to bring priv HC plans under Govt control.
This section indeed establishes the health care insurance exchange President Obama has openly stated he wants for the plan many times. However, it does not bring private insurance plans under government control. Private insurers apply to be part of the exchange and to qualify, they must meet the previously mentioned standards the Commission establishes. Private insurers can offer plans outside of the exchange as well.
Pg 84 Sec 203 HC bill - Govt mandates ALL benefit packages for private Health Care plans in the Exchange
Once again, this goes back to what has already been mentioned in how the Commission will establish standards for what plans are qualified to be offered through the health exchange. The plan divisions are Basic, Enhanced, Premium, and Premium Plus. The minimum benefits are established to meet the criteria of offering one or all of these plans. Private insurers can still offer whatever they want outside of the exchange.
Pg 85 Line 7 HC Bill - Specs for of Benefit Levels for Plans = The Govt will ration your Healthcare!
Here we go again. No, this section is more detail on the standards that each plan must meet to qualify for entry into the health exchange. These are minimum levels of acceptable standards. Health insurers are free to exceed these standards and can still offer private insurance outside of the exchange.
Pg 91 Lines 4-7 HC Bill - Govt mandates linguistic appropriate services. Example - Translation for illegal aliens.
It may come as a shock to some Republicans, but not everyone who cannot speak English is an illegal alien. And as it was earlier established that illegal aliens are not qualified for this government service, what remains is language-neutral healthcare, with translators and alternate language forms made available as needed.
Pg 95 HC Bill Lines 8-18 The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan
Once again, Acorn isn't mentioned anywhere in the document and neither is Americorps, which is a government established program already.
Pg 85 Line 7 HC Bill - Specs of Ben Levels 4 Plans. #AARP members - Your Health Care WILL be rationed
This repeats an earlier statement, above, and includes the dire warning to AARP members. And just as before, no, there is no rationing mentioned.
Pg 102 Lines 12-18 HC Bill - Medicaid Eligible Individual will be automat.enrolled in Medicaid. No choice.
This section is detailing how to handle health care costs for newborn babies not otherwise covered by an acceptable health care plan. In the event the newborn is determined to be unqualified for other plans, s/he is enrolled in Medicare.
Pg 124 lines 24-25 HC No company can sue Govt on price fixing. No judicial review against Govt Monopoly.
Rules governing administrative and judicial review of government agencies are already established. A government health care agency is no different and neither is it immune from lawsuit. To sue, a plaintiff has to show the rules of an agency are "arbitrary and capricious, an abuse of discretion, or otherwise not in accordance with the law." (Administrative Procedure Act)
In short, you will find statements like the section referenced in every published set of regulations of every government agency there is.
Pg 127 Lines 1-16 HC Bill - Doctors/ #AMA - The Govt will tell YOU what you can make.
This section is regarding doctors who work on the public option, provided by the government. If the doctors wish to provide coverage under the public option, they must agree to charge restrictions. This is no different than how your HMO or PPA governs the physicians in its network.
It also does not apply to physicians not under the public option.
Pg 145 Line 15-17 An Employer MUST auto enroll employees into public opt plan. NO CHOICE
This is something taken woefully out of context and deliberately, I believe, omitting contradictory passages to the interpretation.
The section in question reads as:
(4) AUTOENROLLMENT OF EMPLOYEES.—The employer provides for autoenrollment of the employee in accordance with subsection (c).
This section is in keeping with what an employer must do under the requirements of offering health care coverage to its employees. Note, there is no mention of the public option or any specific plan in the health exchange. Rather, it states that the employer must automatically enroll the employee into health coverage offered by the employer, BUT in accordance with restrictions which follow this passage.
Here is subsection C, as referenced in the bill:
(c) AUTOMATICENROLLMENTFOREMPLOYERSPON-
SOREDHEALTHBENEFITS.— (1) INGENERAL.—The requirement of this subsection with respect to an employer and an employee is that the employer automatically enroll suchs employee into the employment-based health benefits plan for individual coverage under the plan option with the lowest applicable employee premium.
(2) OPT-OUT.—In no case may an employer automatically enroll an employee in a plan under paragraph (1) if such employee makes an affirmative election to opt out of such plan or to elect coverage under an employment-based health benefits plan offered by such employer. An employer shall provide an employee with a 30-day period to make such an affirmative election before the employer may automatically enroll the employee in such a plan.
So, the long story short, if hire an employee, you automatically put that employee into the lowest premium plan your company offers UNLESS the employee chooses not to be enrolled. It's really that simple.
Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.
No, the employer must pay a reduced contribution to the plan in effect at that company. This is not paying for health care but is paying a contribution towards the health care plan for those part time employees, based on how many hours the part time employee works. There is no mention of the employee's family either.
It's also worth noting this was on page 146, not page 126. The email was copied verbatim. Given the author's short shrift to fact checking, I guess it's not surprising there would be errors like the actual page number too.
Pg 149 Lines 16-24 ANY Emplyr w payroll 400k & above who does not prov. pub opt. pays 8% tax on all payroll
Pg 150 Lines 9-13 Biz w payroll btw 251k & 400k who doesnt provide public opt pays 2-6% tax on all payroll
No, the employer agrees to pay a contribution toward the health exchange trust fund if they don't offer coverage of any kind. That's it. No mention of required public option.
Pg 167 Lines 18-23 ANY individual who doesnt have acceptable HC according to Govt will be taxed 2.5% of income.
No, not any individual. Only those with incomes. That's the catch.
I think that's enough for one post. See as how this thing is jumping all the way through 1000 pages of legislation, it's going to be an effort to simply remain awake. Catch more in an upcoming post as I continue wading through the FUD.
Part 2
No comments:
Post a Comment