Timeline and details of Health Insurance Reform by Niki2

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Timeline and details of Health Insurance Reform

POSTED BY: NIKI2
UPDATED: Thursday, March 18, 2010 10:23
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Thursday, March 18, 2010 7:55 AM

Gettin' old, but still a hippie at heart...

Okay, does anyone know in essence how the health insurance reform bill will work? I'll call it "health insurance reform", because as someone mentioned, it's not "health reform".

Pelosi has until 72 hours after the CBO score is made public so that everyone can read it. That means a vote will take place sometime on Sunday. After that, the Senate makes its changes and aims to have a vote by Easter. Then it would go to Obama to sign it into law. Nobody can predict this exact timeline, but, from the moment Obama signs it:

Within 90 days there will be a high-risk pool created by the government for patients with pre-existing conditions who have been denied coverage, giving them immediate access to care. Those pools will be CREATED by the government, but the insurance the pools provide will make health-care insurance decisions, not the government.

Ninety days after that, it will be illegal for insurance companies to deny coverage to children based on their “pre-existing conditions”. Also, children will be allowed to stay on their parents’ health insurance until they are 26 years old. Insurers will also be banned from imposing “lifetime limits” on health insurance benefits. They will also be banned from rescinding insurance, taking away your insurance when you file a claim.

As of 2011—the next calendar year, not a year after it becomes law, if you’re on Medicare, you will qualify for free “annual wellness visits”. Insurance companies at that point will be required to spend 80-85% of what they take in from you in premiums on actual medical care. If they don’t, they will have to refund you the difference. Also, if they want to hike your rates, they will have to announce and justify it, and the justification will have to be reviewed. In other words, they won’t be able to automatically, unilaterally raise those rates.

Also this year the tax breaks for seniors would start, plus tax breaks for small businesses (I assume to help cover health insurance for their employees?).

In 2014, pre-existing conditions will no longer be legal for insurance companies to deny anyone coverage. Health-insurance exchanges for anyone who doesn’t have coverage will also be up and running by that time. At that same time, insurance companies will be banned from imposing “annual limits” on coverage. Also the tax credits kick in, and Medicaid expands for childless adults living near poverty.

One of the changes the Senate expects to enact is also to close the “donut hole” in prescription drug coverage fairly fast, to solve some of the problems in that wonderful “prescription drug benefit”. Right now, drugs are covered in the first part, then no coverage until X amount, when coverage kicks in again.

Whether this timeline can be implemented exactly as proposed will, of course, be seen, given it’s a political process and its opponents will do everything they can to stall it.

It won’t change health insurance for the vast majority of us (the exchanges will only effect roughtly 10% of the population, for example), but it means that if/when we run into trouble which would lose us our insurance coverage, keep us out of buying health insurance, or suffer huge out-of-pocket expenses, it won’t be as it is currently.

Now, there are no doubt a gazillion ways insurance companies will find for getting around these provisions, the individual mandate will go into effect in 2014 no doubt, as the exchanges would then be an alternative for those who can’t afford for-profit insurance coverage, but I’m just guessing that by the timeline.

Republican opponents are now claiming it would be unprecedented and unconstitutional for the Congressmen to use the “deem and pass” rule to pass the bill currently in the House. This was put forward by Mike Pence, who was then asked: “Democrats say you voted for [these] rules yourself on three occasions”, to which he replied: “Yeah, sure.” ??? They are trying to make the case that this “self-executing rule” is unconstitutional OVER 200 TIMES in the past 15 years.

It also might be noted that when the Republicans did the Prescription Drug Benefit, they just put it all in the deficit, so it didn’t matter what the CBO said, it was going to cost whatever it cost. They also supposedly suppressed some other data they didn’t like. The Dems have made it harder on themselves by making it supposedly REDUCE the deficit over the first ten years and the second ten years. They’re at least trying to keep it openly part of the deficit and work at reducing same despite implementation of the reform, going back and forth saying “well, what if we tweak this, can we cut the deficit then?

Okay, there is the timeline for the bill and what it contains, in part. I’m sure that’s not all, but in essence that covers what we will get if the bill passes. Given all that, which is the best I can figure out and research, and no doubt since my sources were left-leaning, I’ve missed out on some of the negatives, I can’t understand—unless you consider the HUGE resistance by the insurance companies and how they’re buying people off, putting out millions of dollars in ads, spreading misinformation—why it’s so horrible to people and where the “government takeover of the health care system” comes into it.

Can anyone enlighten me with either FACTS refuting the above, or a REAL argument why this is all so terrifying? I’d really like to know.

"I'm just right. Kinda like the sun rising in the east and the world being round...its not a need its just the way it is." The Delusional "Hero", 3/1/10

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Thursday, March 18, 2010 9:36 AM

NIKI2

Gettin' old, but still a hippie at heart...

Bump. Can't anyone answer this for me? Or are we just sick of health reform and nobody's interested?

"I'm just right. Kinda like the sun rising in the east and the world being round...its not a need its just the way it is." The Delusional "Hero", 3/1/10

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Thursday, March 18, 2010 10:03 AM

FREMDFIRMA

I think most folk are trying to dredge up some reasonable facsimile of what the truth IS, from the mire of propaganda and bullshit comin from both directions.

Me, I'm tempted to give Grayson a very big hammer and then shut the lights off for a while...

-F

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Thursday, March 18, 2010 10:23 AM

NIKI2

Gettin' old, but still a hippie at heart...

Ooo, "I like your thinking, whacker"! I'd LOVE to do some whacking myself.

As far as I've been able to find out, what I posted IS the makeup of the bill, at least insofar as we are concerned, and probably omitting some stuff I couldn't find. Yes, the bill is huge (and doesn't need to be, dammit!) and it's tough going to wend your way through, AND the insurance companies are probably already digging like crazy to find loopholes, but I see it as a good beginning, if not what I want.

Thanx for responding, Frem; I somehow doubt anyone else will. People seem more interested in throwing generalizations, misinformation and name-calling around than discussing the actual aspects of the bill, sadly.

I've got to get off...I spend far too much mornings here, which I love, but which puts housework in a very bad place...and I haven't even walked the huskies (and probably won't, we're headed for the eighties...yuck!)

"I'm just right. Kinda like the sun rising in the east and the world being round...its not a need its just the way it is." The Delusional "Hero", 3/1/10

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