The House Health Care Bill: Read It

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First Posted: 10-29-09 11:04 AM   |   Updated: 10-29-09 02:57 PM

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Pelosi

Speaker Nancy Pelosi (D-Calif.) officially unveiled the House health care reform bill that is headed to the House floor. The ceremony, held on the West steps of the Capitol, marks the greatest progress toward the Democratic Party's top domestic priority goal in more than half a century.

The bill, the Affordable Health Care for America Act -- H.R. 3962 -- includes a public health insurance option that would be required to negotiate with providers -- the top choice of centrist and conservative Democrats.

Coming in at just under $900 billion over ten years, the plan would cover 36 million uninsured Americans.

House Democrats have posted the bill online. A summary can be read here and the full version is here.

The Congressional Progressive Caucus had pushed hard for a "robust" public option that would have reimbursed providers using Medicare rates. Blue Dog Democrats beat back that effort, costing taxpayers $85 billion over ten years -- money that will go to hospitals, doctors and drug makers, increasing the cost of health care.

The bill also prevents insurers from discriminating against people with preexisting conditions, caps the financial responsibility that insured individuals will face when medical emergencies strike, bans insurers for dropping folks because they get sick, and proposes a host of other insurance industry reforms.

Meanwhile, congressional Republicans are hoping that the historic push will give them an advantage in the 2010 midterm elections. "The lasting image coming out of today's press conference is one of dozens of House Democrats standing proudly behind an incredibly unpopular Nancy Pelosi as she prepares to lead them off a political cliff," said Ken Spain, spokesman for the National Republican Congressional Committee.

If anything jumps out at you, let me know at ryan@huffingtonpost.com. The SEIU notes that the bill bans the practice of using domestic violence as a pre-existing condidtion.

SEC. 2754. PROHIBITION ON DOMESTIC VIOLENCE AS PRE-EXISTING CONDITION.
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A health insurance issuer offering health insurance coverage in the individual market may not, on the basis of domestic violence, impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A)) with respect to such coverage.

UPDATE: In what could be seen as a boost for the bill, the insurance industry says they don't like it. Karen Ignagni, President and CEO of America's Health Insurance Plans (AHIP), put out this statement:

"The promise of health care reform has been that if you like your current coverage, you can keep it. We are concerned that this proposal will break this promise by increasing health care costs for families and employers across the country and significantly disrupting the quality coverage on which millions of Americans rely today.

"The lack of system-wide cost containment is a missed opportunity. Without a greater focus on health care costs, families and employers will not be able to afford coverage and health care costs will rise at a rate much faster than the overall economy is able to sustain.

"We share the concerns that doctors, hospitals, employers, and patients have all raised about the significant disruption a new government-run plan would have on the current health care system. A new government-run plan would bankrupt hospitals, dismantle employer coverage, exacerbate cost-shifting from Medicare and Medicaid, and ultimately increase the federal deficit.

"Estimates show that a government-run plan would cause millions of people to lose their current coverage. Moreover, massive Medicare Advantage cuts would cause millions of seniors to lose their Medicare Advantage coverage altogether, while millions more would face benefit cuts and higher out-of-pocket costs.

"Health plans strongly support comprehensive, bipartisan health care reform and have proposed sweeping insurance market reforms and new consumer protections to ensure that every American has guaranteed access to affordable health care coverage. Experience in the states has shown that insurance market reforms must be paired with an effective personal coverage requirement for these reforms to work. While this legislation recognizes the key linkage of market reforms and a personal coverage requirement, more needs to be done to ensure coverage is affordable and our health care system is sustainable.

"As the process progresses, health plans will continue to work to advance bipartisan legislation this year that will cover all Americans, make coverage more affordable, and improve quality."

Democrats have created a side-by-side comparison of the bill as introduced initially and in its present form.


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Speaker Nancy Pelosi (D-Calif.) officially unveiled the House health care reform bill that is headed to the House floor. The ceremony, held on the West steps of the Capitol, marks the greatest progres...
Speaker Nancy Pelosi (D-Calif.) officially unveiled the House health care reform bill that is headed to the House floor. The ceremony, held on the West steps of the Capitol, marks the greatest progres...
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Everyone can agree that there has to be a reform of the current system. As history has taught us, anyone with power in mind will tell you the issue is complicated. It really isn't. Reform should only help those who have it and barely afford it, and those who don't have it because they can't afford it. History has also taught us that government owned industries are not prosperous, do not create wealth, and are inefficient. Markets and competition are such devices. If the government is proposing comprehensive reform that involves mandates and controls across the board - you should be scared - very scared.......

    Reply    Favorite    Flag as abusive Posted 03:25 PM on 11/19/2009

THE GOVERNMENT IS STUPID!

That is MY money coming out of MY paycheck that I work for! Why are they giving it to lazy people?!

We need a better president. We need better representatives. And we need to get rid of government assistance. That means: food stamps, welfare, medicade, and medicare. It's throwing away our money! And they need to stop printing money; isn't that what the federal reserve is supposed to stop?!

    Reply    Favorite    Flag as abusive Posted 10:40 AM on 11/12/2009
- Philclock I'm a Fan of Philclock 36 fans permalink
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Read it...and weep.

    Reply    Favorite    Flag as abusive Posted 08:01 PM on 11/10/2009
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Does is bother anyone else that illegal immigrants are exempt from the 5 years in jail and/or fine if you do not purchase healthcare? Just a thought.

    Reply    Favorite    Flag as abusive Posted 11:28 AM on 11/10/2009

Well, on the bright side, 221 people just committed political suicide, the 220 who voted and the 1 evil dictator who was voted into office by the people he just screwed! Yes, that's right, millions of you who voted for him WILL lose your jobs, and many more of you will end up in prison when you cant afford the public policy. Oh yeah, did I mention that many of you will die and millions will suffer, which would be OK with me if it were only to happen to obama supporters!! So now it's up to the rest of us to call our senators and voice our opposition to what is the worst bill EVER passed in our country. Funny but sad how the dems who wrote the bill exempted themselves from having to be forced into this...Call Your State Senators....Kill the bill.....Impeach the evil dictator...Fight to take back our FREEDOM.. note to president pelosi, STOP the Madness, Please just go away!!!

    Reply    Favorite    Flag as abusive Posted 11:34 AM on 11/08/2009

"Genuine bipartisanship, though, assumes an honest process of give-and-take, and that the quality of the compromise is measured by how well it serves some agreed-upon goal, whether better schools or lower deficits (or health care). This in turn assumes that the majority will be constrained - by an exacting press corps and ultimately an informed electorate - to negotiate in good faith. If these conditions do not hold - if nobody outside Washington is really paying attention to the substance of the bill, if the true costs...are buried in phony accounting and understated by a trillion dollars or so - the majority party can begin every negotiation by asking for 100 percent of what it wants, go on to concede 10 percent, and then accuse any member of the minority party who fails to support this "compromise" of being "obstructionist.""

The Audacity of Hope, page 131.

    Reply    Favorite    Flag as abusive Posted 12:19 AM on 11/08/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Now it's getting good! Page 30:
‘‘(b) INDEPENDENT DETERMINATION.—If the indi-
21 vidual requests such review by an independent, external
22 third-party of a rescission of health insurance coverage,
23 the coverage shall remain in effect until such third party
24 determines that the coverage may be rescinded under the
25 guidance issued by the Secretary under section 2742(f).’’

Burden of proof will be on the insurer to PROVE FRAUD by the customer as the only way to rescind coverage, from the moment a customer is accepted.

    Reply    Favorite    Flag as abusive Posted 06:31 PM on 11/07/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Page 25:
"Health Service Act.
13 (h) FUNDING; TERMINATION OF AUTHORITY.—
14 (1) IN GENERAL.—There is appropriated to the
15 Secretary, out of any moneys in the Treasury not
16 otherwise appropriated, $5,000,000,000 to pay
17 claims against (and administrative costs of) the
18 high-risk pool under this section in excess of the pre-
19 miums collected with respect to eligible individuals
20 enrolled in the high-risk pool."

$5 billion seems miniature, compared to the other amounts being quoted. Whose estimate is that starting budget based on? CBO? BC/BS? Lewin?

    Reply    Favorite    Flag as abusive Posted 06:25 PM on 11/07/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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The first thing that's noteworthy for being good, Page 17:
"(c) ELIGIBILITY.—For purposes of this section, the term ‘‘eligible individual’’ means an individual—
(1) who—
(A) is not eligible for—
(i) benefits under title XVIII, XIX, or XXI of the Social Security Act; or
(ii) coverage under an employment-based health plan (not including coverage under a COBRA continuation provision, as defined in section 107(d)(1)); and ..."

So if they only coverage you can get is COBRA, which is garbage, then that does NOT disqualify you from the public option.

    Reply    Favorite    Flag as abusive Posted 05:42 PM on 11/07/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Page 13:
"(22) PLAN YEAR.—The term ‘‘plan year’’ means—
(A) with respect to an employment-based health plan, a plan year as specified under such plan; or ..."

Here, the Congress is allowing "health insurance" corporations to set this definition as they please, where they really ought to be establishing the legal meanings of terms, not enshrining corporate-speak as law.

    Reply    Favorite    Flag as abusive Posted 05:38 PM on 11/07/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Page 9:
"(4) COST-SHARING.—The term ‘‘cost-sharing’’ includes deductibles, coinsurance, copayments, and similar charges, but does not include premiums, balance billing amounts for non-network providers, or spending for non-covered services."

So the bogus "in network" and "out of network" crap is not going to be outlawed, nor is arbitrarily declaring doctors' recommendations to be "non-covered services" whenever they're expensive. This deal just keeps getting worse!

    Reply    Favorite    Flag as abusive Posted 05:28 PM on 11/07/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Page 5:
"Sec. 103 Ending health insurance rescission abuse."

I think I'm going to dislike Section 103 when I get to it, because I do not believe that the "rescission" option can ever be anything other than abusive. Once any customer has begun making payments to a "health insurance" corporation, BOTH PARTIES have committed to a contractually binding agreement. The customer commits to provide monthly cash and the "insurer" will provide payments as required for health care. All rescission is fraud.

    Reply    Favorite    Flag as abusive Posted 05:14 PM on 11/07/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Page 4:

"(2) BUILDING ON CURRENT SYSTEM.—This division achieves this purpose by building on what works in today’s health care system, while repairing the aspects that are broken."

Should be:
"This division _pursues_ this purpose by ..."
Whose idea was it to declare "Mission Accomplished" while you're just drafting legislation? It's a very old custom, isn't it?

    Reply    Favorite    Flag as abusive Posted 04:57 PM on 11/07/2009

What's wrong with socialism? I mean, I keep hearing people say "socialism" like we're back in the McCarthy Era. if you like you 40-hour work week, the notion of overtime and paid vacations, unemployment insurance, then I hate to tell you, but that was brought to you by the Socialist Party, as was the notion that companies make their profits from the work of employees, who deserve some rights and respect. People forget their history - that Socialism was born as a response to abuses by people in power. Company owners. The notion that you create a system that benefits the most people is not extreme or insane -- what is ludicrous is this notion that it's un-American to force the insurance companies to compete, or the notion that we have a fair, democratic health-insurance system in private insurance. Remember "United We Stand?" Oh, and Labor Day? don't take that off, either - it's a Socialist Holiday.

    Reply    Favorite    Flag as abusive Posted 07:57 PM on 11/06/2009
- ReedYoung I'm a Fan of ReedYoung 134 fans permalink
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Agreed. Comintern is dead, and the federal government of the United States IS supposed to "promote the general welfare." It actually says that exactly. Grr.

    Reply    Favorite    Flag as abusive Posted 04:58 PM on 11/07/2009
- Philclock I'm a Fan of Philclock 36 fans permalink
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Socialism begets government abuse. Government is a legalized monopoly, protected by politicians and the police power of the state.

Who's going to fight THAT abuse?

EG, how many government run agencies have ever gone out of business? Medicare, social security, medicare, AMTRAK, post office, public education all broke and bloated, politicians keep feeding them on our money.

Give up our freedoms, just try to get them back.

    Reply    Favorite    Flag as abusive Posted 08:06 PM on 11/10/2009

I don't understand such extreme emotions and rhetoric by conservatives. I was a fan of Reagan and voted for Bush twice but I always remember Reagan being respectful and humerous as he explained his positions. The present health care bill does not seem like a communist take over, and if anyone is that ideological that they think any government run plan is socialistic then I have a question for them. Would you step up to the plate, do the right thing for the freedom of America and help stop a communist take over of the USA and write a letter to the government refusing to take Social Security payments or if they refuse, commit to donate all your soc. sec. payments to a conservative cause. The reason I say this is that Social Security really is a socialistic law, and yet I see all these people at rallies gladly taking their benefits so they can go to rallies while others are at work.

    Reply    Favorite    Flag as abusive Posted 10:12 AM on 11/06/2009
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So the government forces you to pay into a system that you may or may not get the money you've paid in AND you think conservatives should not take the payments when they can? Unfortunately, government sometimes sets the rules so even though you may not believe in what it does you have take advantage of the program and hope you break even. Then we get to hear from folks that say conservatives use the system so it can't be that bad. If I only had a magic wand...

Also, seems that conservatives have tried to change the system a few times but don't let that fact get in the way.

    Reply    Favorite    Flag as abusive Posted 11:00 AM on 11/06/2009

I understand your point that Republicans are not responsible for creating the Social Security law but wouldn't you agree that some protesters on the right today are shallow in their criticism of health care because they enthusiastically participate in Social Security and Medicare and aren't out there trying to overturn these laws when, I think, you would agree, they are much more socialistic than a health care plan that has mostly private insurance companies and perhaps one public option. If we were in a town hall meeting and you first roused the group into shouting and yelling over the health care plan, wouldn't you agree it would be much more silent if the next speaker spoke up about doing away with social security and medicare. What I am saying is that there is hypocrisy here because many people are not thinking deeply because ideology has a tendency to stop real thinking and just labeling and putting things into categories of them and us and not thinking of the complexities of each issue.

    Reply    Favorite    Flag as abusive Posted 04:29 PM on 11/06/2009
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