"please keep me updated about oximeters "
Sleep Apnea Forum Bringing Power to the Patient
New? Free Sign Up
Then check our Welcome Center to a Community Caring about Sleep Apnea diagnosis and Sleep Apnea treatment:
CPAP machines, Sleep Apnea surgery and dental appliances.
CPAP Supplies
Latest Activity
Healthcare Reform Bill
Let's pop the cork on this bad boy. I think that the bill has alot of good qualities. I am not to happy about insurance now being mandatory. What do you guys think?
Does anyone have a copy of the amended bill?
Views: 140
Replies to This Discussion
-
Permalink Reply by Mike on
-
bold move, my friend -- to open this can of worms. honestly, can anyone start with the high level overview of what this actually means to you and me in concrete terms? basic stuff like, when will this be effective and what are the big points?
-
Permalink Reply by RockRpsgt on
-
This bill has been ratified so many times now that I do not know if anyone knows the true effects . I read the original proposal that was linked by Dan Lyons. An extension of medicare seems to be a far cry from what that original bill suggested. This new bill seems to be modeled off of the German and Canadian systems with one exception. Insurance is not mandated by law in either of those countries. Which is my only opposition to it so far. It is early in the game though. As a fence riding libra I could go either way.
-
-
there have got to be dozens of summaries of the bill's key terms online. if anyone comes across a good one, please add the link here so that we can all make heads/ tails out of this.
Rock Hinkle said:This bill has been ratified so many times now that I do not know if anyone knows the true effects . I read the original proposal that was linked by Dan Lyons. An extension of medicare seems to be a far cry from what that original bill suggested. This new bill seems to be modeled off of the German and Canadian systems with one exception. Insurance is not mandated by law in either of those countries. Which is my only opposition to it so far. It is early in the game though. As a fence riding libra I could go either way.
-
-
Politics of it aside, i think this might be a boost for Sleep Apnea diagnosis, Sleep Apnea treatment and Sleep Apnea awareness. It's going to insure millions of the previously uninsured. Which means millions of additional people able to get tested and be put on CPAP, etc.
Mike said:there have got to be dozens of summaries of the bill's key terms online. if anyone comes across a good one, please add the link here so that we can all make heads/ tails out of this.
Rock Hinkle said:This bill has been ratified so many times now that I do not know if anyone knows the true effects . I read the original proposal that was linked by Dan Lyons. An extension of medicare seems to be a far cry from what that original bill suggested. This new bill seems to be modeled off of the German and Canadian systems with one exception. Insurance is not mandated by law in either of those countries. Which is my only opposition to it so far. It is early in the game though. As a fence riding libra I could go either way.
-
-
it is also rumored that a sleep study may be a requirement of the new policy. It is after all preventative medicine. Just a rumor among the sleep industry though.
Mike said:Politics of it aside, i think this might be a boost for Sleep Apnea diagnosis, Sleep Apnea treatment and Sleep Apnea awareness. It's going to insure millions of the previously uninsured. Which means millions of additional people able to get tested and be put on CPAP, etc.
Mike said:there have got to be dozens of summaries of the bill's key terms online. if anyone comes across a good one, please add the link here so that we can all make heads/ tails out of this.
Rock Hinkle said:This bill has been ratified so many times now that I do not know if anyone knows the true effects . I read the original proposal that was linked by Dan Lyons. An extension of medicare seems to be a far cry from what that original bill suggested. This new bill seems to be modeled off of the German and Canadian systems with one exception. Insurance is not mandated by law in either of those countries. Which is my only opposition to it so far. It is early in the game though. As a fence riding libra I could go either way.
-
Permalink Reply by Renee on
-
Oooooohh Mike,
Rock is right, the bill has been ratified so many times that no one can know the true effects – and not only that but the bill is still in flux. And, from one who was a major proponent of the originally proposed health “care” legislation, I must say, this health “insurance” reform, is really amorphous.
For starters, the bill is still very fluid . . . the bill, which was originally passed by the Senate, and then on Saturday by the House will be signed by the President tomorrow at 11:15 and then next week the Senate will take up the changes proposed by the House on Saturday. However, the Republicans in the Senate are planning a Point of Order connected somehow to a Reconciliation Bill linked to Student Loans. And if the Republicans are successful in their Reconciliation Point of Order – they will be able to force the Democrats to vote on the health insurance bill in the Senate in its present form – without the changes that the House has submitted to the Senate – and they are MAJOR changes. So what the Senate will vote on next week is still uncertain.
Next, most of the health insurance reforms don’t go into effect until 2014 through 2019 – and the Republicans (hoping to get more seats in the House and Senate in 2010 and 2012 and beyond) intend to continue to make deep cuts in health insurance reform ASAP – and on-going – besides court challenges to have the bill thrown out altogether.
Now, about the whole idea of 30 some millions of previously uninsured people being insured . . . first of all, that isn’t in the plan ‘til years down the road – and without a public option – how’s that going to happen ? Firstly, some millions of people – those who make 133% of the poverty level are going to be put into Medicaid – and those people are expected to find it very difficult, near impossible, to find health care providers to treat them. But how about all the rest?
There aren’t all of a sudden going to be millions of newly insured Americans; rather, there will be millions of people mandated to purchase insurance from an "Exchange". However, an “Exchange” is nothing other than a conglomerate consisting of the same large insurance companies currently available. The “Exchange” is already available right now simply by contacting one’s State Department of Health or searching online to get a listing of those same large insurance companies in one’s area in order to be able to contact them to find about premiums, deductibles, co-pays, exclusions, benefits, etc. The “Exchange” is nothing but the same large high-priced insurance companies which are available NOW ! ! !
Does anyone think that the insurance companies are going to reduce their rates to entice millions of individual members to sign up when they are only considered transient, between jobs – and MANDATED to have insurance – given that the insurance companies have not been willing to reduce their rates for all these years as millions of individual members have been seeking insurance – when insurance wasn’t mandated ? I don’t get the incentive . . . But, I do live in NYC and I do have a bridge to sell you.
Oh, yes, and, sadly, there are tax increases in the Senate bill – regardless of how their vote goes next week. The Senate bill decreases the use of FSA's and raises the tax deduction for medical expenses from 7.5% to 10% and adds a tax penalty for those who cannot afford insurance.
Some odds-and-ends . . . the government is constrained by the health insurance reform from negotiating with the drug companies for any savings on pharmaceuticals for the next 10 years. And the drug companies have been given multi-year extensions of patents so that their RX will remain “brand” longer and thus will be more expensive rather than if they were to change to “generic”. Also, deals were cut medical equipment companies, hospitals and doctors, et al.
Something else that will increase the deficit in the out years is that in addition to about 30 million Americans required to buy insurance, there is expected to be coverage of a large portion of illegal immigrants (anticipated 12 million). Although coverage of illegal immigrants is not supposed to be included in the reforms - any suggestion to require any proof of citizenship other than the falsified documents readily purchased and currently used by illegal immigrants was opposed and rejected from the bills - and this impact was not permitted to be scored into the cost of the bill.
And, most importantly, I don’t go along as readily as everyone else that the health insurance bill will end discrimination against people pre-existing conditions – who I have heard are going to be “lumped into a high-risk pool”. No one has mentioned whether their premium would be exceptionally higher OR whether their pre-existing condition and anything / everything potentially related to it would NOT be covered under the policy. AND simply by placing a few carefully chosen prescriptions onto their restricted classification of drugs which are not covered, an insurance company automatically makes an insurance policy worthless for people with a great variety of illnesses because if an RX is going to cost $400 to $1000 per month or more in addition to the insurance premium, deduction and co-pay – most families would be forced to pay the tax penalty in addition to continuing to pay for their own medical bills. So by choosing a few drugs associated with certain conditions and placing them on the restricted list, the insurance companies can effectively ward off people with a variety of illnesses. And – what is the mechanism to prevent the insurance companies from denying coverage for pre-existing conditions ? – Well, Congress determined that it is to pay a SMALL fine ! – hmm – would the insurance companies prefer to start welcoming customers with pre-existing conditions – OR –would they choose to pay the SMALL fine in order to increase profits ?
Also, under the new bill, a policy is not "supposed to be cancelled" if one uses it for a large claim - BUT other than the “slogan” that policies are not “supposed to be cancelled”, there has been no mention of how the bill will restrict the cancellation of policies for the VERY SAME reasons already cited as absurdly egregious - eg: saying that one did not claim "this or that" related OR completely unrelated condition on the application. Just questioning issues of the application or the claims themselves can hold up pre-authorizations for treatment - as well as payments – and drag out in appeal – and, therefore, hold up treatments for YEARS - and the person could simply give up fighting the insurance company or be more grievously ill or dead – if / when treatment is finally approved. And – what is the mechanism to prevent the insurance companies from cancelling coverage for large claims ? – Again, it is to pay a SMALL fine ! SO – will the insurance companies cooperatively pay the large claims on a timely basis – OR – pay the SMALL fine to increase profits ? Well consider this . . .in the last 4 years, when insurance companies received large claims, administrators scoured the claimants’ claims and applications and closed more than 19,000 policies – saving just 4 large insurance companies $300 MILLION ! ! !
Overall, I think the insurance companies are the biggest winners in the mandated health insurance reform bill that is being passed.
Also, in general, there is expected to be a minimal lowering of premiums realized over the next few years for those who work for large employers – and a quite small lowering of premiums for those who work for smaller employers and who, now, already have employer-based health coverage. -- And those who are currently purchasing insurance individually on the open market are expected to see an increase.
Well, that’s some of the nuts-and-bolts of a saga for which the sands are still shifting.
Renee
Mike said:there have got to be dozens of summaries of the bill's key terms online. if anyone comes across a good one, please add the link here so that we can all make heads/ tails out of this.
Rock Hinkle said:This bill has been ratified so many times now that I do not know if anyone knows the true effects . I read the original proposal that was linked by Dan Lyons. An extension of medicare seems to be a far cry from what that original bill suggested. This new bill seems to be modeled off of the German and Canadian systems with one exception. Insurance is not mandated by law in either of those countries. Which is my only opposition to it so far. It is early in the game though. As a fence riding libra I could go either way.
-
Permalink Reply by Walt Service on
-
Personally think this bill is just another nail in the coffin of our Country. To think that the Fed Gov is going to take over roughly 1/6th of our economy is wicked scary. Lord knows the Feds haven't touched ANYTHING that has gone well. More MDs will be leaving their business...waiting times/lines are going to increase at medical offices...treatments will soon begin to be rationed due to shortages...sigh... The times they are achanging for the worse.
-
-
CNN provides a timeline of when stuff kicks in: http://www.cnn.com/2010/POLITICS/03/23/health.care.timeline/index.h...
-
-
Main Entry: amor·phous
Pronunciation: \ə-ˈmȯr-fəs\
Function: adjective
Etymology: Greek amorphos, from a- + morphē form
Date: circa 1731
1 a : having no definite form : shapeless b : being without definite character or nature :
What?! I didn't know what it meant! Don't judge me!
Good post Renee. Way to do your homework!
Renee said:Oooooohh Mike,
Rock is right, the bill has been ratified so many times that no one can know the true effects – and not only that but the bill is still in flux. And, from one who was a major proponent of the originally proposed health “care” legislation, I must say, this health “insurance” reform, is really amorphous.
For starters, the bill is still very fluid . . . the bill, which was originally passed by the Senate, and then on Saturday by the House will be signed by the President tomorrow at 11:15 and then next week the Senate will take up the changes proposed by the House on Saturday. However, the Republicans in the Senate are planning a Point of Order connected somehow to a Reconciliation Bill linked to Student Loans. And if the Republicans are successful in their Reconciliation Point of Order – they will be able to force the Democrats to vote on the health insurance bill in the Senate in its present form – without the changes that the House has submitted to the Senate – and they are MAJOR changes. So what the Senate will vote on next week is still uncertain.
Next, most of the health insurance reforms don’t go into effect until 2014 through 2019 – and the Republicans (hoping to get more seats in the House and Senate in 2010 and 2012 and beyond) intend to continue to make deep cuts in health insurance reform ASAP – and on-going – besides court challenges to have the bill thrown out altogether.
Now, about the whole idea of 30 some millions of previously uninsured people being insured . . . first of all, that isn’t in the plan ‘til years down the road – and without a public option – how’s that going to happen ? Firstly, some millions of people – those who make 133% of the poverty level are going to be put into Medicaid – and those people are expected to find it very difficult, near impossible, to find health care providers to treat them. But how about all the rest?
There aren’t all of a sudden going to be millions of newly insured Americans; rather, there will be millions of people mandated to purchase insurance from an "Exchange". However, an “Exchange” is nothing other than a conglomerate consisting of the same large insurance companies currently available. The “Exchange” is already available right now simply by contacting one’s State Department of Health or searching online to get a listing of those same large insurance companies in one’s area in order to be able to contact them to find about premiums, deductibles, co-pays, exclusions, benefits, etc. The “Exchange” is nothing but the same large high-priced insurance companies which are available NOW ! ! !
Does anyone think that the insurance companies are going to reduce their rates to entice millions of individual members to sign up when they are only considered transient, between jobs – and MANDATED to have insurance – given that the insurance companies have not been willing to reduce their rates for all these years as millions of individual members have been seeking insurance – when insurance wasn’t mandated ? I don’t get the incentive . . . But, I do live in NYC and I do have a bridge to sell you.
Oh, yes, and, sadly, there are tax increases in the Senate bill – regardless of how their vote goes next week. The Senate bill decreases the use of FSA's and raises the tax deduction for medical expenses from 7.5% to 10% and adds a tax penalty for those who cannot afford insurance.
Some odds-and-ends . . . the government is constrained by the health insurance reform from negotiating with the drug companies for any savings on pharmaceuticals for the next 10 years. And the drug companies have been given multi-year extensions of patents so that their RX will remain “brand” longer and thus will be more expensive rather than if they were to change to “generic”. Also, deals were cut medical equipment companies, hospitals and doctors, et al.
Something else that will increase the deficit in the out years is that in addition to about 30 million Americans required to buy insurance, there is expected to be coverage of a large portion of illegal immigrants (anticipated 12 million). Although coverage of illegal immigrants is not supposed to be included in the reforms - any suggestion to require any proof of citizenship other than the falsified documents readily purchased and currently used by illegal immigrants was opposed and rejected from the bills - and this impact was not permitted to be scored into the cost of the bill.
And, most importantly, I don’t go along as readily as everyone else that the health insurance bill will end discrimination against people pre-existing conditions – who I have heard are going to be “lumped into a high-risk pool”. No one has mentioned whether their premium would be exceptionally higher OR whether their pre-existing condition and anything / everything potentially related to it would NOT be covered under the policy. AND simply by placing a few carefully chosen prescriptions onto their restricted classification of drugs which are not covered, an insurance company automatically makes an insurance policy worthless for people with a great variety of illnesses because if an RX is going to cost $400 to $1000 per month or more in addition to the insurance premium, deduction and co-pay – most families would be forced to pay the tax penalty in addition to continuing to pay for their own medical bills. So by choosing a few drugs associated with certain conditions and placing them on the restricted list, the insurance companies can effectively ward off people with a variety of illnesses. And – what is the mechanism to prevent the insurance companies from denying coverage for pre-existing conditions ? – Well, Congress determined that it is to pay a SMALL fine ! – hmm – would the insurance companies prefer to start welcoming customers with pre-existing conditions – OR –would they choose to pay the SMALL fine in order to increase profits ?
Also, under the new bill, a policy is not "supposed to be cancelled" if one uses it for a large claim - BUT other than the “slogan” that policies are not “supposed to be cancelled”, there has been no mention of how the bill will restrict the cancellation of policies for the VERY SAME reasons already cited as absurdly egregious - eg: saying that one did not claim "this or that" related OR completely unrelated condition on the application. Just questioning issues of the application or the claims themselves can hold up pre-authorizations for treatment - as well as payments – and drag out in appeal – and, therefore, hold up treatments for YEARS - and the person could simply give up fighting the insurance company or be more grievously ill or dead – if / when treatment is finally approved. And – what is the mechanism to prevent the insurance companies from cancelling coverage for large claims ? – Again, it is to pay a SMALL fine ! SO – will the insurance companies cooperatively pay the large claims on a timely basis – OR – pay the SMALL fine to increase profits ? Well consider this . . .in the last 4 years, when insurance companies received large claims, administrators scoured the claimants’ claims and applications and closed more than 19,000 policies – saving just 4 large insurance companies $300 MILLION ! ! !
Overall, I think the insurance companies are the biggest winners in the mandated health insurance reform bill that is being passed.
Also, in general, there is expected to be a minimal lowering of premiums realized over the next few years for those who work for large employers – and a quite small lowering of premiums for those who work for smaller employers and who, now, already have employer-based health coverage. -- And those who are currently purchasing insurance individually on the open market are expected to see an increase.
Well, that’s some of the nuts-and-bolts of a saga for which the sands are still shifting.
Renee
Mike said:there have got to be dozens of summaries of the bill's key terms online. if anyone comes across a good one, please add the link here so that we can all make heads/ tails out of this.
Rock Hinkle said:This bill has been ratified so many times now that I do not know if anyone knows the true effects . I read the original proposal that was linked by Dan Lyons. An extension of medicare seems to be a far cry from what that original bill suggested. This new bill seems to be modeled off of the German and Canadian systems with one exception. Insurance is not mandated by law in either of those countries. Which is my only opposition to it so far. It is early in the game though. As a fence riding libra I could go either way.
-
-
Here's a fusion of info on the recently passed health care reform - CNN, Clark Howard, etc.
CNN – Posting on Health Insurance Reform –http://www.cnn.com/2010/POLITICS/03/23/health.care.timeline/index.h...
Sources: House Ways and Means, Energy and Commerce, and Education and Labor committees; Kaiser Family Foundation
(CNN) -- President Obama signed sweeping health care reform into law Tuesday. The Senate must now pass a package of changes that will reconcile the differences between Senate and House bills. If those changes are worked out, here is how health care reforms will affect you:
Within the first year
2011
2013
2014
2018
Within the first year
• Young adults will be able stay on their parents' insurance until their 26th birthday.
• Seniors will get a $250 rebate to help fill the "doughnut hole" in Medicare prescription drug coverage, which falls between the $2,700 initial limit and when catastrophic coverage kicks in at $6,154.
• Insurers will be barred from imposing exclusions on children with pre-existing conditions. Pools will cover those with pre-existing health conditions until health care coverage exchanges are operational.
• Insurers will not be able to rescind policies to avoid paying medical bills when a person becomes ill.
• Lifetime limits on benefits and restrictive annual limits will be prohibited.
• New plans must provide coverage for preventive services without co-pays. All plans must comply by 2018.
• A temporary reinsurance program will help offset costs of coverage for companies that provide early retiree health benefits for those ages 55 to 64.
• New plans will be required to implement an appeals process for coverage determinations and claims.
• Adoption tax credit and assistance exclusion will increase by $1,000. The bill makes the credit refundable and extends it through 2011.
• A 10 percent tax will be imposed on amounts paid for indoor tanning services on or after July 1.
• Businesses with fewer than 50 employees will get tax credits covering 35 percent of their health care premiums, increasing to 50 percent by 2014.
2011
• Medicare will provide free annual wellness visits and personalized prevention plans. New plans will be required to cover preventive services with no co-pay.
• States can offer home- and community-based services to the disabled through Medicaid rather than institutional care beginning October 1.
• A 50 percent discount will be provided on brand-name drugs for Prescription Drug Plan or Medicare Advantage enrollees. Additional discounts on brand-name and generic drugs will be phased in to completely close the "doughnut hole" by 2020.
• Additional tax for health savings account withdrawals before age 65 for nonqualified medical expenses will increase from 10 percent to 20 percent. Additional tax for Archer medical savings account withdrawals not used for qualified medical expenses will increase from 15 percent to 20 percent.
• A plan to provide a vehicle for small businesses to offer tax-free benefits will be created. This would ease the small employer's administrative burden of sponsoring a cafeteria plan.
• The Medicare payroll tax will increase from 1.45 percent to 2.35 percent for individuals earning more than $200,000 and married filing jointly above $250,000.
2013
• Health plans must implement uniform standards for electronic exchange of health information to reduce paperwork and administrative costs.
• Contributions to flexible savings accounts will be limited to $2,500 per year, indexed by the Consumer Price Index in subsequent years.
• The Employer Medicare Part D subsidy deduction will be eliminated. Employers will lose the tax deduction for subsidizing prescription drug plans for Medicare Part D-eligible retirees.
• There will be increases to the income threshold from 7.5 percent to 10 percent of adjusted gross income. Those older than 65 can claim the 7.5 percent deduction through 2016.
• The hospital insurance tax will increase 0.9 percentage points for those earning more than $200,000 ($250,000 for married filing jointly), and it includes net investment income.
• A 2.9 percent excise tax on the first sale of medical devices will be established. Excepted are eyeglasses, contact lenses, hearing aids or other items for individual use.
2014
• Citizens will be required to have acceptable coverage or pay a penalty of $95 in 2014, $325 in 2015, $695 (or up to 2.5 percent of income) in 2016. Families will pay half the amount for children, up to a cap of $2,250 per family. After 2016, penalties are indexed to Consumer Price Index.
• Workers who are exempt from individual responsibility for coverage but don't qualify for tax credits can take their employer contribution and join an exchange plan.
• Companies with 50 or more employees must offer coverage to employees or pay a $2,000 penalty per employee after their first 30 if at least one of their employees receives a tax credit. Waiting periods before insurance takes effect is limited to 90 days. Employers who offer coverage but whose employees receive tax credits will pay $3,000 for each worker receiving a tax credit.
• Insurers can no longer refuse to sell or renew policies because of an individual's health status. Health plans can no longer exclude coverage for pre-existing conditions. Insurers can't charge higher rates because of heath status, gender or other factors.
• Health plans will be prohibited from imposing annual limits on coverage.
• Health insurance exchanges will open in each state to individuals and small employers to comparison shop for standardized health packages.
• Credits will be available through exchanges for those whose income is above Medicaid eligibility and below 400 percent of poverty level who are not eligible for or offered other acceptable coverage.
• Medicaid eligibility will increase to 133 percent of poverty for all nonelderly individuals to ensure that people obtain affordable health care in the most efficient and appropriate manner. States will receive increased federal funding to cover these new populations.
• An annual health insurance provider fee will be imposed across the health insurance sector according to insurers' market share to companies whose total premiums exceed $25 million.
2018
• 2018 Taxing "Cadillac" plans: An excise tax will be imposed on high-cost, employer-provided health plans beyond $27,500 for family coverage and $10,200 for single coverage; it will increase to $30,950 for families and $11,850 for individuals, retirees and employees in high-risk professions.
____________________________________________________________________________________
Clark Howard posting on Health Insurance Reform
Mar 23, 2010 -- Clark's take on the health care reform law
Following the passage of the new federal health care law, Clark wants to discuss the issues in way that's not political.
This law is not by itself going to destroy freedom in America as we know it, nor will it by itself bankrupt the country. But the problem is that it continues in a direction that's unhealthy for long-term prosperity, by having government take a bigger role in health care and having more of our nation's wealth go to health care.
You've got to understand that the politicians are not stupid people. This law was structured so that many of the benefits come first while the costs come later. Having said that, some things the law does are long overdue, such as banning insurers from redlining customers.
Here's a quick rundown of some highlights you need to know:
• In September, there will be several immediate benefits for children. First, no more pre-existing exclusions for kids. Second, a child can remain on a parent's health care plan until age 26.
• The next big changes come three years down the road and involve higher taxes. For the average person, that means a tax increase of around $450 annually to pay for the law's mandates. Those who earn $125,000 or more will be hit much harder.
• Beginning in 2014, families earning an annual income of $88,000 or less can leave their employer's health plan and get a taxpayer-subsidy to buy health coverage. This provision also applies to small businesses and individuals.
One side-note: From an economic standpoint, the problem with any subsidy is that it takes away some of the pressure to control costs. If somebody else is paying, there's not as much focus on the total bill, is there?
As Clark says, if you work for a big company and get your health insurance through them, there's not much either good or bad for you in this law. Things stay the same. If you're a low-income earner, however, there's a lot of benefit. And those who earn high incomes face a lot of hazard thanks to higher taxes.
In the final summation, what we spend on health care is not sustainable regardless of this new law. The signing of this bill into law is not the end of the process. It's part of the continuation of a dialogue about how we balance between choosing to provide for the well-being of our own health and the nation's wallet.
____________________________________________________________________________________
MY ADDITIONAL COMMENTS
2010 – New plans will be required to implement an appeals process for coverage determinations and claims. Existing plans are not required to implement appeals process.
____________________________________________________________________________________
2010 – Insurance coverage should not be cancelled if one uses it for a large claim. However, the penalty for the insurance companies if they are found to break the “cancellation” ban is only that they would have to pay a SMALL fine (not sure of the amount – however, given that they ONLY have to pay a $100 a day for denying coverage for a pre-existing condition, I don’t expect the fine would be too large for breaking this law either).
– AND, in the legislation, while the insurance companies are to be bound by the “letter” of the law – they are NOT bound by the “spirit” of the law. Therefore, saying that one did not claim "this or that" related OR completely unrelated condition on the application. Or by just questioning issues of the application or the claims themselves can hold up pre-authorizations for treatment – as well as payments – and drag out in appeal – and, therefore, hold up treatments for YEARS - and the person could simply give up fighting the insurance company or be more grievously ill or dead – if / when treatment is finally approved. – And, so, the insurance companies can, readily, by a variety of machinations – LEGALLY EVADE THE "SPIRIT" OF THE LAW.
____________________________________________________________________________________
2014 –Coverage should not be denied to adults with pre-existing conditions; however, the penalty to the insurance companies if found guilty of breaking the pre-existing ban is only to pay a SMALL fine – ONLY $100 a day!
– AND, in the legislation, again, while the insurance companies are to be bound by the “letter” of the law – they are NOT bound by the “spirit” of the law. Therefore, an insurance company could plausibly stipulate a person’s pre-existing condition and / or anything / everything potentially related to it as NOT eligible to be covered under the policy.
ALSO, by simply placing a few carefully chosen prescriptions onto their restricted classification of drugs NOT covered, an insurance company automatically makes an insurance policy worthless for people with a great variety of illnesses because if an RX is going to cost $400 to $1000 per month or more in addition to the insurance premium, deduction and co-pay – most families would be forced to pay the tax penalty in addition to continuing to pay for their own medical bills. So by choosing a few drugs associated with certain conditions and placing them on the restricted list, the insurance companies can effectively ward off people with a variety of illnesses.
And, in the worse case, the only penalty for large insurance companies for restricting policies based on pre-existing conditions is to simply pay the SMALL fine of ONLY $100 a day – and, then, only if they are found to guilty of deliberately breaking the “letter” of the law. Seems likely the insurance companies will readily be able to find methods to LEGALLY EVADE THE "SPIRIT" OF THE LAW.
Also, individuals with pre-existing conditions will be in “high-risk” pools which will likely affect policy premiums, etc.
____________________________________________________________________________________
MISC – The drug companies have been given multi-year extensions of patents so that their RX will remain “brand” longer and thus will be more expensive rather than if they were to change to “generic”.
Until 2020 – The health insurance reform prohibits Congress or any other branch of government from negotiating with the drug companies for any savings on pharmaceuticals.
____________________________________________________________________________________
-
-
Thanks Renee. Your are a breath of fresh air to this forum.
My family and I will hopefully be out of our current situation before this bill would or could help us. If this bill were fully functioning right now I would benefit from it as would my family. I have to support it as it will help future people get out of my situation. I personally would gladly pay more in taxes to that effect.
There are some really good political talks happening on Rock Conners facebook page. You guys should check it out. he has been hiding some political savvy from us.
-
-
The more I've read about it, I have come to the mindset that if all this socialistic health mickey mouse actually gets through the various legal battles that's going to occur, I'm just going to become Amish...they have the option to say "thanks, but no thanks"
Plus, they have way cool hats!
© 2024 Created by The SleepGuide Crew.
Powered by
