Obamacare – The REAL Talking Points

Amid all the barbs and rhetoric, most people have completely missed the true points of health care, or more precisely, health insurance reform. That is probably because very few have read the bill known as HR 3200.

I have read through it but admittedly not line by line. But I have read enough to become familiar with what should be the REAL talking points and things that are truly frightening if they come to pass.

Those of you who want to play along at home can by clicking the link above and searching for the notated section. Feel free to offer your own take. I promise not to pull a Barney Frank and say that arguing with you is like talking to a dining room table.

So here goes.

Section 101 requires that coverage be affordable. That is well and good but salient points of the bill do just the opposite.

Section 102 says you can keep your current coverage. So far that tracks what the president has said but here is what he has not said. You may keep your current coverage, including employer based coverage. But if the plan changes after “Y1” (the year when these provisions go into effect) you must change to a new, QUALIFIED health plan that meets the guidelines of HR 3200.

For those concerned, I am not going to hit every section of the bill, so don’t think you need to get popcorn and a beer. This will be long, but not that long and slightly more entertaining than Ishtar.

I have no idea what happened to sections 103 – 110, but it certainly appears they want to stuff more goodies in this bill.

Section 111 addresses banning the practice carriers have of excluding coverage for pre-existing medical conditions. On the surface this seems great but Congress has not asked the CBO to price these provisions as well as most other benefit enhancements. This provision alone will increase CURRENT premiums by 50 – 100%. That does not meet my definition of “affordable”. Since the CBO has not priced Section 111 you won’t find those figures in the $1 trillion plus budget amounts that have been discussed.

Section 113 (see, I told you I would not address every section) sets premium limits. This is what is commonly referred to as community rating and currently exists in the small group health market and a handful of states for the individual market. To an extent, it also is used in many risk pools as well as HIPAA plans. Limiting the premium span to 2x the rate may sound great but unfortunately you don’t know what that lower rate will be. Using 2x a single rate of $300 might not seem that bad if you are taking a medication that costs $3,000 per month. Even boosting the starting rate to $600 is still a bargain for the $3,000 per month pill poppers but those who are healthy will not be willing participants at $600.

Therein lies one of the problems. The more sick people you want to cover under this plan and the more restrictions that are placed on premium caps the higher the base premium goes which drives off the healthy ones.

Section 114 isn’t getting much play, but mental health parity is a mine field. Simply put, health insurance plans can no longer refuse to cover or limit treatment for any mental health condition, including drug and alcohol abuse. If you have a mental health problem you are entitled to the same level of benefits as someone with cancer or a heart condition. That is one expensive benefit. Add at least 15 – 20% to base premiums on top of the 50 – 100% you have increased current rates for Section 111 (non-discrimination of existing medical conditions).

If you are keeping score, take your current premium and increase it by 65 – 120% just to cover Sections 111 & 114.

Section 122 requires health insurance plans issued once HR 3200 goes into effect to cover all preventive care at no charge to the individual. In addition to your annual exam, there is a litany of diagnostic tests that will be available at no charge to the patient. Newborns are covered from birth to age 21 for preventive care, dental, vision, and hearing at no charge. This will add about 20% to current premiums for children’s premiums.

How are you liking this so far?

We haven’t even touched on the new layers of government oversight and bureaucracy, public options, health insurance exchanges, reductions in Medicare. I think I will save that for later.

But in case you haven’t been keeping track, the benefit mandates up through Section 122 will increase your individual premiums by 65% – 120% over current levels and if you have children add another 20% minimum to cover them for new benefits. Did I mention there are over 3000 sections and 1100 pages in this bill and we are just getting started.

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