Thursday, October 29, 2009

Dissecting the Healthcare Bill (H.R. 3962)

Having many years of consulting experience to the healthcare industry, I thought I'd study this bill and how it affects the healthcare market. Briefly:

Page 18,Line 23: Residency is a requirement for the high-risk pool but there is no exclusion of illegal residents.

Page 26 on lack of funds: the Secretary shall make such adjustments
as are necessary to eliminate such deficit, including
reducing benefits, increasing premiums, or estab
lishing waiting lists.
Nope, no healthcare rationing here (sarcasm).

Page 32,Line 24: Hey,lookie here! Insurers must allow you to insure your children to age 26! WTF?

Page 50, Line 5: No more lifetime benefit limits. So reinsurers will have to buy more catastrophic risk as part of their excess layer package. That'll cost...who pays?

Page 52, Line 22: Hmmm...apparently, no annual limits either.

Page 63, Wellness Grants. Oh cool, the Government will provide preventative care grants to eligible employers. Here's the verbiage for the amount:

(i) the product of $150 and the number of employees of the employer for any plan year; and
(ii) $50,000 for the entire period of the grant.


Wow. That sure would encourage me as that equals about 0.7% of my plan costs paid by me and my employer.

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There's more to read but I have to take a break for now. I'll post more later. What a nightmare.
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Anyone have doubts that this is a government takeover?

Page 94:
(c) LIMITATION ON INDIVIDUAL HEALTH INSURANCE COVERAGE.—
(1) IN GENERAL.—Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of

Y1 as an Exchange-participating health benefits plan.

You weasel-worded lying sacks of shit. Guess Congress thinks we can't read.

Page 102:

(c) PREMIUMS.—Nothing in this section shall be construed as preventing a qualified health benefits plan from increasing the premiums otherwise required for coverage
provided under this section consistent with standards established by the Commissioner based upon family size under section 213(a)(3).


Yeah, trim those costs.

Page 109:

(e) ABORTION COVERAGE PROHIBITED AS PART OF MINIMUM BENEFITS PACKAGE.—

Holy crap, a shred of honesty!

Page 131:

(a) IN GENERAL.—There is hereby established, as an independent agency in the executive branch of the Government, a Health Choices Administration

Yes, folks, we get a whole new agency with a bullshit name. They are eliminating choices, so why not include Choice in the name? Orwellian.

Page 150:

SEC. 262. RESTORING APPLICATION OF ANTITRUST LAWS TO HEALTH SECTOR INSURERS.

What constitutes anti-trust?? Insurance pricing is based on statistical science and one company's premium is likely to be very similar to another's given the same benefits package since actuarial tables are pretty standard. This is just the Dems pissing on another "Big".

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More later.
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Page 272:

Employers contributions are.....

(A) in case of individual coverage, not less than 72.5 percent of the applicable premium
(as defined in section 4980B(f)(4) of such Code, subject to paragraph (2)) of the lowest
cost plan offered by the employer that is a qualified health benefits plan (or is such

current employment-based health plan); and (B) in the case of family coverage which
includes coverage of such spouse and children, not less 65 percent of such applicable premium
of such lowest cost plan.


This is NUTS. Emplyers are already providing a benefit via reducing premiums via group coverage. This is nakedly to discourage employer-sponsored insurance.

Page 276:

Here's one of the more heinous parts:


SEC. 413. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of
the average wages paid by the employer during the period of enrollment

(determined by taking into account all employees of the employer and in
such manner as the Commissioner provides, including rules providing for the
appropriate aggregation of related employers) but not to exceed the minimum
employer contribution described in section 412(b)(1)(A).
Any such contribution—
(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance

Exchange Trust Fund; and
(2) shall not be applied against the premium of the employee under the Exchange-participating
health benefits plan in which the employee is enrolled.


Boil this down. You can opt out of your employee group plan which will become very expensive due to the provisions I detailed above by paying 8% of your employee wages. Right now, for an employee making $50,000 with a wife and 2 kids the premium is probably about $9,600 a year. Right now, it's a crapshoot who (employer or employee) is paying what but if you look at the previous provision the employer would be required to pay 65%, or $6,240. OTOH, the employer can forego an employer-sponsored healthcare plan and send 8%, or $4,000, to the Government. If you opt out you save $2000+ per employee per year and your employees are now in the Exchange and likely moving to the "public option". More lies about not taking over the healthcare market when the economics force otherwise.

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Pause for reflection. I've read 1/6th of the bill so far and it's mainly a red herring for the crap the Dems claim that they wouldn't do, but they do it indirectly. Like killing private health plans.

Is it too much to ask for these fuckwads to come clean once in a while? Why lie, hide, and otherwise misdirect your intent if you're so sure it's right?

My liberal friends hate me because they claim I'm conservative. My conservative friends are upset because I'm libertarian. But what it all boils down to, for me, is the truth. Tell me the truth - I don't have to like it but it begins an honest debate. Lie to me, treat me dishonestly, and I'll never listen to you and I'll try to discredit you with the facts every chance I get. Today's absolute, no doubt liars are House Democrats. Somehow I doubt I'll get any factual rebuttals. Just your typical pod-people koolaid drinkers.

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