OK, I started reading this thing and taking notes on it yesterday.
Text in red is directly from the GPO pdf of the bill.
Dr. Who is much more interesting.
DIVISION A - AFFORDABLE HEALTH CARE CHOICES
Sec. 100 PURPOSE; TALBLE OF CONTENTS OF DIVISION; GENERAL DEFINITIONS
a)1) The purpose of this division is to provide affordable, quality health care for all Americans and reduce the growth in health care spending.
Will the bill ever address how you can increase the number of people utilizing our health care system without increasing the amount you need to spend?
a)2) actually uses the word "broken" to describe aspects of the health care system.
a)3) discusses how the bill will reform health insurance.
a)4) Entitled HEALTH DELIVERY REFORM
First the snarky question - how do you deliver health? Second - similar question to a1, how do you increase quality of health care to more people while spending less per person?
b) the table of contents
c) general definitions used throughout the bill, with many references to ERISA 1974
c)25) Y1 ... and similar subsequently numbered terms, mean 2013 and subsequent years, respectively.
Do most folks who are pushing for this realize that it won't help anyone for at least 4 years?
Now we get to the actual TITLE I of the bill - PROTECTIONS AND STANDARDS FOR QUALIRIED HEALTH BENEFITS PLANS.
Subtitle A - General Standards
Sec. 101 REQUIREMENTS REFORMING HEALTH INSURANCE MARKETPLACE
That is an exact quote from the GPO copy of the bill. Does anyone out there know what it means? Otherwise the section is actually comprehensible, at least to someone with a postgraduate level of education.
Sec. 102 PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE
a) defines grandfathered coverage. If I'm reading this right, only individual plans (not group, or employer plans) can be grandfathered. However, per b)1) there is a 5 year transition period for group plans.
a)1) beginning with day 1 of Y1, no new enrollees in existing plans, except for adding dependents.
a)2) NOTHING about a plan can change except for the premiums or other changes required by law.
a)3) defines the premium increase rules.
b)1) by the beginning of Y6, all employment based plans must meet requirements of Sec 101 for QHBPs, i.e., unless your plan already met the requirements on Day 1, Y1, YOU CAN NO LONGER KEEP YOUR
PLAN
b)2) beginning with Day1, Y1, the only individual plans for new enrollees must be QHBPs and must be Exchange participating.
Subtitle B - Standards Guaranteeing Access to Affordable Coverage
Sec. 111 PROHIBITING PRE-EXISTING CONDITION EXCLUSIONS
A short section, only one paragraph, which prohibits QHBPs from imposing pre-existing condition exclusions or limits.
Sec. 112 GUARANTEED ISSUE AND RENEWAL FOR INSURED PLANS
This is a little unclear on initial reading, partly because it references sections 2711 and 2712 of the Public Health Service Act, but it sounds like once someone is in a plan, as long as they pay their premiums they can never be dropped, for any reason. As a reasonable person, I would read this section to say that a) an insured can never be dropped unless they fail to pay their premiums, and b) as long as a single insured wishes to keep their plan, the insurer MUST keep insuring them.
Does this mean that once a plan is offered the insurance company can never stop offering it? i.e., if BigInsCo decides they no longer want to offer group plans, they must continue for as long as a single
client wishes to use that plan?
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