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#992153 Sep 30, 2013
COMPILATION OF PATIENT PROTECTION
AND AFFORDABLE CARE ACT
[As Amended Through May 1, 2010]
RELATED PORTIONS OF THE
PREPARED BY THE
Office of the Legislative Counsel
FOR THE USE OF THE
U.S. HOUSE OF REPRESENTATIVES
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June 9, 2010
OFFICE OF THE LEGISLATIVE COUNSEL
SANDRA L. STROKOFF, Legislative Counsel
EDWARD G. GROSSMAN, Deputy Legislative Counsel
Deputy Legislative Counsel
with the assistance of
This document is of the Patient Protection and Affordable Care
Act (‘‘PPACA’’; Public Law 111–148) consolidating the amendments
made by title X of the Act and the Health Care and Education Rec-
onciliation Act of 2010 (‘‘HCERA’’; Public Law 111–152). The text
of the Indian Health Care Improvement Reauthorization and Ex-
tension Act of 2009 (S. 1790), as enacted (in amended form) by sec-
tion 10221 of PPACA, is shown in a separate, accompanying docu-
Preparation of document
.—This document was prepared by
the attorneys and staff of the House Office of the Legislative Coun-
sel (HOLC) for the use of its attorneys and clients. It is not an offi-
cial document of the House of Representatives or its committees
and may not be cited as ‘‘the law’’. At the request of the Leader-
ship, it is being made available to the public through Congressional
websites and may be downloaded at http://docs.house.gov/
energycommerce/ppacacon.pdf. Errors in this document are solely
the responsibility of HOLC. Please email any corrections to
‘‘firstname.lastname@example.org’’ . This document (originally dated
May 24, 2010) may be updated to reflect corrections of errors or
subsequent changes in law.
United States Code citations
.—United States Code section
numbers assigned to sections in PPACA are specified in brackets
after the section numbers in the heading of each section, viz., 2711
42 U.S.C. 300gg–11
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June 9, 2010
#992155 Sep 30, 2013
how's it feel to have conservatives telling the tea party nutjobs that they're failing?
#992156 Sep 30, 2013
sonicmoron always 24/7 bent over and punked by cut-n-paste spam and Fox News...
If it's ghetto, ignorant, and idiot, it's free cheese, loser, and liberal..
It's the culture...
#992157 Sep 30, 2013
OK, write this down: Topix September 30, 2013, Page 45746. We can have a 1 year reunion and then a 2 year reunion where those of us who didn't believe the Have Teleprompter Will Speak Empty Suit POTUS will get to shout in unison: "Told you so."
Obamacare is an Invitation to fraud:
The system also can’t verify your income or whether your employer offered you “affordable” coverage. So Team Obama says it will often have to rely on applicants’“attestation”— that is, take their word for it. After all, who would lie?
And get ready for Identify theft:
To figure out who’s eligible for subsidies or Medicaid, the exchanges will collect both tax and health-care data from applicants — everything from last year’s income to the prescription drugs you take.
All that data’s supposed to go into a “data hub” that draws on records from at least seven different government agencies — the IRS, the Social Security Administration, Homeland Security, the Veterans Health Administration, the Department of Defense, the Office of Personnel Management and the Peace Corps.
But the administration has missed repeated deadlines for testing, reporting and correcting security risks for the hub. The program’s security is supposed to be certified ... today — the day before it goes into effect.
That’s not all. State-employed “navigators” are supposed to help people through the exchange’s byzantine application process; they’ll have access to such sensitive information as your Social Security number, date of birth, bank account number, place of employment and medical history. But many states hired navigators without doing criminal background checks; the only definite requirement is 20 hours of training. Can you imagine the hoodie wearing thugs of the same calibre as TSA screeners will be handling your application?
For years we’ve been debating ObamaCare. Now, at last, millions of Americans are about to find out exactly what it means for them. They’re not likely to be pleased but the mostly clueless will as intended by Democrats, not wake up until after the midterm elections or in a couple of years when they eventually find out their kids social security numbers are being used by a couple of thousand illegal aliens. Or, their personal medical info has been sold after having been hacked into.
#992158 Sep 30, 2013
when in doubt, do what your VP tells you to do...
Biden's Shotgun Advice Invoked as Defense by Man Arrested for Shooting Gun in Air"
#992159 Sep 30, 2013
The physician said on CNN’s “State of the Union” that consumers are in for a case of sticker shock, adding that Americans will have difficulty finding a doctor to care for them.
“The president made a couple of promises. One with the exchanges, and he said it would be cheaper than a cell phone bill. And I don't expect a lot of people to be able to find something less than $71 a month on the exchanges,” he said.
“People are going to be paying more. And he said … if you have your doctor and you like your doctor, you can keep your doctor. We're seeing all across the country exchanges that trying to get the price down have had to exclude many doctors.”
Barrasso rattled off a list of states with exchange problems, including Vermont, Oregon and the District of Columbia.
“This law is unworkable. It's unpopular. It is unaffordable for us as a nation. It's hurting jobs. It's hurting the economy. And now, what I'm hearing and I was at a health fair in Wyoming yesterday, it is unfair,” Barrasso said.
“Someone said to me why is it that the president is going to give my boss a one-year delay? The bosses are getting a delay, but the workers are not. And we need a delay in the individual mandate.”
Senators on Monday are expected to consider a stopgap spending bill approved by the House early Sunday that delays ObamaCare for one year.
Read more: http://thehill.com/video/sunday-shows/325355-...
Follow us:@thehill on Twitter | TheHill on Facebook
#992160 Sep 30, 2013
$5 grand deductible on the lowest cost plan?
if I get sick and spend a week in the Hospital: cost around $200,000
I only owe $5 grand!
On the lowest cost plan!
SIGN ME UP!
Most people who buy their own insurance now have $10,000 deductible.
OBAMACARE! Saving me $400 per month with BETTER coverage!
Provided by Blue Cross......great outfit!
(Sell your poison to your grandma....stupid idiot!)
#992161 Sep 30, 2013
PORTLAND, Ore.— Rocky King, the executive director of Oregon’s new health insurance exchange, has done everything in his power to tamp down expectations for its opening on Tuesday.
Shopping for Coverage
On the Threshold of Obamacare, Warily (September 29, 2013)
Your Money: A Guide to the New Exchanges for Health Insurance (September 28, 2013)
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Thomas Patterson for The New York Times
Rocky King, who heads Oregon’s new health insurance exchange, said,“I have no idea what this thing’s going to look like on Oct. 1.”
He rejected the idea of a flashy downtown news conference that morning. He postponed a series of ads meant to drive customers to its Web site, coveroregon.com . In fact, Mr. King is not even allowing people to sign up for health coverage online without assistance at first; they will have to go through an insurance agent or a community group until at least mid-October.
Tuesday is the long-awaited kickoff of President Obama’s signature health care law, when millions of Americans can start signing up for new insurance options. Yet across the country, officials are issuing warnings that despite fevered efforts, their new insurance exchanges — online markets where people can shop for health plans and see if they qualify for federal subsidies — will not be fully operational for weeks or even months.
Last week, the District of Columbia’s exchange announced that it would not immediately be able to determine online whether people qualify for Medicaid, which about half the states are expanding under the law, or for a federal subsidy to help cover the cost of private coverage. In Colorado, for the first month, people who want to know if they are eligible for a subsidy will have to call a customer service line.
In Nevada, home to a large Hispanic population, a Spanish-language version of the exchange Web site will not be ready until mid-November. And in Maryland, small businesses will not be able to buy insurance for their employees through the state exchange until January. Federally run exchanges are having similar problems.
Many of the 16 directors of state-run exchanges are describing October as a “soft launch” period, when Americans can start exploring their coverage options — but on Web sites that may be incomplete, vulnerable to glitches and perhaps not ready for an onslaught of customers.
“I have no idea what this thing’s going to look like on Oct. 1,” Mr. King said one afternoon last week as dozens of tense-looking programmers, scattered through the exchange offices outside Portland, rushed to finish testing and fix problems.“We could crash and burn and have to close it down.”
The outcome could hardly be more important for Mr. Obama. With Republicans threatening to shut down the government unless Democrats agree to delay the law for a year, even small problems with the exchanges could be powerful fodder for the law’s opponents.
In an indication of the difficulty of the job, some of the states with delays, like Oregon and Maryland, have been preparing for many months and have political leaders who strongly support the law.
“It makes you wonder about the exchanges that actually have been at this a shorter period of time,” said Jon Kingsdale, a managing director at Wakely Consulting Group, who is advising several state-run exchanges.“Do they even know what their problems are?”
The federal government, which will operate all or part of the exchanges in more than 30 states that declined to create their own, mostly because of political opposition to the law, is having readiness problems of its own. In one example, the Obama administration said on Thursday that small businesses would not be able to buy coverage online through federally run exchanges until November.
#992162 Sep 30, 2013
If it's ghetto, ignorant, and idiot, it's illiterate, loser, RealDumbDave and liberal..
We're suppose to care what you ghetto cheese folk "think?" LMAO.. You folk ain't NO Tea Party....
It's the culture...
#992163 Sep 30, 2013
Total BS unless this is already Rwanda or Zimbabwe. If the applicants couldn't get their welfare checks without photo ID, they'd manage to get a picture taken and pronto.
#992164 Sep 30, 2013
“Everybody is working 24/7,” Christine C. Ferguson, the director of Rhode Island’s exchange, told reporters in a conference call last week.“We are sliding into that date still testing and making sure that we are able to fulfill the promise that we’ve made for Oct. 1.”
Enlarge This Image
Thomas Patterson for The New York Times
Cover Oregon is the state’s new insurance marketplace.
On the Threshold of Obamacare, Warily (September 29, 2013)
Any insurance coverage acquired through the exchanges will not take effect until Jan. 1, when the health care law will start requiring most Americans to have insurance or pay a tax penalty. Ms. Ferguson and other officials are predicting that while people might flood the exchange Web sites in October to learn about their options, few will actually enroll so soon.
To be covered starting Jan. 1, people need to sign up for coverage through the exchanges by Dec. 15. The first open enrollment period will run from Oct. 1 to March 31.
“The idea that huge numbers are in essence going to do layaway purchasing three months out, I just think runs against the American way,” Ms. Ferguson said.
Peter V. Lee, the executive director of California’s exchange, joked in the conference call with Ms. Ferguson last week that he expected a total of two people to sign up for health plans on Day 1. Tuesday, he said, would be “important as a historic marker of our nation saying health care is a right, not a privilege.” But California does not expect many people to start signing up until November, he added.
At the state’s exchange here, known as Cover Oregon, posters urge the staff to “Keep Calm and Go Live.” Last week, 180 staff members and consultants were proofing some 500,000 lines of computer code, 1,500 Web site pages and 5,000 possible premium rates that will vary depending on where people live, how old they are, how much money they make and which insurance company and plan they choose. A downstairs conference room had taken on the look of a modern-day sweatshop, with long tables lined with workers tapping away on laptops. Even the bike storage room had been converted to a testing room.
“Still smiling?” Mr. King asked one group of workers.“O.K.”
Mr. King said rate quotes had been one of the trickiest things to get right, a problem that also appears to be plaguing other states and the federal government. Mila Kofman, the executive director of the D.C. Health Benefit Exchange Authority, said she had discovered “a high error rate, about 15 percent,” in tests to determine if people were eligible for tax credits or Medicaid. The errors, she said, occurred in complicated cases involving large families with different sources of coverage.
“If one in 10 people get the wrong information,” Ms. Kofman said,“that’s too many in my book.”
Because of the errors, Ms. Kofman said, a family might be told it qualified for a tax credit of $150 a month when it was eligible for only $50.
The agency will be able to determine eligibility in November, she added, and people who qualify will still be able to get subsidized coverage on Jan. 1 as originally planned.
In Portland, Mr. King said a “go-live team” would hunker down on Tuesday in a “situation room” next to his office, monitoring a hot line that insurance companies, agents and community groups helping with enrollment and others can call to report technological problems. Similar efforts will play out in state exchanges across the country.
“I tell everybody,‘If the site isn’t right, I’ll close it and we’ll fix it,’” he said.“We’ve just got to make sure that stuff is correct for folks.”
#992165 Sep 30, 2013
Peter Suderman has a clear explanation of “the disarray, dysfunction, and legislative blundering” that is plaguing the congressional GOP. He observes that Republicans have nothing like a workable legislative strategy, because a determined group of GOP lawmakers refuses to acknowledge that a legislative minority can only do so much:
The trick will be to work effectively within those limits, exploiting clear opposition weak points and pushing for narrow victories that stand some change of being accomplished.…
But what Cruz and many of his allies in the defunding fight have done is just the opposite. They have gone big—on rhetoric, on theatrics, on policy requests. And they have stoked demand for grand showdowns amongst many of their supporters, making it harder for those who might prefer more targeted battles to proceed. They’re getting the showdowns. But they’re not getting much else.
Right now the GOP has no strategic or tactical savvy. Instead, the party has a surfeit of bluster.
#992166 Sep 30, 2013
New Yorkers will pay less than they used to for individual health insurance under ObamaCare — but they better not get used to it, because steep increases are on the way and the choice of doctors will be limited, critics warn.
While health-insurance costs will balloon around the country under the Affordable Care Act, an unusual legal situation in the Empire State will lower prices when the markets for President Obama’s signature legislative achievement open on Tuesday.
Everyone who doesn’t already have a medical policy — through work, Medicare or otherwise — will have to buy a policy or face fines once ObamaCare begins.
In New York, the new presidential plans can be had for an average of 29 percent less than old individual policies —$356 a month, compared with $500 — experts at the Manhattan Institute for Policy Research predict.
By comparison, the monthly rate for a 27-year-old man in Connecticut will soar 98 percent, to $238. A 64-year-old woman in that state will see her premium surge 83 percent, to $683, an analysis by the institute found.
Lead researcher Yevgeniy Feyman said New York’s situation is “very, very unique” due to insurance-industry reforms signed into law by Gov. Mario Cuomo in 1992.
The state’s “pure community rating” system requires insurance companies to offer policies at the same price, regardless of the purchaser’s age, gender or health.
“This is what destroyed the New York individual market,” where costs are currently among the highest in the nation, Feyman said.“That being said, the rate we [will] have,$356, is not cheap.”
Feyman said his group’s $356 figure for New York is a composite based on the average cost of the “bronze” policies that are the least expensive among four levels of standard coverage:“platinum,”“gold,”“si lver” and “bronze.”
Top-tier platinum policies will cost individuals up to $896 a month, the state Health Department’s online estimator shows.
Available tax credits can reduce the price for individuals earning less than $45,960 or families of four earning less than $94,200, limiting their maximum cost to 9.5 percent of annual taxable income.
The complex formulas also offer bigger breaks to residents of Staten Island.
For example, a single Manhattan resident earning $35,000 a year will get a monthly credit of $88, while a single Staten Islander will get a credit of $107.
A Health Department spokesman said the difference was due to the higher price of Staten Island’s second-lowest-cost silver plan.
The penalty for ignoring ObamaCare’s “individual mandate” to buy health insurance next year is $95 per adult and $47.50 per child — up to $285 per family — or 1 percent of taxable family income, whichever is higher.
But it will jump to $325 per adult and $167.50 per child, or 2 percent of income, in 2015, and to $695 per adult and $347.50, or 2.5 percent of income, in 2016, with future hikes tied to cost of living.
Pacific Research Institute President Sally Pipes, author of “The Cure for Obamacare,” said that’s not enough to get healthy, young adults to shell out for coverage.
“Even though the price is down, the price is still very expensive,” she said.“People are not going to buy into this. Then the system will implode.”
Merrill Matthews, a resident scholar at the Institute for Policy Innovation, predicted a “death spiral” in which the rates rise over the next several years, leading healthy people to drop their coverage while “very sick” people “stay in until the very last drop,” forcing rates up even more.
#992167 Sep 30, 2013
I don't think there should be a delay. Let voters find out that as usual, there are negative consequences for not paying attention. Obamacare is the domestic outcome of his failing. Losing the war on terror and a diminished world presence is the international outcome, and we've already seen it and the US may never recover from it.
#992168 Sep 30, 2013
You ain't NO Tea Party....
AND... We're suppose to care about what you ignorant ghetto folk "think?" LMAO..
It's the culture...
Since: May 11
#992169 Sep 30, 2013
Yes, everything relates to Hitler. Lets just nuke the bastards now.
#992171 Sep 30, 2013
Cruz and the Defeat Caucus
To the extent that the theatrics of the last week contribute to a government shutdown, that will likely sour the public even more on Republicans in Congress and that might end up undermining Republican candidates in competitive states.
#992172 Sep 30, 2013
“The death spiral is well known in health insurance,” he said.
Edmund Haislmaier, who studies health-care policy for The Heritage Foundation, said some medical providers will refuse to accept ObamaCare, noting four of the insurers offering policies in New York specialize in Medicaid plans.
“You’re going to have very limited access to doctors and hospitals,” he said.
Danielle Holahan, deputy director of the New York State of Health marketplace, said that officials believe the rates being offered are “sustainable,” and that 330,000 uninsured residents will buy ObamaCare over the next three years, up from 17,000 who buy individual insurance now.
She also said a “network adequacy requirement” for insurers means everyone on ObamaCare will be able to get to a doctor or hospital in their network within 30 minutes on public transportation.
THE WHOLE NATION WILL TURN AGAINST OBAMA AND THE
GOP AND DEM THAT SUPPORT OBAMA CARE!!!!!I AM TALKING ABOUT THE MIDDLE CLASS PEOPLE PAYING FOR
IT,NOT THE HEALTHY PEOPLE THAT ARE ON WAFARE WERE IT IS FREE AND THE RICH WILL NOT GIVE A DAMN LIKE OBAMA WHO DOES NOT HAVE TO BE ON OBAMA CARE!
#992173 Sep 30, 2013
Then you are either a welfare case or a lying communists scumbag.
#992174 Sep 30, 2013
Hitler too blamed the Jews and gassed them...
RealDumbDave ain't no Tea Party...
It's the culture...
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