Health Care Debate - Atlanta, GA

[ru kidding]

General Robert E Lee wrote:

<quoted text>
Page 57, section 163.
http://usconservatives.about.com/b/2009/08/02...

It is just not there, plain and simple.

[ru kidding]

Yet page 57
Sec. 1252 PPACA (Consolidated) 56
health plan (as defined in section 5000A(f)(2) of the Internal
Revenue Code of 1986) other than such grandfathered
health plan.
(b) ALLOWANCE FOR FAMILY MEMBERS TO JOIN CURRENT COVERAGE.—
With respect to a group health plan or health insurance
coverage in which an individual was enrolled on the date of enactment
of this Act and which is renewed after such date, family
members of such individual shall be permitted to enroll in such
plan or coverage if such enrollment is permitted under the terms
of the plan in effect as of such date of enactment.
(c) ALLOWANCE FOR NEW EMPLOYEES TO JOIN CURRENT
PLAN.—A group health plan that provides coverage on the date of
enactment of this Act may provide for the enrolling of new employees
(and their families) in such plan, and this subtitle and subtitle
A (and the amendments made by such subtitles) shall not apply
with respect to such plan and such new employees (and their families).
(d) EFFECT ON COLLECTIVE BARGAINING AGREEMENTS.—In the
case of health insurance coverage maintained pursuant to one or
more collective bargaining agreements between employee representatives
and one or more employers that was ratified before
the date of enactment of this Act, the provisions of this subtitle and
subtitle A (and the amendments made by such subtitles) shall not
apply until the date on which the last of the collective bargaining
agreements relating to the coverage terminates. Any coverage
amendment made pursuant to a collective bargaining agreement
relating to the coverage which amends the coverage solely to conform
to any requirement added by this subtitle or subtitle A (or
amendments) shall not be treated as a termination of such collective
bargaining agreement.
(e) DEFINITION.—In this title, the term ‘‘grandfathered health
plan’’ means any group health plan or health insurance coverage
to which this section applies.
SEC. 1252 ø42 U.S.C. 18012¿. RATING REFORMS MUST APPLY UNIFORMLY
TO ALL HEALTH INSURANCE ISSUERS AND
GROUP HEALTH PLANS.
Any standard or requirement adopted by a State pursuant to
this title, or any amendment made by this title, shall be applied
uniformly to all health plans in each insurance market to which
the standard and requirements apply. The preceding sentence shall
also apply to a State standard or requirement relating to the standard
or requirement required by this title (or any such amendment)
that is not the same as the standard or requirement but that is not
preempted under section 1321(d).
SEC. 1253 ø42 U.S.C. 18013¿. ANNUAL REPORT ON SELF-INSURED
PLANS.
Not later than 1 year after the date of enactment of this Act,
and annually thereafter, the Secretary of Labor shall prepare an
aggregate annual report, using data collected from the Annual Return/
Report of Employee Benefit Plan (Department of Labor Form
5500), that shall include general information on self-insured group
health plans (including plan type, number of participants, benefits
offered, funding arrangements, and benefit arrangements) as well
as data from the financial filings of self-insured employers (includ-
VerDate

[ru kidding]

What page your were not informed well about:

37 PPACA (Consolidated) Sec. 1104
(c) AUTHORITY TO CONTRACT.—The Secretary may carry out
this section through contracts entered into with qualified entities.
SEC. 1104. ADMINISTRATIVE SIMPLIFICATION.
(a) PURPOSE OF ADMINISTRATIVE SIMPLIFICATION.—Section 261
of the Health Insurance Portability and Accountability Act of 1996
(42 U.S.C. 1320d note) is amended—
(1) by inserting ‘‘uniform’’ before ‘‘standards’’; and
(2) by inserting ‘‘and to reduce the clerical burden on patients,
health care providers, and health plans’’ before the period
at the end.
(b) OPERATING RULES FOR HEALTH INFORMATION TRANSACTIONS.—
(1) DEFINITION OF OPERATING RULES.—Section 1171 of the
Social Security Act (42 U.S.C. 1320d) is amended by adding at
the end the following:
‘‘(9) OPERATING RULES.—The term ‘operating rules’ means
the necessary business rules and guidelines for the electronic
exchange of information that are not defined by a standard or
its implementation specifications as adopted for purposes of
this part.’’.
(2) TRANSACTION STANDARDS; OPERATING RULES AND COMPLIANCE.—
Section 1173 of the Social Security Act (42 U.S.C.
1320d–2) is amended—
(A) in subsection (a)(2), by adding at the end the following
new subparagraph:
‘‘(J) Electronic funds transfers.’’;
(B) in subsection (a), by adding at the end the following
new paragraph:
‘‘(4) REQUIREMENTS FOR FINANCIAL AND ADMINISTRATIVE
TRANSACTIONS.—
‘‘(A) IN GENERAL.—The standards and associated operating
rules adopted by the Secretary shall—
‘‘(i) to the extent feasible and appropriate, enable
determination of an individual’s eligibility and financial
responsibility for specific services prior to or at the
point of care;
‘‘(ii) be comprehensive, requiring minimal augmentation
by paper or other communications;
‘‘(iii) provide for timely acknowledgment, response,
and status reporting that supports a transparent
claims and denial management process (including adjudication
and appeals); and
‘‘(iv) describe all data elements (including reason
and remark codes) in unambiguous terms, require that
such data elements be required or conditioned upon
set values in other fields, and prohibit additional conditions
(except where necessary to implement State or
Federal law, or to protect against fraud and abuse).
‘‘(B) REDUCTION OF CLERICAL BURDEN.—In adopting
standards and operating rules for the transactions referred
to under paragraph (1), the Secretary shall seek to reduce
the number and complexity of forms (including paper and
VerDate 0ct

[ru kidding]

Now the key thing: It allows for rules for Administrative funds transfers.‘‘(B) REDUCTION OF CLERICAL BURDEN.—In adopting
standards and operating rules for the transactions referred
to under paragraph (1), the Secretary shall seek to reduce
the number and complexity of forms (including paper and
VerDate 0ct

Nothing here gives Uncle Sam access to your bank account. Try reading and posting from the bill, not some crack pot Faux news site. Educate your self. You may have been an educated man over 200 years ago General, but it is 2012.

http://housedocs.house.gov/energycommerce/ppa...

[General Robert E Lee]

The government has the sole authority to fish money out of patient bank accounts without constraint and in real time. Under (4)(C) of this subsection it says the government would have the capability to "enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice ... "

For individuals who opt in on a government plan, there are, according to (a)(6)(F) of subsection 1173A, "civil monetary and programmatic penalties for non-compliance ..."

Nowhere in section 163 does it outline a requirement for patient authorization. In other words, the government can take patient money without their permission, authorization, or knowledge.

[ru kidding]

General Robert E Lee wrote:

The government has the sole authority to fish money out of patient bank accounts without constraint and in real time. Under (4)(C) of this subsection it says the government would have the capability to "enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice ... "
For individuals who opt in on a government plan, there are, according to (a)(6)(F) of subsection 1173A, "civil monetary and programmatic penalties for non-compliance ..."
Nowhere in section 163 does it outline a requirement for patient authorization. In other words, the government can take patient money without their permission, authorization, or knowledge.

Nowhere in section 163 does it outline the government to take any patients funds, in other words the government cannot take funds from a private individuals account ..

[ru kidding]

Again General, you were educated over 200 years ago.

‘‘(A) demonstrates to the Secretary that the plan conducts
the electronic transactions specified in paragraph (1)
in a manner that fully complies with the regulations of the
Secretary;

http://housedocs.house.gov/energycommerce/ppa...

Notice above, as repeated throughout this section, this electronic transfer is conducted by the plan [insurance provider] to the service provider. And relates to the following bill:(a) PURPOSE OF ADMINISTRATIVE SIMPLIFICATION.—Section 261
of the Health Insurance Portability and Accountability Act of 1996 as stated in section 1104. This section only joins HIPPA to the AHA. Nowehere in this section does it refer to private patient bank accounts, or for that matter any new law on fund transfers. It allows for existing Hippa law to stay intact. The law that has protected patients since 1996.

Again ADMINISTRATIVE SIMPLIFICATION, plan administration.

[ru kidding]

Now if this is the part you do not get allow me to explain.

‘‘(i) to the extent feasible and appropriate, enable
determination of an individual’s eligibility and financial
responsibility for specific services prior to or at the
point of care;
‘‘(ii) be comprehensive, requiring minimal augmentation
by paper or other communications

When I go to the doctor I have a co-pay, when I get meds I have a co pay. My insurance is put in a computer at the doctors office and or pharmacy. My eligibility and financial
responsibility for specific services is determined at this time, I cough up the co-pay and the insurance end of the transaction is electronic. Could you imagine the administrative cost if BC BS cut a check every time one of their clients got blood drawn, had a CT, an exray, an ER visit, a doctors visit or visited the pharmacy. These electronic transactions take place under HIPPA. I give my insurance card to a provider. The provider punches in my info. Enabling determination of an my eligibility and financial responsibility for specific services. My responsibility is coughed up out of my pocket. My (eligibility) is transfered from my insurance company to the provider.

[General Robert E Lee]

In addition to the government being enabled to engage in electronic funds transfers from personal accounts without authorization, here are 10 other tax increases that are included in Obamacare. These are not the only new taxes in Obamacare.

1. Hospital Insurance Tax. Beginning in 2013, Obamacare increases the Hospital Insurance (HI) portion of the payroll tax from 2.9 percent to 3.8 percent for families earning more than $250,000 a year and for single filers earning more than $200,000 annually. The increased HI tax is also applied to investment income for the first time. The 3.8 percent surtax on investment income is the most economically damaging tax in Obamacare. And these tax increases won’t remain just on families making more than $250,000 a year for long. As the JEC explains, this tax is not indexed to inflation:“This means that in just 10 years from now, the so-called ‘high-income’ thresholds will have effectively ratcheted down to $152,000 and $190,000 in today’s dollars.” This tax increase amounts to $210 billion between 2013 and 2019.

2. Mandate Penalties. In 2014, Obamacare’s individual and employer mandates go into effect, forcing individuals to purchase coverage and employers to offer coverage to their workers. The penalties paid in association with these mandates are an estimated $65 billion between 2014 and 2019.

3. Health Insurance Provider Fee. Starting in 2014, Obamacare imposes an annual fee on health insurance providers based on each company’s share of the total market. This totals a $60 billion tax hike between 2014 and 2019.

4.“Cadillac” Tax. In 2018, Obamacare puts a new 40 percent excise tax on “Cadillac” health plans, meaning plans that cost more than $10,200 for an individual and $27,500 for families. However, this tax is not indexed to medical inflation, causing it to eventually tax “Honda” plans at this rate as well. The JEC points out that “[t]he bulk of revenues from the ‘Cadillac’ tax would not be paid by platinum health insurance plans, but rather by employees who are forced to exchange tax-free health insurance benefits for taxable wages after employers reduce or eliminate health insurance.” This tax amounts to $32 billion in higher taxes in the first two years of its implementation.

5. Prescription Drug Fees. Since 2011, Obamacare has put an annual fee on manufacturers and importers of branded drugs based on each individual company’s share of the total market. Between 2011 and 2019, this will amount to a $27 billion tax increase.

6. Ethanol Tax. In 2010, Obamacare excluded ethanol from the existing cellulosic biofuel producer tax credit. This will hike taxes $24 billion from 2010–2019.

7. Medical Device Tax. Beginning in 2013, Obamacare imposes a 2.3 percent excise tax on medical device manufacturers. This will raise taxes on patients needing medical devices, who will ultimately pay the tax through higher prices, by $20 billion from 2013 to 2019.

8. Business Regulation Costs. Beginning in 2012, Obamacare raises corporate taxes through stricter enforcement, because businesses will be required to report more information on their business activities. This will raise taxes $17 billion from 2012 to 2019.

9. Reducing Medical Deductions. In 2013, Obamacare raises the floor on itemized medical deductions from 7.5 percent of adjusted gross income to 10 percent, meaning Americans must spend 2.5 percent more of their income before they get a medical deduction, costing $15 billion from 2013 to 2019.

10. FSA Limits. Starting in 2014, Obamacare limits the amount of pre-tax dollars that taxpayers can deposit in flexible savings accounts (FSAs) to $2,500 a year. This results in an extra $13 billion in taxes from 2014 to 2019.

[General Robert E Lee]

Regrets on the Left: Democrats Second-Guessing Obamacare.

Earlier this week we learned that former Obama Administration official Elizabeth Warren is calling for a repeal of one of Obamacare’s many taxes, and today The Hill is reporting that several Democrats in Congress are starting to regret President Obama’s signature health care law.

[ru kidding]

ru kidding wrote:

Now if this is the part you do not get allow me to explain.
‘‘(i) to the extent feasible and appropriate, enable
determination of an individual’s eligibility and financial
responsibility for specific services prior to or at the
point of care;
‘‘(ii) be comprehensive, requiring minimal augmentation
by paper or other communications
When I go to the doctor I have a co-pay, when I get meds I have a co pay. My insurance is put in a computer at the doctors office and or pharmacy. My eligibility and financial
responsibility for specific services is determined at this time, I cough up the co-pay and the insurance end of the transaction is electronic. Could you imagine the administrative cost if BC BS cut a check every time one of their clients got blood drawn, had a CT, an exray, an ER visit, a doctors visit or visited the pharmacy. These electronic transactions take place under HIPPA. I give my insurance card to a provider. The provider punches in my info. Enabling determination of an my eligibility and financial responsibility for specific services. My responsibility is coughed up out of my pocket. My (eligibility) is transfered from my insurance company to the provider.

Once again General, your 200 year old education is useless. You are FOS, a Foux news dream.

[ru kidding]

2010
Immediate Access to Insurance for Uninsured Individuals with a Pre-Existing Condition: Provides eligible individuals access to coverage that does not impose any coverage exclusions for pre-existing health conditions. This provision would end when Exchanges are operational.
Prohibition on Rescissions: Prohibits abusive practices whereby health insurance companies rescind existing health insurance policies when a person gets sick as a way of avoiding covering the costs of enrollees’ health care needs.
No Lifetime or Annual Limits: Prohibits lifetime limits on benefits in all group health plans and in the individual market and restricts the use of annual limits. This takes effect for plan years beginning on or after the date that is six months after enactment.
Coverage of Preventive Health Services: All group health plans and plans in the individual market must provide first dollar coverage for preventive services. This takes effect for plan years beginning on or after the date that is six months after enactment.
Extension of Dependent Coverage: Requires any group health plan or plan in the individual market that provides dependent coverage for children to continue to make that coverage available until the child turns 26 years of age. This takes effect for plan years beginning on or after the date that is six months after enactment.
Bringing Down the Cost of Health Care Coverage: Specifies that health plans must annually report on the share of premium dollars spent on medical care and provide consumer rebates for excessive medical loss ratios in each year between 2010 and 2013.
Reinsurance for Early Retirees: Creates a new temporary reinsurance program to help companies that provide early retiree health benefits for those ages 55-64 offset the expensive cost of that coverage.
2
Improved Consumer Assistance: Requires that any group health plan or plan in the individual
market implement an effective appeals process for coverage determinations and claims. Also,
requires the Secretary of HHS to award grants to States to establish health insurance consumer
assistance or ombudsman programs to receive and respond to inquiries and complaints concerning
health insurance coverage. This takes effect for plan years beginning on or after the date that is six
months after enactment.
Early Internet Portal: Requires the Secretary of HHS to establish an Internet website through
which residents of any State may identify affordable health insurance coverage options in that state.
So-called “mini-med” or limited-benefit plans will be precluded from listing their policies on this
website.
Crackdown on Health Care Fraud: Requires enhanced screening procedures for health care
providers to eliminate fraud and waste in the health care system.
Part D “Donut Hole” or Coverage Gap: Shrinks Medicare prescription drug coverage gap by
$500 and begins a 50 percent discount on brand name drugs and biologics when beneficiaries fall
into the coverage gap. Currently, the coverage gap falls between $2,700 and $6,154 in total drug
costs
Ensuring Access to Doctors for Seniors and Military Families: Averts a 20 percent pay cut for
physician services that threatens Medicare beneficiaries’ access to medical care.
http://dpc.senate.gov/healthreformbill/health...

[ru kidding]

Dependent Coverage: Health care reform has made significant changes in terms of dependents. Employers will now have to provide additional coverage for dependents of workers up to age 26. Your dependent can’t qualify for coverage with their own employer, but if they don’t have available coverage you can add them to your policy until they are age 26 or until they can receive coverage on their own. Some states have already had this in place and a few even go to ages 28 or 29, but going forward this will be available to almost everyone. It comes at a cost, but it is better than the alternative of having an older uninsured dependent.

Children and Pre-existing Conditions: One of the dirty tricks in the health insurance industry was the ability for insurers to deny coverage on children for pre-existing conditions. With the new changes taking effect insurers can’t drop a child’s coverage for a pre-existing condition up to age 19. This change is coming for adults, too, but not until 2014. The same is true for insurers who would drop coverage when a customer gets sick or go back and look for errors in application paperwork that could nullify coverage. This is good news for everybody.

Doctor Choice: Going forward, plans must allow pediatricians and OB/GYN to get primary physician status. This eliminates the need to get pre-authorization from the insurer or obtain a doctor’s referral to see one of these physicians.

Better Appeals Process: If you’ve ever had to appeal a claim or correct an error you understand how frustrating this can be. The changes being made require insurers to establish a new appeal process for claims to make it easier for customers. Not only that, but they can no longer refuse to pay claims while you have something under appeal. You will now have your claims paid even if something is being appealed so you don’t have to worry about continuing to receive treatment.

No Lifetime Limits: While not something you hope to ever use, you may notice that your health insurance has maximum lifetime dollar limit. It may be in the millions of dollars, but if you ever need expensive treatment over a long period of time it’s easy to reach that limit. Now, insurers can no longer impose lifetime dollar limits on essential benefits, including hospital stays.

Free Preventive Care: All new plans must cover many common preventive services. This includes mammograms and colonoscopies. In addition, insurers are not allowed to charge a deductible or co-pay on these services. This won’t apply if you keep your existing plan or won’t apply until your group plan gets changed.

And again General with the average family plan costing over 14,000 a year the insurance companies will afford it and still be required to cap their profits as ststed in the bill. This is a consumers bill hands down. Lots of coporate money spent to defeat it. Lots of fools listening to faux entertainment and voting against their own best enterest. Why do we rank last among industrial nations when it comes to health care General?