Wingnut 102: How HR3200 Outlaws Private Health Insurance

by Bruce WebbDid you know that the House Tri-Committee Bill HR3200 candidly and brazenly outlaws new private individual physical condition cover plans after Year 1 (now set for 2013)? Well me neither, chiefly since it is only not true but in total context absurd. Not quite as ridiculous as the idea that the Moon landings were faked, that walking into a court with a bullion fringed flag means you have lost all protections under the Constitution, that you can make yourself exempt from central Income tax by declaration, otherwise any of the previous engrained notions floating around Wingnuttia. But since somehow Flat Earthers, and Young Earthers and Birthers never go absent it is worth examining this particular theory before it goes even additional viral, I have by now seen it on multiple sites.What is the origin of this? Well it is from some seemingly clear language in the book of the bill, the entirety of which can be establish here: HR3200: America's Affordable Health Choices Act. This language is not hidden deep within the bill, which is what you would expect if something sneaky was going on (which should have known these guys pause for thought), nope it is right up front on page 16 of the bill, indeed it is in the second section of the bill's Title 1, that is 'SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE' The language itself: (1) LIMITATION ON NEW ENROLLMENT.â€" (A) IN GENERAL.â€"Except as provided in this paragraph, the individual physical condition cover issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on otherwise after the first day of Y1. Which for some is the "insane" smoking gun, no new individual cover after 2013. To understand why this is just a profound fallacy of the bill (if you do not already) you can follow me below the fold as I try to explain.First thing to need to understand that Congressional language is a little tormented to start with. For one thing it is nested, that is you have to work your way up from the language of any known paragraph to the higher level organization and purpose. Second as at this time you always have to look out for language representative exceptions.The top level of this section is generous 'Protecting the Choice to Keep Current Coverage' in custody with Obama's promise that if you like what you have you get to keep it. But this right is not completely unlimited, there are constraints that together keep employers from gaming the cover pool and individual employees from evading the individual mandate by buying inadequate (but cheap) coverage. So the legislation sets out some terms and parameters. Right after the title we get sub-section (a) itself generous 'Grandfathered Health Insurance Coverage Defined'. (Those of you not aware of the term 'grandfathering' is the principle that a property right once exercised can not arbitrarily taken absent and in some cases is inheritable). Sub-section (a) lays out three limitations (1) Limitation on New Enrollment, (2) Limitation on Change in Terms otherwise Conditions, (3) Restrictions on Premium Increases all of which taken together has led our conspiracy bugs to believe they are beating a plan to strangle the individual cover market out in favor of a public plan (which then I guess is free to destroy Tokyo unchecked.)To understand why this is not so, otherwise at smallest amount not consequently in the sense opponents would like to take it you need to back up and see what Sec 102 was opposing Grandfathered coverage AGAINST. Meaning that to completely understand Sec 102 you need to understand Sec 101 and in particular the meaning of 'Qualified Health Benefit Plan' as set out in Sec 101 (b). In order to offer new coverage under HR3200 private insurers simply need to offer a product that meets the new requirements. This is no different than requirements in past legislation that car manufacturers had to include such things as turn-signals, back up lights, seat belts in new model years, but in most cases grandfathered alive cars by now on the road.Backing up a little more. In order for a new plan for individual otherwise group cover to be obtainable it has to meet three tests under 101 (b):those of Sub-title B: Affordable Coverage, Sub-title C: Essential Benefits, and Sub-title D: Consumer Protection. If you meet those tests you are allowed to write new individual policies. Nothing is outlawed apart from the right to sell inadequate plans to new customers.Now you do not need to dig into the law-making language to see why this wingnut reading of Sec 102 had to be wrong. For example you could have just examined the CBO estimates of who would be covered by whom in the day 2019.Insurance Coverage Specifications and associated text. If CBO estimates that in 2019 30 million people will bet getting cover through the exchange and only 9 million of them covered by the pubilc options, who is absent to write the previous 21 million chiefly individual policies? Private insurance. How can they do that if Sec 102 of the bill plainly makes writing any such coverage after 2013 illegal? Well they couldn't. Which should suggests that the 'simple' reading of Sec. 102 that apparently sets up this inconsistency was not the correct reading, that in reading it that way that those readers just missed something. Something I suggest was Sec 101, the overall context of the unfolding debate, and CBO scoring.__________________________________While I am here. A good part of the progressive blogosphere is rending their clothing and gnashing their teeth since the current plans limit people with boss supplied cover from resorting to the pubic plan. This too is a profound mis-understanding of the bill, though at this time from the previous side.For one thing current enrollees in boss plans are secluded by the provisions of Sec 102 (b) which provides that they are not bound by a 'unacceptable' plans as defined, moreover employers are only known a five day grace period after Y 1 to upgrade their current plan to fit plan standards. Additionally there are restrictions which keep your boss waged plan from costing the individual worker additional than 11% of gross pay and which allow worker opt-out from being stuck in a lower cost plan just to meet that test. In fact I am not seeing in Title II otherwise Title III anything that would keep an worker from choosing individual cover from the exchange after Year 2 whether that coverage be private otherwise through the public option. Nor am I seeing any 'firewall' custody the boss out of the exchange, otherwise in exchange for a charge amounting to 8% of payroll from simply dropping boss coverage at all.Now it is additional than possible that I am missing something here, and any help would be appreciated. But please if you can supply citations to the particular section of the bill containing the real controlling language. Because while I can see restrictions that keep EMPLOYERS from shoving people against their will onto the public option, I am not seeing much to keep EMPLOYEES from freely choosing that.Although even if there were such restrictions they would under some situation be defensible. What you do not want is a situation where the boss sets up what is in effect two plans, one for favored employees and/or low cost cover needs and another for less-favored employees and/or high cost cover needs. There are some protections built in by salary, you cannot candidly have two very much different systems, but what you need is some protections against employers covertly and selectively pushing some people out the door. For example I would think it would be profoundly against the law to tie decisions on preservation of probationary employees by the type of coverage they 'freely' chose. But employers know how to pass hints that suggest that people over 50 otherwise who have lots of kids have problems passing probation if they insist on being on the boss plan, hint, hint, nudge, nudge. On my reading the bill attempts as most excellent it can to limit this, but realistically it is hard to remove game live from any complex system.___________________________On a final note. Those who claim this plan is a blatant, open attempt to drive private cover out of the market starting on Day 1 are completely off-base. On the previous hand there are pretty good possibilities that that will be the effect by say day 20. Because the legislation is knowingly otherwise not set up as a one-way valve, there are incentives in place to let some otherwise all of your employees pass through that control device into the public option, while there is not much inducement to draw them back out. Which is the result that some of us dirty socialist DFHs are in the end hoping for, Universal Single Payer through the back-door.So people mis-reading Sec. 102 might well have identified the reason and the objective even as they mis-identify the real mechanism.
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