Wingnut 102A: When private insurance is outlawed only outlaws will have insurance

OR; HR3200 Sec 102 revisited. by Bruce WebbWe first visited the physical condition care reform meme sweeping the right wing of the Blogosphere with this post HR3200 abolishes private physical condition insurance. This seemed at first to be a simple confusion of the limits of the following from Sec 102 of the legislation: 1) LIMITATION ON NEW ENROLLMENT.â€" (A) IN GENERAL.â€"Except as provided in this paragraph, the individual physical condition cover issuer contribution 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.I pointed out that Sec 102 only refers to 'Grandfathered' plans and not to 'Qualified' plans eligible to be included in the new Exchanges. But regular commenter Movie Guy showed that the confusion may be on my part and the result of inadequate notice to Sec 123-144. As he place it in comments: Section 102 cannot be viewed in isolation. Moreover, Section 102 cannot simply be compared to Section 101 as the magic answer. There is far additional involved than Webb's explanations and opinions expressed in the comment posts on the open thread and this major post and related comments. Aside from reading the entire bill, single would need to read some provisions in existing U.S. Code as cited by the bill. This provides the broader picture. The problem with Section 102 is the clock. If this stipulation of the bill is also adopted by the U.S. governing body and a conference bill is approved and then signed by the President, there will be a gap period that is not being addressed. The cutoff dates are specific. Yet, the Administration will not have a "Commissioner" until the individual is nominated and confirmed by the U.S. Senate. The "Health Benefits Advisory Committee" will not be in place until the members are selected; the Committee has 18 months to make its first recommendations. Moreover, the Committee will be advising the Secretary of Health and Human Services. And you cannot call the "Health Insurance Ombudsman" until the "Commissioner" appoints one. Recommend reading some of the preceding sections, including Sections 123-144. During the interim period, who will be approving the plans acceptable for the "Health Insurance Exchange" under slogan A of title II? Based on what criteria? Those are responsibilities identified for the "Commissioner". If you lose your job on otherwise after day 1 of the enacted legislation and your company cover is terminated, what will you do until such time as the "Commissioner", "Health Insurance Exchange", Commissioner identified criteria, and accepted list of cover providers are identified? Who will be able to get new physical condition cover until that system is up and running? Not Cobra. That won't be allowed. If you're starting a business and need physical condition cover for yourself and a a small number of employees during the gap period, what are your options for physical condition insurance? That's why Section 102 is insane. Well after wading through a lot of the book of the Bill I came to the conclusion that much of the problem was terminological. Bur rather than waste the research that got me to that point I will include it after the fold. If nothing also it clarifies the future timeline.(UPDATE: in comments on the preceding post MG has conceded that if my reading below is correct that his concerns have been largely addressed. But given that there are others out there with this same take, I am going to leave this post up as is.)First from the Bill text:p.32 DEADLINE.â€"The Health Benefits Advisory Committee shall recommend first benefit standards to the Secretary not afterwards than 1 day after the date of the enactment of this Act. p.35 (1) REVIEW OF RECOMMENDED STANDARDS.â€" Not afterwards than 45 days after the date of receipt of benefit standards recommended under section 123 (including such standards as modified under paragraph (2)(B)), the Secretary shall review such standards and shall determine whether to propose acceptance of such standards as a package. p.36 (b) ADOPTION OF STANDARDS.â€" (1) INITIAL STANDARDS.â€"Not afterwards than 18 months after the date of the enactment of this Act, the Secretary shall, through the rulemaking process consistent with subsection (a), adopt an first set of benefit standards. p. 72 (a) ESTABLISHMENT.â€"There is recognized within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality physical condition cover coverage, including a public physical condition cover option. p. 88-89 2) SOLICITING AND NEGOTIATING BIDS; CONTRACTS.â€"The Commissioner shallâ€" (A) ask for bids from QHBP contribution entities for the contribution of Exchange-participating physical condition benefits plans; (B) based winning a review of such bids, negotiate with such entities for the contribution of such plans; and (C) enter into contracts with such entities for the contribution of such plans through the Health Insurance Exchange under terms (consistent with this title) negotiated between the Commissioner and such entities .At risk of spoiling the punchline it is essential to maintain a clear distinction between "date of the enactment of the Act" and day single of "Y 1". Which latter is defined as follows:(25) Y1, Y2, ETC..â€"The terms ‘‘Y1’’ , ‘‘Y2’’, ‘‘Y3’’, ‘‘Y4’’, ‘‘Y5’’, and alike then numbered terms, mean 2013 and following years, respectively.Before returning to the point lets examine the functioning timeline (from comments)First unless the Blue Dogs get their way the current plan by the President and House Leadership is to get this bill enacted this year. So lets take the effective date as Jan. 1, 2010. Second the clock for the Health Benefits Advisory Committee is not 18 months it is single day and the clock starts not when the members are appointed but at the date of enacting of the bill. Meaning that standards will be in place by Jan 1, 2011. Third this gives the governing body a full day to confirm the Commissioner. Nor do I see that the appointment of the Ombudsman makes much difference here, his position seems comparatively minor for implementation. Fourth, the Commissioner is limited to 45 days to review the standards once inward and must have them through the Rule process within 18 months of enactment. Meaning that adopted standards would be in place negative afterwards than June 30, 2011. Fifth the general outlines of the standards are well recognized in the bill itself, and if the Advisory Committee develops its specific recommendations in a publicly accessible form (and note that cover companies have representation on the Committee) cover companies have almost two years to prepare themselves for contract negotiations in the summer of 2011. Sixth which gives the Commissioner and the companies another 18 months for contract approval and administrative implementation. So to do again the question: If you lose your job on otherwise after day 1 of the enacted legislation and your company cover is terminated, what will you do until such time as the "Commissioner", "Health Insurance Exchange", Commissioner identified criteria, and accepted list of cover providers are identified? Who will be able to get new physical condition cover until that system is up and running? Well on my reading if you lose your job and so your cover between "day 1 of the enacted legislation" and "day 1 of Y 1" you can get cover just where you always would have if you lost your job between tomorrow and the date of enactment. As a matter of individual convenience you may ask if the company plans to participate in the Exchange after it goes into operation Jan 1. 2013 but I just am not seeing the inherent madness some others do. Instead I see two fundamental mistakes. One the belief that the clocks start from the point that the Commissioner and Committee members are confirmed rather than the date the act is enacted. And the second a confusion between that date and Y 1 as referenced in Sec 102, i.e. 2013..
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