Tuesday, August 25, 2009

More Teabagger Lies about HR3200

This morning I got an email from a friend asking me to watch a video and forward it to others so they could be thusly informed about HR3200 being considered in the house. Unfortunately, he didn't do any homework before forwarding it on to others ... and he's become part of the Party of Nope's distribution machine.

Here's a link to Rep. Mike Roger's distorted teabagger statement before Congress about one of the sections within HR3200.

It's apparent to me that this guy has an agenda ... and partakes of the Party of Nope's koolaid. He also can't apparently read because he specifically cites "Section 141" as the defective section of the health care bill (HR3200) and claims that it would allow the government to disenroll individuals from their insurance plan as well as disenroll entire companies from plans. Section 141 merely creates a "Health Choices Commissioner" who would be appointed by the President and confirmed by the Senate.

Section 142, however, discusses the duties and authorities of the Commissioner, one of which is determining whether a QHBP (Qualified Health Benefit Plan) being offered by an entity is in conformance with the act. Under Section 142, if and when the Commissioner determines that a QHBP offering entity violates a requirement of the act, the Commissioner can: (1) assess penalties to the entity (similar to what might be assessed under the Social Security Act); (2) suspend enrollment under the plan until the violation is corrected and until it can be assured that the violation is not likely to recur; (3) suspend subsidy payments to "exchange" entities until the violation is corrected and it can be assured that the violation is not likely to recur; and (4) work with state insurance regulators to disqualify entities and terminate plans of those entities who have repeat violations under the act. Nowhere in the wording does it give the Commissioner the authority to disenroll individuals or entire groups of individuals from any plan. 'Suspending enrollment' and 'disenrolling' are two different terms with two different definitions. This guy needs to spend some time reading Websters or just understanding terminology used within industry at large. If he's relying on item (4) which speaks to 'disqualify and terminate plans' ... well geez luiz ... if the insurance carrier is so bad (remember ... these are health care exchanges, not governmental agencies) that the Commissioner has to take it before a State Insurance Regulator ... well I would think those employers and employees would be looking for all the help they could get to be relieved of a fraudulent contract so they could obtain effective health care coverage. Plus, if it is item (4) that he's relying on to make his claim, it would be the State Regulators who have the most impact over the Insurance carrier.

The Health Choices Commissioner is the person who is responsible for administering the Health Insurance Exchange program. I certainly would hope that this person could disqualify shady insurance operations and protect consumers. Would Congressman Mike Rogers prefer to give this commissioner no power to act to protect consumers? With all the windfall the Insurance Companies will get if this bill passes, if anything, the situation will be ripe for fraud on the part of unscrupulous parties within the insurance industry. This is just another "teabagger" lie being perpetrated to stir up the masses who, in all likelihood, won't read the bill for themselves to fact-check his statement.

Here's the full text of Sections 141 and 142:

(a) IN GENERAL.—There is hereby established, as an independent agency in the executive branch of the Government, a Health Choices Administration (in this division referred to as the ‘‘Administration’’).
(1) IN GENERAL.—The Administration shall be headed by a Health Choices Commissioner (in this division referred to as the ‘‘Commissioner’’) who shall be appointed by the President, by and with the advice and consent of the Senate.
(2) COMPENSATION; ETC.—The provisions of paragraphs (2), (5), and (7) of subsection (a) (relating to compensation, terms, general powers, rulemaking, and delegation) of section 702 of the Social Security Act (42 U.S.C. 902) shall apply to the Commissioner and the Administration in the same manner as such provisions apply to the Commisioner of Social Security and the Social Security Administration.

(a) DUTIES.—The Commissioner is responsible for carrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE.—The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
(3) INDIVIDUAL AFFORDABILITY CREDITS.— The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.
(4) ADDITIONAL FUNCTIONS.—Such additional functions as may be specified in this division.
(1) IN GENERAL.—The Commissioner shall undertake activities in accordance with this subtitle to promote accountability of QHBP offering entities in meeting Federal health insurance requirements, regardless of whether such accountability is with respect to qualified health benefits plans offered through the Health Insurance Exchange or outside of such Exchange.
(A) IN GENERAL.—The commissioner shall, in coordination with States, conduct audits of qualified health benefits plan compliance with Federal requirements. Such audits may include random compliance audits and targeted audits in response to complaints or other suspected non-compliance.
(B) RECOUPMENT OF COSTS IN CONNECTION WITH EXAMINATION AND AUDITS.—The Commissioner is authorized to recoup from qualified health benefits plans reimbursement for the costs of such examinations and audit of such QHBP offering entities.
(c) DATA COLLECTION.—The Commissioner shall collect data for purposes of carrying out the Commissioner’s duties, including for purposes of promoting quality and value, protecting consumers, and addressing disparities in health and health
care and may share such data with the Secretary of Health and Human Services.
(1) IN GENERAL.—In the case that the Commissioner determines that a QHBP offering entity violates a requirement of this title, the Commissioner may, in coordination with State insurance regulators and the Secretary of Labor, provide, in addition to any other remedies authorized by law, for any of the remedies described in paragraph (2).
(2) REMEDIES.—The remedies described in this paragraph, with respect to a qualified health benefits plan offered by a QHBP offering entity, are—
(A) civil money penalties of not more than the amount that would be applicable under similar circumstances for similar violations under section 1857(g) of the Social Security Act;
(B) suspension of enrollment of individuals under such plan after the date the
Commissioner notifies the entity of a determination under paragraph (1) and until the Commissioner is satisfied that the basis for such determination has been corrected and is not likely to recur;
(C) in the case of an Exchange-participating health benefits plan, suspension of payment to the entity under the Health Insurance Exchange for individuals enrolled in such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Secretary is satisfied that the basis for such determination has been corrected and is not likely to recur; or
(D) working with State insurance regulators to terminate plans for repeated failure by the offering entity to meet the requirements of this title.
(e) STANDARD DEFINITIONS OF INSURANCE AND MEDICAL TERMS.—The Commissioner shall provide for the development of standards for the definitions of terms used in health insurance coverage, including insurance-related terms.
(f) EFFICIENCY IN ADMINISTRATION.—The Commissioner shall issue regulations for the effective and efficient administration of the Health Insurance Exchange and affordability credits under subtitle C, including, with respect to the determination of eligibility for affordability credits, the use of personnel who are employed in accordance with the requirements of title 5, United States Code, to carry out the duties of the Commissioner or, in the case of sections 208 and 241(b)(2), the use of State personnel who are employed in accordance with standards prescribed by the Office of Personnel Management pursuant to section 208 of the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728).

1 comment:

Todd said...

In the context of his comments, Rogers cites section 141 to back up his point that this new system is clearly a "govt run system".

When you go on to discuss 142 and the commissioner's authority to go as far as suspending enrollment, you only back up Rogers point. It is being subjected to an unprecedented amount of govt management.

To the point that those of us who are happy with our current healthcare can expect changes if our plans are "so bad" in the eyes of politicians. Insurance companies will be forced (according to Obama last night) to eliminate lifetime limits, accept anyone with a pre-existing condition, provide preventative care as defined by the govt, etc, etc, etc. How will that be done without raising costs? It can't. So... there WILL be a change for those of us currently satisified, and they will go out of business because of those increased costs, or the govt will shut them down. Simple as that.

Don't write off valid arguments as koolaid drinking.