http://docs.house.gov/rules/health/111_ ... ingell.pdf
Summary of the Amendments
((summary for the Adobe impaired))
SUMMARY OF MANAGER’S AMENDMENT
Building on the legislation House Democrats introduced last week, the manager’s amendment provides for several changes to the bill, including the following:
* Establishes a process for the review and public disclosure of health insurance premium increases and justifications for those increases by the Secretary of Health and Human Services and states beginning in 2010. Permits the Commissioner of the Health Insurance Exchange, beginning in 2013, to take into consideration excessive and unjustified premium increases in making decisions regarding which insurance companies will be permitted into the exchange and how quickly to open the exchange to employers for the purchase of insurance for their employees. Provides a total of $1 billion in funding for states for this process over the period 2010 to 2014.
* Repeals the McCarran-Ferguson Act insurance antitrust exemption with respect to health insurance and medical malpractice insurance.
* Authorizes the Federal Trade Commission to investigate insurance companies that are registered as not-for-profit companies.
* Directs the HHS Secretary to work with states that have alternative programs to state high risk pools as a part of the new National High Risk Pool program for people who can’t get health insurance in today’s marketplace.
* Amends the National High-Risk Pool to make those early retirees whose premium increases are excessive eligible for the new program.
* Prohibits undocumented individuals from accessing financial assistance from the national high risk pool program with requirements for verification of citizenship or lawful presence.
* Requires that the Medicare fraud and abuse phone number be printed prominently on beneficiaries’ Explanation of Benefits forms.
* Imposes a 90-day waiting period for new durable medical equipment suppliers to be paid if the HHS Secretary believes there is a risk for fraud.
* Establishes a new public health program on mental health and substance abuse screening, intervention, referral, and recovery services.
* Provides for the development of quality indicators for Alzheimer’s care.
* Provides for diabetes screening collaboration and outreach through the Department of Health and Human Services in collaboration with the Centers for Disease Control and Prevention.
* Codifies the Office of Minority Health within the Office of the HHS Secretary and establishes satellite minority health offices in various HHS agencies.
* Clarifies that states may reimburse nursing homes for costs incurred in conducting background checks on potential employees.
* Provides a special rule for the expansion of certain physician-owned hospitals that consistently treat the highest percentage of Medicaid patients in their communities.
* Changes the effective date for a payment change for skilled nursing facilities from January 1, 2010 to April 1, 2010.
* Imposes performance assessment and accountability measures on the Health Choices Administration, including requirements for improving customer service and streamlining redundant rules, regulations, and procedures.
* Permits a qualified health benefits plan to provide coverage through a qualified direct primary care medical home plan.
* Repeals the worldwide interest allocation rules.
* Closes down the loophole that allows unprocessed fuels (like black liquor) to claim the $1.01 producers credit.
* Makes clarifications to the interstate insurance compacts that require the Secretary of Health and Human Services to develop model guidelines for compacting states, ensures that the interstate insurance compacts do not override state laws governing rate review and fraud, and makes clear that the compacting states determine which of the compacting state’s laws serve as primary for the insurance company.
* Delays implementation of the provision that would eliminate the ability of employers to deduct Federal subsidies with respect to prescription drug benefits provided to retirees by two years.
* Clarifies that the business/consumer purchasing collaborative provided for in the early access health grants is a non-profit business collaborative.
* Requires HHS Secretary to conduct a study to determine the existence of duplicative HHS programs and establishes a process for the elimination of any such program.
What else is in the House HCR Bill
Moderator: Super Moderators
What else is in the House HCR Bill
Last edited by Rombaldi on 11-09-2009 09:36 PM, edited 1 time in total.
Republican - re·pub·li·can (r-pbl-kn) - political party, which will control part of Congress 2011-2012, undermining the strength of the country - on purpose, in public, without apology or shame - simply for a campaign advantage in 2012.
Rom - do you not see what a total nightmare this is becoming? I can clearly see this 'plan' is going to pretty much wipe out all the planning I have done during my working career to ensure adequate and affordable health care. I imagine this is the case with many people.
For instance, this is BS for 'rationing':
* Provides for the development of quality indicators for Alzheimer’s care.
And what is the purpose of this?
* Requires that the Medicare fraud and abuse phone number be printed prominently on beneficiaries’ Explanation of Benefits forms.
What is the purpose of this? To frighten and intimidate senior citizens? This makes no sense at all.
* Imposes a 90-day waiting period for new durable medical equipment suppliers to be paid if the HHS Secretary believes there is a risk for fraud.
What is going to happen during the 90 days that some poor soul needs 'durable medical equipment'? When you get into a position of needing this stuff, you usually need it right away. Are we to depend on charity in the meantime?
And what is this? Why is this needed?
* Codifies the Office of Minority Health within the Office of the HHS Secretary and establishes satellite minority health offices in various HHS agencies.
And why are these benefits being effectively eliminated, because that would be the effect of this?
* Delays implementation of the provision that would eliminate the ability of employers to deduct Federal subsidies with respect to prescription drug benefits provided to retirees by two years.
And the list goes on and on. The list itself is a bureacratic nightmare.
All this just for the mantra of providing coverage for the 36-40 million uninsured?
If the Democrats ram this HCR through as it is now - I believe the Democrats will be thrown out of office for a long, long time.
We do not need all this BS. Just a straightforward, simple plan to cover the uninsured and to prevent the exploitation for profit by health insurers.
I also do not believe this is a case of 'get whatever we can through now and fix it later' either.
For instance, this is BS for 'rationing':
* Provides for the development of quality indicators for Alzheimer’s care.
And what is the purpose of this?
* Requires that the Medicare fraud and abuse phone number be printed prominently on beneficiaries’ Explanation of Benefits forms.
What is the purpose of this? To frighten and intimidate senior citizens? This makes no sense at all.
* Imposes a 90-day waiting period for new durable medical equipment suppliers to be paid if the HHS Secretary believes there is a risk for fraud.
What is going to happen during the 90 days that some poor soul needs 'durable medical equipment'? When you get into a position of needing this stuff, you usually need it right away. Are we to depend on charity in the meantime?
And what is this? Why is this needed?
* Codifies the Office of Minority Health within the Office of the HHS Secretary and establishes satellite minority health offices in various HHS agencies.
And why are these benefits being effectively eliminated, because that would be the effect of this?
* Delays implementation of the provision that would eliminate the ability of employers to deduct Federal subsidies with respect to prescription drug benefits provided to retirees by two years.
And the list goes on and on. The list itself is a bureacratic nightmare.
All this just for the mantra of providing coverage for the 36-40 million uninsured?
If the Democrats ram this HCR through as it is now - I believe the Democrats will be thrown out of office for a long, long time.
We do not need all this BS. Just a straightforward, simple plan to cover the uninsured and to prevent the exploitation for profit by health insurers.
I also do not believe this is a case of 'get whatever we can through now and fix it later' either.
Perhaps the silence is acknowledgement that we've been sold a bill of goods by a group of politicians?
An acknowledgement that what we are about to get in the form of healthcare reform bares no real resemblance to the actual reform that is desperately needed, no real resemblance to the promises that began this new year, nor any resemblance to the declarations many of us made on this topic as recently as two months ago?
I could be wrong - but if I am right, then silence is what one might expect as it is the far easier course to chart - especially given the emotional investment made by so many to make this dream a reality.
What are the different stages of grief again?
Also, if I am right, and if we are willing to admit that this bill is an absolute mess that is just as likely to make things worse as it is likely to make things better in the long run, then who out there is positioned to do anything about it?
Ironic, isn't it?
The only people out there organized enough to stop this mess of a bill in it's tracks at this point are the townhall protesters (and that is quite problematic all on it's own). The Republicans do not have the political power to stop it, and the Democratic base carries no weight on this issue anymore (they've been wedged/distracted - intentionally in my opinion - in to the public option and single-payer fight), the cost of not securing a political "victory" on healthcare reform is too great a price for the Democratic party to pay. For the politicians in the party, It is now all about passing a bill at any cost - for example, the biggest blow to abortion rights this nation has seen in many years, a price Democrats seem sadly willing to pay to cobble together this legislative "victory" (where is the outrage?).
This entire process has been badly bungled from the start, and has been terribly flawed due to a lack of leadership & vision in my opinion.
I don't know - It's just a theory - but it can be applied to several other issues we don't talk about too much anymore, such as our military conquests, and counter-terrorism operations for example.
An acknowledgement that what we are about to get in the form of healthcare reform bares no real resemblance to the actual reform that is desperately needed, no real resemblance to the promises that began this new year, nor any resemblance to the declarations many of us made on this topic as recently as two months ago?
I could be wrong - but if I am right, then silence is what one might expect as it is the far easier course to chart - especially given the emotional investment made by so many to make this dream a reality.
What are the different stages of grief again?
Also, if I am right, and if we are willing to admit that this bill is an absolute mess that is just as likely to make things worse as it is likely to make things better in the long run, then who out there is positioned to do anything about it?
Ironic, isn't it?
The only people out there organized enough to stop this mess of a bill in it's tracks at this point are the townhall protesters (and that is quite problematic all on it's own). The Republicans do not have the political power to stop it, and the Democratic base carries no weight on this issue anymore (they've been wedged/distracted - intentionally in my opinion - in to the public option and single-payer fight), the cost of not securing a political "victory" on healthcare reform is too great a price for the Democratic party to pay. For the politicians in the party, It is now all about passing a bill at any cost - for example, the biggest blow to abortion rights this nation has seen in many years, a price Democrats seem sadly willing to pay to cobble together this legislative "victory" (where is the outrage?).
This entire process has been badly bungled from the start, and has been terribly flawed due to a lack of leadership & vision in my opinion.
I don't know - It's just a theory - but it can be applied to several other issues we don't talk about too much anymore, such as our military conquests, and counter-terrorism operations for example.
Last edited by Kaztronic on 11-10-2009 01:57 AM, edited 1 time in total.
"You'll get used to my babbling, all the others have." - Anna Madrigal from "Tales Of The City" by Armistead MaupinNot sure I could comment on all of these issues here, but there is something which intervened between the original Obama campaign/election and where we now find ourselves - the deteriorating situation regarding the economy and the bailouts - and subsequent downturning of the economy which is impacting this HCR issue.
Frank Rich had an Op-Ed in the NYT this weekend which focused on this issue. It is difficult to switch gears, but the pressures of the economy, especially unemployment and slow recovery (if there is to be a sustained recovery) have made it very difficult to pass far-reaching health care legislation. And especially on a scale of nearly a trillion dollars over the 10 year forecast period.
Frank Rich's article is here:
http://www.nytimes.com/2009/11/08/opini ... .html?_r=1
If a realistic HCR which does cleanly what it is supposed to do (establish a public option for health care for the uninsured and underinsured - and get control over the excesses and stranglehold of for-profit insurers) this current 'political mosaic' of a cobbled together 'what is possible' given the push back and politicking - and lack of public enthusiasm for 'adventuring' into a costly and little understood HCR - would not be what we are being sold we must settle for. HCR at any cost is seen as the only solution to a political problem when the 'will of the people' is just not behind it. A mistake. A huge mistake in my opinion.
I believe the better course of action, is to realize this - and to put HCR aside for now - and return the focus to the economy and how it is impacting the country. And, as Frank Rich points out - go after the financial institutions to ensure there will not be the lack of oversight which would allow continued abuses, etc.. Get a new focus on stimulating the economy, and restore confidence in govt to being able to be effective on this front.
Afghanistan is other critical issue which needs a clear focus and committment as to what the objectives are there. Sooner rather than later.
The HCR is too important of an issue and a major, major change which deserves the very best this country can deliver. Not what is being offered now.
Frank Rich had an Op-Ed in the NYT this weekend which focused on this issue. It is difficult to switch gears, but the pressures of the economy, especially unemployment and slow recovery (if there is to be a sustained recovery) have made it very difficult to pass far-reaching health care legislation. And especially on a scale of nearly a trillion dollars over the 10 year forecast period.
Frank Rich's article is here:
http://www.nytimes.com/2009/11/08/opini ... .html?_r=1
If a realistic HCR which does cleanly what it is supposed to do (establish a public option for health care for the uninsured and underinsured - and get control over the excesses and stranglehold of for-profit insurers) this current 'political mosaic' of a cobbled together 'what is possible' given the push back and politicking - and lack of public enthusiasm for 'adventuring' into a costly and little understood HCR - would not be what we are being sold we must settle for. HCR at any cost is seen as the only solution to a political problem when the 'will of the people' is just not behind it. A mistake. A huge mistake in my opinion.
I believe the better course of action, is to realize this - and to put HCR aside for now - and return the focus to the economy and how it is impacting the country. And, as Frank Rich points out - go after the financial institutions to ensure there will not be the lack of oversight which would allow continued abuses, etc.. Get a new focus on stimulating the economy, and restore confidence in govt to being able to be effective on this front.
Afghanistan is other critical issue which needs a clear focus and committment as to what the objectives are there. Sooner rather than later.
The HCR is too important of an issue and a major, major change which deserves the very best this country can deliver. Not what is being offered now.
My personal thoughts are this is what was voted for "Health Care" at any cost. I find it strange, that today is the anniversery of the Berlin Wall coming down and the people struggled with new found freedom from the government that took such good care of them.(sarcasm) It seems I don't understand much of what is going on any more. Do we not understand the consequences of our insatiable need to be take care of. There really is no free ride.
Hi Doka. Glad you are weighing in on this issue. I agree government is becoming too huge, and can not resolve all problems. Health care might be an issue which is important for government to intervene in though. At least to the extent that it no longer allows private for profit insurers the free reign they have been given.
The private insurers are the problem as they are run as virtual monopolies. I believe the profits of the major health insurers rose at the rate of 300% last year (or maybe 2 years). Whatever it was, the system we have is clearly exploitive and weighted toward private insurers. In addition, the increasing costs of health care are having a major impact on the economy with employers, including small businesses - to stay in business, or at least continue to provide health care benefits. I read that health care consumes one sixth of the economy, and that share is predicted to rise rapidly.
The rate of death and general misery in the uninsured population is also something that should not happen in a country with the wealth we have - and other large countries have found solutions to universal coverage.
What do you think would work?
The private insurers are the problem as they are run as virtual monopolies. I believe the profits of the major health insurers rose at the rate of 300% last year (or maybe 2 years). Whatever it was, the system we have is clearly exploitive and weighted toward private insurers. In addition, the increasing costs of health care are having a major impact on the economy with employers, including small businesses - to stay in business, or at least continue to provide health care benefits. I read that health care consumes one sixth of the economy, and that share is predicted to rise rapidly.
The rate of death and general misery in the uninsured population is also something that should not happen in a country with the wealth we have - and other large countries have found solutions to universal coverage.
What do you think would work?
I understand that our health care needs a lot of overhauling. Over the years all the restraints on health care and just about anything else have been quietly removed and this has not been in our best interests for sure. It is a big corporate free for all. I would like to see the restraints re-instated. But of course I thought well of the tooth fairy too. So I doubt that is going to happen. I would settle for a nice clean health care bill that would take you an afternoon to read not two weeks and then not know what it really said. I think I'm back at the tooth fairy thing again. But I do like my freedom, what really truely little there is. Are you still so sure that we are such a rich nation? If we are it is being sucked out of us at a pretty fast rate, I would think. And if people can't work or no new business starts are happening , where will the "created" wealth come from? Our $ is drowning. How are we going to pay for our new health care? All I seem to have is questions???? 
I agree that it is very confusing and seems impossible almost to fix. The primary starting point, I think - is to get the economy on the road to recovery - to any degree that is possible. We are not experts in this field, but this should be the current focus in Washington, in my opinion. In other words, if more stimulus to the economy is needed and can be effective - the attitude should not be there is no more to be done on that front and let's move ahead with HCR.
The economy is always most important to people, and there are just too many people unemployed - and losing what health care they may have now as well.
The economy seems to be stabilizing, but this continued unemployment is a real problem.
The economy is always most important to people, and there are just too many people unemployed - and losing what health care they may have now as well.
The economy seems to be stabilizing, but this continued unemployment is a real problem.
Maybe more because some are simply tired of arguing about it, than "silence is acknowledgement..." or any other such notion.
It's not done yet anyhow. This is just a first step. The road is weeks, maybe even months, long yet. There's still the Senate to deal with. And then the conference. None of this is set in stone. There's still much work to be done.
I'm waiting to see what shakes out. And don't feel like wrangling over the finer points of something that isn't anywhere near to being finished yet and will likely go through many more changes.
There's information, misinformation, disinformation -- take your pick. A veritable wheel of fortune out there. When we get something to talk about that's a little more solidified, I might have something to say. Or I might not. Right now, I'm just waiting to see what happens.
So, if people aren't talking so much about it, it doesn't necessarily mean much -- such as that they aren't interested, or don't care. They may just be tired of talking about it, or waiting to see, or just don't want to argue with anyone right now.
Maybe it's just too damn volatile an issue to talk about within such a diverse group as this. Who wants to fight with, or worse yet, lose friends over it? Those who want to talk about it eventually will, and those who don't -- well, please don't go reading anything more into it than it really is. There's a myriad of reasons why NOT to talk about it right now, all of them just as vaild as the reasons TO talk about it. Different strokes for different folks, and all that jazz.
For whatever it's worth, welcome or not, that's my 2 cents.
It's not done yet anyhow. This is just a first step. The road is weeks, maybe even months, long yet. There's still the Senate to deal with. And then the conference. None of this is set in stone. There's still much work to be done.
I'm waiting to see what shakes out. And don't feel like wrangling over the finer points of something that isn't anywhere near to being finished yet and will likely go through many more changes.
There's information, misinformation, disinformation -- take your pick. A veritable wheel of fortune out there. When we get something to talk about that's a little more solidified, I might have something to say. Or I might not. Right now, I'm just waiting to see what happens.
So, if people aren't talking so much about it, it doesn't necessarily mean much -- such as that they aren't interested, or don't care. They may just be tired of talking about it, or waiting to see, or just don't want to argue with anyone right now.
Maybe it's just too damn volatile an issue to talk about within such a diverse group as this. Who wants to fight with, or worse yet, lose friends over it? Those who want to talk about it eventually will, and those who don't -- well, please don't go reading anything more into it than it really is. There's a myriad of reasons why NOT to talk about it right now, all of them just as vaild as the reasons TO talk about it. Different strokes for different folks, and all that jazz.
For whatever it's worth, welcome or not, that's my 2 cents.
Anchors Aweigh!Thanks for your perspective, Joolz. And I agree it is not pleasant or realistic to argue the details. My interest in the discussion was to take a larger view of how HCR is, or is not, meshing with all the other factors out there, as the impact of the economy, the 'political will' and so forth - in a more general assessment of what may be possible.
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Cynthia Lynn
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Linnea wrote: Just checking back and find it difficult to believe there are no other comments here. This health care debate used to be vibrant and of importance here, but voices have fallen silent. This is fairly obvious all across the forum on the discussion of a lot of issues.
What does that portend?
Linnea, I'm very discouraged.
I see this as a massive shift of taxpayer wealth upward into private sector hands.
It's unbelievable to me that the health of the American people has evolved into nothing more than a commodity -- a freakin' commodity for Wall Street gamblers and shareholders.
What kind of government allows its citizens to be treated this way?
I agree, Cynthia Lynn. There should be a public option, which as we know is not government run health care. As Joolz pointed out, there is so much information/disinformation out there many people are confused and discouraged - and when that happens, are less informed and less able to participate in the process or influence outcomes.
There should be a clear message to the politicians - if you are going to do this, do it right.
I also believe people are concerned, in this current economic climate, with the costs now and going forward with health care reform. We deserve the very best in a major reform of this magnitude, and I do not see the current trajectory producing the best outcome.
There should be a clear message to the politicians - if you are going to do this, do it right.
I also believe people are concerned, in this current economic climate, with the costs now and going forward with health care reform. We deserve the very best in a major reform of this magnitude, and I do not see the current trajectory producing the best outcome.
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Cynthia Lynn
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People really ARE confused and worried.
My hometown is dying and my youngest brother just lost his job. It's really sad.
Anyway, I don't know the answer to this health care problem* (especially at this hour of the morning), but I'm really disappointed in the President and in the Democrats.
With a few exceptions, they seem to be totally oblivious to reality.
I'm going back to bed... am already so depressed I can't think straight.
*I personally think we should have Medicare for All or something similar, but then, I've been accused of being a Socialist.
My hometown is dying and my youngest brother just lost his job. It's really sad.
Anyway, I don't know the answer to this health care problem* (especially at this hour of the morning), but I'm really disappointed in the President and in the Democrats.
With a few exceptions, they seem to be totally oblivious to reality.
I'm going back to bed... am already so depressed I can't think straight.
*I personally think we should have Medicare for All or something similar, but then, I've been accused of being a Socialist.
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Cherry Kelly
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I am just thoroughly disgusted by the government attempt to take over the health care of the nation. AND in a dictatorial manner - you get it or else!
Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan."
(OF NOTE - the "qualified plan" has not be written yet.))
Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan.
Those two alone should be enough to make people realize just how dictatorial - do it or else -- bit.
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Medicare is what workers have been paying into since 1966 so when you retire you have health care. SS retirement age has gone up and up and will go further up in age.
Medicaid is designed for low income people who cannot afford, or does not have health insurance.
==
I am waiting until we hear what the Senate is planning.
We need reforms - but not this way.
Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan."
(OF NOTE - the "qualified plan" has not be written yet.))
Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan.
Those two alone should be enough to make people realize just how dictatorial - do it or else -- bit.
===
Medicare is what workers have been paying into since 1966 so when you retire you have health care. SS retirement age has gone up and up and will go further up in age.
Medicaid is designed for low income people who cannot afford, or does not have health insurance.
==
I am waiting until we hear what the Senate is planning.
We need reforms - but not this way.