decision making / politics

What You Should Understand About HR3200–Part III


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This is the third (starting from page 103) in my discussion of the Congressional Health Care Bill. I have accepted Nancy’s challenge and will read every word of it and share my thoughts with you. You, therefore, vicariously through me, have read it and cannot be accused of being ‘misinformed’ or ‘misdirected’.

Before I go on, here’s a tidbit I found out:

The House version of the Health Care bill, HR 3200, creates fifty-three new departments, agencies and commissions

One of these is National Institute of Comparative Effectiveness. A similar institution exists in Britain, called the National Institute for Health and Clinical Excellence, given the curious acronym of N.I.C.E. Rulings on whether people live or die are made frequently in Britain and Canada, and if an individual has a pre-existing condition, is elderly, or for some reason deemed “unfit” for a lifesaving procedure, his chances of being granted that lifesaving procedure become uncertain. With health care rationing, lives will literally hang in the balance, subject to the whims of government. (from Confounding America’s Ideals – Washington Times)

Before I go on (oh, I already said that–hmmm… last time), a few people pointed out some sections I missed. Look at these:

  • Section 121 (page 25): Rationing and Denial of Care – Health plans authorized to impose restrictions on access
    to care according to “clinical appropriateness.”
  • Section 122 (page 26): Political Appointees Decide – A health benefit advisory committee (political appointees)
    will decide what kind of benefits (medical treatments/practitioners/drugs) are and are not
    essential. The Secretary of HHS will implement the decision by rule.
  • Section 142 (page 42): Limited Choice of Insurance Plans – A new “Health Choices Commissioner” will rule
    over insurance options for all Americans, deciding what insurers are available.
  • Section 152 (page 50): Free Care to Non-Citizens? – An anti-discrimination section appears to allow the free
    provision of medical treatment to non-U.S. citizens.
  • Section 155 (page 53): Privacy Intrusions/National Patient ID Card – An electronic data system will be set up
    to access bank accounts for “real-time adjudication of claims” and to determine “whether
    the individual is eligible for a specific service with a specific physician at a specific
    facility.” A “machine-readable health plan beneficiary identification card” – a national
    patient identification & tracking card – may be used.
  • Section 201: (page 72): A government “Health Insurance Exchange” will be set up to establish federal control over the definition, amount, and type of insurance options available, and to eliminate a free and thriving market in health insurance.
  • Section 205: (page 97) Forced Enrollment in Medicaid – All Medicaid-eligible individuals will be
    automatically enrolled in Medicaid. Individuals will be forced into Medicaid. (Sec 205)

Now let’s continue:

  • Page 103–once you’re eligible, you must enroll in Medicaid. In fact, the government will enroll you if you don’t.
  • Forced Enrollment in Medicaid – All Medicaid-eligible individuals will be
    automatically enrolled in Medicaid. Individuals will be forced into Medicaid. (Sec 205)
  • Page 110–Section 207: TAXES ON INDIVIDUALS NOT OBTAINING ACCEPTABLE COVERAGE. What’s that mean? This is what I’ve been hearing second-hand in the news. Now I’m informed Nancy–it’s actually right here, on page 110. It shows up on places where revenue will be derived to fund the program
  • Page 110–EMPLOYMENT TAXES ON EMPLOYERS NOT PROVIDING ACCEPTABLE COVERAGE. Just like the point above. Here is what I’ve heard from people at the townhall meetings.
  • Page 110–EXCISE TAX ON FAILURES TO MEET CERTAIN HEALTH COVERAGE REQUIREMENTS.—This and the two above are some of the methods the House proposes to fund HR 3200.
  • Page 116–Section  221–this is where the responsibilities of the National Health Care Exchange are laid out–to insure choice of medical care, competition for demand, affordability, high quality coverage.  (in this division referred to as the ‘‘public health insurance option’’) that ensures choice, competition, and stability of affordable, high quality coverage throughout the United States …the Secretary’s primary responsibility is to create a low-cost plan without compromising quality or access to care. This will eliminate private health insurance and to build a national Medicare for-all government health care plan. (Sec. 221)
  • Page 118–Section 222–explains that premiums will be geographically based rather than market-based. The Secretary shall establish geographically-adjusted premium rates for the public health insurance option…at a level sufficient to fully finance the costs of— (i) health benefits provided by the public health insurance option; and (ii) administrative costs related to operating the public health insurance option. I’m pleased that the intention is to ‘fully finance’ health insurace based on rates, but that contradicts ‘affordable’ and the earlier comments about fines and penalties being contributed to the operating funds of the plan.
  • Page 121–Section 223–sets out that doctors and medical practitioners will follow the Medicare plan for payment. The Secretary shall base the payment rates under this section for services and providers described in paragraph (1) on the payment rates for similar services and providers under parts A and B of Medicare.
  • Page 130–Section 241    Again, defers to the State Medicaid services for direction and implementation. With the financial problems the nation has with Medicaid, why would we do that? Use a broken system as a role model? The State Medicaid agency is authorized to conduct such determinations for any Exchange-eligible individual who requests such a determination
  • Page 132–Section 242: Define who is eligible for health insurance (again, I think). It sounds like you cannot be an illegal immigrant.  the term ‘‘affordable credit eligible individual’’ means, subject to subsection (b), an individual who is lawfully present in a State in the United States
  • Page 135–Section 243: Defines what ‘affordable’ is. Pretty convoluted. Here’s a table:


  • Page 143–Section 246: Specifically disallows coverage for ‘those not lawfully present in the US’ Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
  • Page 149 Section 313 Here’s where employers are fined if they don’t participate. Bad bill! A penalty is based on gross payroll, but doesn’t take into account the bottom line of the business. Where does a small business get 2-8% extra cash to donate? Sometimes that’s their entire profit margin. A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment


  • Page 152–SEC. 801: ELECTION OF EMPLOYER TO BE SUBJECT TO NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS. This is effectively the end of the Insurance Market – 7.

Enough! I need a break. I’m going to go pet my dogs and pretend that my congressional representatives want what’s best for me.


One thought on “What You Should Understand About HR3200–Part III

  1. Pingback: Self-Employed and Single-Employee Businesses: Nailed by Section 45R in Health Care Reform « Word Dreams…

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