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Reply #6: I don't think so-- although it's unclear [View All]

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Home » Discuss » Archives » General Discussion: Presidential (Through Nov 2009) Donate to DU
andym Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 09:56 PM
Response to Reply #5
6. I don't think so-- although it's unclear
Edited on Sun Nov-01-09 09:59 PM by andym
But they'll still be in a quandary with respect to rebates and the 85% cap, because they need to report accurate medical risk ratios to their stockholders (via SEC regulation). So they can't just fib.

They don't really describe how much regulation they will be funding. From the summary:

Sec. 242. Duties and authority of Commissioner. The Health Choices Commissioner carries out functions
including: establishment of qualified plan standards, establishment and operation of the Health Insurance
Exchange, administration of affordability credits, and additional functions as laid out within the bill. The
Commissioner can collect data necessary to carry out his or her duties and to promote quality and value and
address disparities in health care. Such information can also be shared with HHS. The Commissioner also has
oversight and enforcement authority including the authority to impose sanctions and suspend enrollment of a
plan. This authority requires the Commissioner to coordinate with the Department of HHS, the Department of
Labor and State insurance regulators.

Sec. 243. Consultation and coordination. Requires the Health Choices Commissioner to consult with other
regulatory bodies and state and federal agencies in carrying out his or her duties and to ensure appropriate
oversight and enforcement.

Sec. 244. Health Insurance Ombudsman. Establishes a Qualified Health Benefits Plan Ombudsman to assist
individuals in navigating the new health reform system and report to Congress on recommendations for
improvements in administration of the program.
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