Top 14 Health Care Reform Provisions That Take Effect Immediately on January 1, 2010

[ClarkUSA]

Amid all the negative rumors and misleading assumptions that are floating around here about what the Affordable Health Care For America Act will or will not do for/to Americans, I thought I'd share some actual facts about what positive changes HCR will enact as of January 1, 2010 should the bill now being debated in the Senate be signed into law by President Obama by the end of the year:


1. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE - Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1. 2010.

2. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POLL) - Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions.

3. BANS LIFETIME LIMITS ON COVERAGE - Prohibits health insurance companies from placing lifetime caps on coverage.

4. ENDS RESCISSIONS - Prohibits insurers from nullifying or rescinding a patient's policy when they file a claim for benefits, except in the case of fraud.

5. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENT'S INSURANCE - Requires health plans to allow young people through age 26 to remain n their parents' insurance policy, at the parents' choice.

6. ELIMINATES COST-SHARING FOR PREVENTATIVE SERVICES IN MEDICARE - Eliminates co-payments for preventative services and exempts preventative services from deductibles from the Medicare program.

7. IMPROVES HELP FOR LOW-INCOME MEDICARE BENEFICIARIES - Improves the low-income protection programs in Medicare to assure more individuals are able to access this vital help.

8. PROVIDES NEW CONSUMER PROTECTIONS IN MEDICARE ADVANTAGE - Prohibits Medicare Advantage plans from charging enrollees higher cost-sharing for services in their private plan than what is charged in traditional Medicare.

9. IMMEDIATE SUNSHINE ON PRICE GOUGING - Discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases.

10. CONTINUITY FOR DISPLACED WORKERS - Allows Americans to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage.

11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM - Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.

12. HELP FOR EARLY RETIREES - Creates a $10 billion fund to finance a temporary reinsurance program to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64.

13. COMMUNITY HEALTH CENTERS - Increases funding for Community Health Centers to allow for a doubling of the number of patients seen by the centers over the next 5 years.

14. INCREASING NUMBER OF PRIMARY CARE DOCTORS - Provides new investment in training programs to increase the number of primary doctors, nurses, and public health professionals.

As someone who has friends and family who will be positively affected by all of the above changes, I am pleased on their behalf that President Obama has accomplished so much so soon with regard to health care reform. 97% of all bills that reach this point in the process become law, so I'm crossing my fingers. Later on, as with Social Security and Medicare, there will plenty of opportunity to amend the law in Congress. For now, let's help Democrats get HCR passed.

"A journey of a thousand miles begins with a single step." ~ Lao Tse

[CTLawGuy]

1. but teh bill sux

St. Dennis told me so.

[RBInMaine]

16. Dennis is well intended but also batshit nuts at times. We need an ADVANCE, not the whole load.

[DissedByBush]

89. Just to get that advance

We need someone fighting for the whole load. That way even a compromise is an advance.

Dennis may be a bit crazy, but he's sincere and fights like a bulldog.

[elocs]

88. You reference a god as a mere saint?

Remember: "Dennis" spelled backwards is "sinned".

[ClarkUSA]

196. 'Remember: "Dennis" spelled backwards is "sinned".'

[Frances]

2. Every time a Dem gets a minute on TV

that Dem should list these items

We need to hear these items and nothing else from Dems

The media will do its best not to let the public know what is really in the bill so we have to have some discipline and stick to the facts!

[ClarkUSA]

73. Right. We grassroots supporters of HCR also need to write LTTE to our local papers.

Today, there was a lying liar from Roll Call on MSNBC who said nothing would change until 2014. The bleached blonde talking head just presented that as the truth with no other source other than that. I wrote to MSNBC to complain about it, but it was annoying and a symptom of how stupid MSM reporters are.

[Old Codger]

3. Sounds ok I guess

BUT, this is what they are saying now, this is not in any way the final bill, they will have to stave off the butchering by the rethugs and blue thugs and insurance company employees who call themselves representatives. All that and then they have to get it passed... Long Long ways to go yet...and I would not even be willing to bet they can pass anything.

[goclark]

10. On a positive note ~ this information is important for all Americans

to understand so they can encourage their Congress members to get to stepping.

[Old Codger]

15. You bet

As the saying goes information is power, being aware of what they start with and keeping up to date with it as it evolves is important.

[goclark]

94. I have not heard One M$$M person outline it this way

Do all of them have this information?
All they are saying is stuff like, " Obama was guarded in his response because it is a matter for Congress."
and
" He will look bad at his State of the Union message if this is not approved."

or
" Lil Joey does not like the Health Care Provisions as is and he will not approve it."

Can they for five minutes talk about the wise ones that DID make the decision to get something this important for the American people?

Please send this to Keith etc. and let's all send it to our newspapers.

Thanks for one of the few posts I have seen here at DU that is positive on this issue. It is real quiet around here ~ Huum.

[NC_Nurse]

4. Thank you. Great post.

[ClarkUSA]

122. You're welcome, NC_Nurse.

[Motown_Johnny]

5. K&R, it isn't the bill I wanted but it does have some important benefits to it

nice post, thanks

[IndianaGreen]

27. It is worse than you think!

On the public option

• The public plan option is a sham. According to the Congressional Budget Office, the premiums will actually be higher than premiums in the private sector, and fewer than 2 percent of Americans (6 million people) will enroll.

• Payment rates would not be tied to Medicare. Instead, the government has to negotiate payment rates with providers.

• So the public plan option will be an expensive, tax-funded subsidy to private health insurance, because the public plan option will take the sickest patients off their hands. It won’t expand coverage or decrease costs. In the Senate bill, only about 1 percent of Americans (3-4 million) will enroll in the public option, and states can choose not to offer it.

On the employer-mandate

• Starting in 2013, employers with payrolls over $500,000 are required to provide coverage and pay a share of the premiums (72.5 % for individual, 65% for family coverage) or pay an 8 percent payroll tax. The Senate bill places the burden on individuals, not employers, to obtain coverage. Employers would only pay a $750 penalty per worker for employees who sought subsidized coverage.

• Employers are not required to meet benefit standards until 2018, but even then are only required to help fund the “lowest cost plan” that meets the “essential benefits package,” and so may offer very skimpy coverage. The “basic plan” on the insurance exchange, for example, is only required to cover 70 percent of benefit costs. As there are no cost controls, coverage will deteriorate further, leading to a rise in underinsurance nationwide.

• Millions of working Americans will continue to lack coverage. In Hawaii, which has had an employer mandate since the 1970’s, many employers circumvent the requirement by hiring part-time employees or using consultants. Also, small businesses are not required to provide coverage (but receive a paltry tax credit for two years if they do).

http://www.pnhp.org/news/2009/november/talking-points-o...

[ClarkUSA]

52. Oooh! You're so handy with the PHNP anti-HCR op-eds that are long on rhetoric but short on facts!

Where's the link to the text of the latest CBO report where it says that "premiums will actually be higher than premiums
in the private sector"?

Also, Senators are planning to decrease the employer mandate penalty in the final bill, so there goes another RW talking point.

[jwirr]

6. That looks good so far. Thanks.

[firedupdem]

7. Rec'd! Thanks for posting this

IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POLL) - Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions.

[Ruby the Liberal]

12. Tells me that they can still deny coverage for pre-existing

unless I am missing something.

[ClarkUSA]

20. You're "missing something." Read #2.

2. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POLL) - Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions/b].

[Ruby the Liberal]

24. That is what I was referring to. If they have to create a new (temp)

program for pre-existing conditions, that means insurance companies are allowed to continue to deny coverage based on pre-existing conditions.

How do you read it?

[ClarkUSA]

30. Until the Exchange is set up, folks w/pre-existing conditions will be covered starting Jan. 1.

I'm not translating #2 into a feeling that insurance companies might be "allowed to continue to deny coverage based on pre-existing conditions" as I haven't come across any facts that indicate this to be true.

I believe that the immediate reforms that I've outlined in the OP are measures designed to get help to those who need it most ASAP, as opposed to inevitable waiting for millions of Americans to call insurance companies to find a policy, especially when the Exchange has not been set up yet and public option pricing has not been negotiated by the Secretary of HHS yet.

[Ruby the Liberal]

33. I agree that it will cover those already denied, but

I have yet to see language that states they can't continue denying people.

If that distinction isn't made, everyone and their Aunt Fran will be denied and pushed off into the "temp plan" which would not be exactly cost effective.

[ClarkUSA]

42. There's nothing that points to your assumption, though.

<<I have yet to see language that states they can't continue denying people.>>

I have yet to see language that states they can, so there's no point in trying to prove a negative. Until the bill
has passed the gauntlet of 800+ GOP amendments and enters the final vote, neither you or I can say for sure
either way, unless you can point to a section in the HCR bill that says otherwise now.

<<If that distinction isn't made, everyone and their Aunt Fran will be denied and pushed off into the "temp plan"
which would not be exactly cost effective.>>

Presently, those who have pre-existing conditions are effectively denied insurance coverage, anyway. Provision #2
will give access to medical care that would otherwise be impossible for many millions of Americans -- including a
close relative of mine who's going lose his COBRA coverage on February 1, 2010.

[Ruby the Liberal]

64. That is a fallacy

If the language does not prohibit a practice that makes them money, you can double down that it will not only happen, but it will accelerate.

I am not meaning to piss in your Cheerios on this. Your thread is positive and appreciated. This is just a HUGE concern of mine and until I see "prohibited" in writing, I have to assume status quo.

[ClarkUSA]

70. How so? You're entitled to your opinion but that doesn't mean what I've said "is a fallacy" at all.

As I said earlier: Until the bill has passed the gauntlet of 800+ GOP amendments and enters the final vote, neither
you or I can say for sure either way, unless you can point to a section in the HCR bill that says otherwise now?

Furthermore, why are you arguing a point that you cannot prove, especially since the final bill has yet to be revealed?
Wouldn't you be better spent writing to your Senators and congresscritters than arguing with me?

[Ruby the Liberal]

71. Arguing? I thought we were discussing.

Today: Insurance cartel is allowed to deny coverage for pre-existing conditions.

Post-Reform: If they are not specifically told "NO" they will keep on keeping on.

Where the fallacy comes into play is that you are promoting a new, public, temporary plan for those currently affected as a change in regulation of private insurance.

Nothing in the current bill addresses going forward.

[Name removed]

72. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[ClarkUSA]

130. "Nothing in the current bill addresses going forward." Um, no. Actually, it does.

Denial of claims will not be a decision of the insurance companies unless there's a case of fraud, according to the language in both
the House and Senate bills. As you may already know, the Senate Bill S. 1679 is the Affordable Health Choices Act. The language of
the bill prohibits discrimination against individual participants and beneficiaries based on health status. Coverage terms cannot be
based upon an individuals health status, medical condition (including physical and mental illness) or disability. I hope the final bill
will hew to these guidelines.

[AVID]

160. K

[Garam_Masala]

157. Not quite true!

Since majority of privately insured folks are insured through employers,
they are part of a group policy and are NOT denied coverage based on exisiting
preconditions. I am a living example of that!

[saracat]

49. That was changed to 2014 to make the bill more appealing to the conservatives.

[ClarkUSA]

53. Do you have any credible proof of your assertion? nt

[saracat]

55. it was on PBS yesterday. I'll look. I was disturbed by it. I'll try to find a link.

[vaberella]

63. not the pbs special the language in the bill please. n/t

[saracat]

69. Oops and I meant 2012 not 2014! Still looking!

[pattmarty]

101. Well, there is not going be a fucking bill by 1/1/10, so you can.............

.........forget about the "temporary coverage". Any idiot SHOULD know that you just can't create this by a fucking edict. It will take at the very least a couple of months to get the so called "temporary" plan into existence. This "reform" is starting to look like a really bad joke on the Dems and my prediction is they will lose more seats than they would have if they could have passed "reform" with substance. The Dems have control of all 3 parts of the government and IF they get ANYTHING passed (which the longer it goes, the more doubtful it gets) it will be shit. SHAME ON THE FUCKING DEMOCRATS.

[ClarkUSA]

103. Time will tell. nt

[Name removed]

106. Deleted sub-thread

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[saracat]

47. But that preexisting condition provision was changed to not take effect till 2014 by the Senate

what will be in the final bill no one knows.

[Name removed]

54. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[ClarkUSA]

129. Isn't that 2012? Nevertheless, the gov't. will offer interim healthcare until the Exchange is set up

[Frosty1]

8. Good first step

Thanks for the info

[vaberella]

9. Thanks Clark. This needed reposting. n/t

[CaliforniaPeggy]

11. Shout these from the fucking rooftops!

VERY important post; thank you!

K&R

[IndianaGreen]

17. You are not getting what you think you are getting!

Upbeat policy wonks and political spinners who tend to see only portions of cups that are full will point out some good things: no preexisting conditions, insurance exchanges, 30 million more Americans covered. But in reality, the cup is 90 percent empty. Most of us will remain stuck with little or no choice -- dependent on private insurers who care only about the bottom line, who deny our claims, who charge us more and more for co-payments and deductibles, who bury us in forms, who don't take our calls.

http://www.pnhp.org/news/2009/november/the-public-optio...

[ClarkUSA]

19. Unlike the OP, heated doomsday rhetoric is not factual. nt

[IndianaGreen]

21. I've heard this meme on the lead up to Iraq War, when your side supported IWR

and my side was trying to prevent the mess that Iraq turned out to be.

[Name removed]

25. Deleted sub-thread

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[Cleita]

35. Yep, the same old mistakes get repeated over and over again.

I remember the DU debates on the Iraq War and even though it may not be the same opposition, the memes are the same.

[ClarkUSA]

46. What are these "mistakes" and "memes" that you speak of? nt

[Cleita]

76. Oh, I don't know. Everything that hasn't worked in the last hundred years

that we insist on going back and doing again. If you don't know what I'm talking about, go read a history book, preferably one not written by Pat Buchanan.

[ClarkUSA]

98. Wow, you're still bemoaning the "mistakes" and "memes" from 1909? Why not go back to 1776? nt

[Cleita]

112. I could go back to the Bronze Age if you like.

A mistake is a mistake and shouldn't be repeated.

[ClarkUSA]

113. I'm curious. What mistakes pertaining to the HCR effort "go back to the Bronze Age"? nt

[Cleita]

116. NIce try. You are setting up straw men and I'm not playing anymore.

[ClarkUSA]

117. lol! You're the one who brought up the Bronze Age in relation to the "mistakes" and "memes" of HCR

I've tried to ask you for specifics, but you haven't offered anything buy vague platitudes.

[Cha]

51. You don't anything about who supported what..I know as my senator Hillary

and her husband Bill supported the War on Iraq.

And, President Obama didn't.

[goclark]

96. Thank you Cha ~ I remember that also

Memories get short around here.

I am not putting the Clinton's down at all, it is a good example of what happens in politics all the time. That was their decision at that time.

None of us knew how it would work out, especially the Horror that it was -- and GW walked away with his Library and Millions in cash.

Blackwater is still collecting major $$$$$$.

[vaberella]

111. Cha---YOU'RE A NEW YORKA?! ahhh!! hello my brethren!!!

Wait...are you part of that crazy upstate crowd who makes me thik most up there is from Tallahasee?!

Of course I'm not providing any substance to the debate...but whatever.

[Cha]

134. Here's some more non-substance..

We live in a wonderful little community up here that is full of great people and a Natural Food's co-op. We even have a Democratic Mayor but we are the exception..surrounded by those who live in fear of an Obama admin.

vabby~

[ClarkUSA]

148. Upstate NY has wonderful little havens like that. Good school system, too?

[kid a]

126. forwarded to email list

[ClarkUSA]

190. Thanks, CaliforniaPeggy! That's what I'm aiming to do.

[sandnsea]

13. And here are ten cost cutting measures

The Senate bill, particularly, includes a tax on high-value “Cadillac” which often allow costs to spiral completely out of control. Another proposal creates a commission that would make binding recommendations on wasteful Medicare spending, which has also been endorsed by the Business Roundtable.

Penalties for high readmissions. Too often, patients are discharged
from the hospital without the necessary follow-up care leading to
re-hospitalization, risks to one's health, and higher costs. Under the
proposals being considered, Medicare would collect data on readmission rates
by hospital and would assess penalties on those hospitals with high,
preventable readmission rates.
Bundled payments, which pay a fixed amount for an entire episode of care rather than piecemeal for each individual treatment or procedure, would help improve patient care by encouraging better and more coordinated care than under a fee-for-service system. Bills in both the Senate and the House would develop, test, and evaluate bundled payment methods through a national, voluntary pilot program. Once we see what works and what doesn't, bundled payments can be quickly scaled up across the country.
Quality incentives for physicians. Creating incentives in the payment
system to reward quality of care rather than just the quantity of
procedures. These proposals would expand quality incentives for physicians and provide more timely feedback on physician performance based on their submitted data.
Accountable Care Organizations (ACOs). Under the current system,
quality and efficiency are not sufficiently rewarded, and there is little
incentive for physicians to collaborate in the coordination of patient
care.� Legislation in both Houses would encourage and reward ACOs, which are groups of providers that are jointly responsible for the quality and cost of health care services for a population of beneficiaries with chronic conditions.
Investing in research into what works and what doesn’t in health care.
Reducing hospital-acquired infections and other avoidable health-center acquired conditions through rigorous reporting and transparency.
Putting prevention first, rewarding care that focuses on wellness and
treating the whole patient in an integrated and coordinated delivery system.
Tackling the insurance bureaucracy, streamlining the payment system to save time and money that is now spent processing claims and navigating through the byzantine insurance system.
Establishing a health insurance exchange with a public insurance option, where individuals and small businesses can buy lower-cost insurance that will spur competition and put downward pressure on costs.

http://obama-mamas.com/blog/?p=636

[JDPriestly]

81. Does anyone know what is meant by wasteful Medicare spending?

I'm on Medicare and haven't seen any wasteful spending. What are they talking about?

[mdmc]

86. I can think of a lot of ways the system has waste

right now medicaid (and medicare) pay for 6 month maintenance of c-pap machines. I found out that companies can bill for maintenance even if no service is performed on the machines.
Lots of people get these machines and then refuse to use them. Think of all those unused machines getting "serviced" every 6 months.

That is just one way that there is waste..
The law is written for the corporations (in my example, the c-pap machine corporations). That means that profit is more important then wasteful spending.

[mopinko]

135. i had to swear to use mine. bcbs

ok, not swear, but after 2 months, i had to send a signed statement that i was using it and intended to continue to use it. i know a lot of people get them and can't stand it. DH is one. he needs it worse than i do, but he is just freaked out by it. i am sure he would be honest, and send it back. but i also presume that if no one asked, he would let it collect dust. the co-pay is $10/mo. he would mean to get around to it, but.....

[ClarkUSA]

102. New authorities will allow for pre-enrollment screening of providers and suppliers.

Also, the bill will simplify the paperwork burden that adds tremendous costs and improve Medicare payment accuracy to providers (i.e., eliminating overpayments to Medicare Advantage plans.

[AVID]

164. good stuff

[pattmarty]

107. I'm not on it yet (close), I believe it's the "Advantage" plans that by.......

.......the way under Bush's "reform" are HEAVILY subsidized by the government. Cutting back the subsidies (which by the way is what the "new reform" does) on Advantage plans will save a ton of money. Just goes to show ya, what "privatization" can do to a perfectly good "government run" plan, by costing us (the taxpayers) more money paid to private insurance companies for an already good plan.

[JDPriestly]

115. In a city like L.A., I think a senior just about has to be on an advantage

plan in order to locate a doctor who will accept Medicare. I'm on the Kaiser Advantage Plan and I can't afford to pay more than I am already paying for my healthcare.

[pattmarty]

119. I don't want to bust on you, but If Medicare would have been funded...........

.............properly over the years and the doctor payment was re-visited every two or five years and fairly adjusted if needed, then WE wouldn't need a fucking "advantage" plan, would we? Use the fucking money to fix goddamn Medicare and scrap the fucking government subsidized "advantage" plans. We have a basically Socialist government single payer program (Medicare) that the government gives private companies taxpayer money to what, "compete" with? Why fucking do that? Medicare is a good plan. Properly fund it.

[IndianaGreen]

14. Are mandates not required for those states that opt out of 'public option'?

I didn't think so.

[ClarkUSA]

18. lol! Which states will dare voters' wrath by opting out?

I don't think so.

[IndianaGreen]

22. Bible Belt!

and that's just for starters.

[Name removed]

28. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[saracat]

48. Arizona already plans to do so. It is wrong to allow states to do so.

[ClarkUSA]

58. Talk is cheap. Let's see what'll happen once political reality hits and their bluff is called.

Red-state wingnuts who say that are posturing for re-election. I doubt any state's GOP governor and legislature will opt out.
Remember all those GOP blowhards (including some politicos from AZ) who criticized the stimulus plan and/or said they'd
reject stimulus money? None of them followed through because they're not as dumb as they seem from their red meat
soundbites which are mainly meant to whip up their teabagger base in order to drive them to the polls next year.

I think the opt-out is an excellent notion. Basically, Republicans had their bluff called by the Democratic leadership. If they
opt-out, they know they're screwed with independents and any purple state GOP governor or senator will be forever gone.
If they don't, they have to justify their decision to their whacked out base. Damned if they do, damned if they don't.

[saracat]

65. Unless you live he don't make that assumption. We DID reject NCLB

funds and we DID originally reject the stimulus.Even our Dem official know AZ will opt out. They tell me so and I believe them.They deal with the wingnuts everyday as the beleaguered minority.

[ClarkUSA]

67. I'll believe when I see it. AZ ended up accepting stimulus $ after whining about it at first. nt

I may not live in AZ but I have close relatives who do. They're activist Democrats and they think as I do.

[Better Today]

23. Please NOTE that NONE of them will be effective Jan 1 at this point in time.

Really, folks need to start using correct tenses with their OPs.

The title should read "...that would take effect," or "...that could take effect," or even "...that might take effect". Or better yet, "this bill, if passed in its current form..."

But since this bill isn't the end all and it has to be consolidated with the House bill, it seems to me important to realize that

1. If you don't like the bill or parts therein, there's sure time to nudge your politicians to change a few things.

2. If you love the bill today, you may want to let your politician know you loveit the way it is.

Personally I'm hoping we all stay revved up and start feeding some of the Repubs' "concerns" back at them with solutions. The one I'd like attended first is the idea that is being addressed in this OP. Since the Repubs don't like taxation pre-health care reforms, then I say let's get started with the entire program on Jan 1, 2010 or at the latest 2011.

I'm very uncomfortable with the 2014 for any part of the program. As I've read on some of the comments that were posted during and after the broadcast yesterday, many who seem to think it is a bad idea, are looking forward to 2013 when they hope there will be a new Repub installed int the Whitehouse and with a signing statement, all will be stopped and abandoned.

If it's a good program or set of programs, then it should be able to be instituted in Obama's first term, not left with so many months and years.

[ClarkUSA]

44. You've raised some interesting points.

<<Really, folks need to start using correct tenses with their OPs.>>

I didn't think it was necessary to do so in the OP since I did so in the 1st paragraph of the text. I understand your point,
though. Since there's a 97% chance of HCR passing at this point, I guess you could say I'm full of HOPE that there will
be CHANGE.

<<But since this bill isn't the end all and it has to be consolidated with the House bill, it seems to me important to realize that

1. If you don't like the bill or parts therein, there's sure time to nudge your politicians to change a few things.

2. If you love the bill today, you may want to let your politician know you love it the way it is.>>

I agree 100%.

<<Personally I'm hoping we all stay revved up and start feeding some of the Repubs' "concerns" back at them with solutions.
The one I'd like attended first is the idea that is being addressed in this OP. Since the Repubs don't like taxation pre-health
care reforms, then I say let's get started with the entire program on Jan 1, 2010 or at the latest 2011.>>

It's not feasible to "get started with the entire program" so soon but the 14 provisions outlined in the OP is a great start until
the Exchange is set up.

<<I'm very uncomfortable with the 2014 for any part of the program. As I've read on some of the comments that were posted
during and after the broadcast yesterday, many who seem to think it is a bad idea, are looking forward to 2013 when they hope
there will be a new Repub installed int the Whitehouse and with a signing statement, all will be stopped and abandoned.>>

I understand your fears, but it's difficult to fathom how President Obama could be defeated in 2012 by one of the wingnuts
among the current crop of GOP primary favorites.

<<If it's a good program or set of programs, then it should be able to be instituted in Obama's first term, not left with so
many months and years.>>

It's unrealistic to want every aspect of HCR to be enacted a couple of weeks after being signed into law. We are talking about
a very complex bill affecting the biggest change in the federal government since Medicare, after all. The public option needs
to be administered and negotiated by the Sec. of HHS. HHS needs to gather and process applications from millions of Americans
and they must be careful about fraud. HHS also needs to negotiate formal and legally binding rates with providers. And that's
just on the federal side. States and territories will also need to restructure on their end in tandem, which will take a significant
amount of time as well.

If Pres. Obama signs the bill into law by Christmas, then I'm sure you can understand how more than two weeks is needed to
implement only what I've described in the previous paragraph, much less the thousands of other details needed to make sure
things run smoothly (see what rushing through TARP under Bush II brought us).

Me? I'm happy with the 14 immediate provisions in the OP which will begin Jan. 1 (barring any FUBAR).

[slipslidingaway]

26. #11 - revenues from this program will be used to finance HC reform....

see the CBO estimates for the revenue generating in the first decade.

http://www.pnhp.org/news/2009/november/talking-points-o...

Talking points on HR 3962 with some comparisons to the Senate (Reid) bill in bold.

"Community Living Assistance Services and Supports

•The bill calls for the establishment of a “voluntary federal program for long-term care insurance” that would pay a cash benefit to help fund home-based services.

•The CBO estimates that the revenues in the Senate version of this new program would exceed premiums by $72 billion in its first years of operation, and these revenues could be used to fund the bill. In other words, $72 billion of the funding for taxpayer subsidies of private insurers would come from raiding a new federal long-term care insurance plan.

•This is just one example of how completely inadequate the bill is at addressing the real crisis in access to health care, including access to long-term care services..."

[prolesunited]

29. Nice to see some positive, factual information posted here for a change

As a person with numerous pre-existing conditions whose COBRA will end in February, I would be helped by this bill. I'm so sick of hearing that I don't count.

It's not where I want to be, but it's a start. Name one piece of legislation that started out perfect. Heck, even our Constitution had a number of defects that needed to be corrected over time. Should we have waited on that as well?

[ClarkUSA]

32. Thanks. I have a close relative who is in exactly the same situation as you.

He has a family to worry about as well, so passing HCR is of great importance to him as well.

[DU GrovelBot]

31. ## PLEASE DONATE TO DEMOCRATIC UNDERGROUND! ##

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[Cleita]

34. Nothing will take effect until a final bill is signed, I do

detect a Trojan Horse in your post, if that is the final bill that is signed by President Obama, and that makes me happy.

[Name removed]

36. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Cleita]

37. thanks..I did edit the post and I never in my life until now have called

our President, whom I admire very much, Osama. It was a genuine typo and I'm so sorry. I guess you have never read any of my posts until now or you would know that. I did read your post and I appreciate that you took the time to distill it for everyone. The Trojan Horse that I referred to will give legislators a base to build real health care reform from this Insurance Profit Protection Act being offered in the future. Obama has nothing to do with this health bill until he signs it. That is all. My apologies

[impik]

38. Just amazing how nobody even knows about that

I feel like banging my head in the wall.

[ClarkUSA]

123. I know how you feel.

I guess Reid is too busy counting votes/herding cats.

[Cha]

39. This is what Dean was saying..get these out there as

quickly as possible!

I imagine these will help immensely right away..

10. CONTINUITY FOR DISPLACED WORKERS - Allows Americans to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage.

11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM - Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.

12. HELP FOR EARLY RETIREES - Creates a $10 billion fund to finance a temporary reinsurance program to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64.

13. COMMUNITY HEALTH CENTERS - Increases funding for Community Health Centers to allow for a doubling of the number of patients seen by the centers over the next 5 years.

14. INCREASING NUMBER OF PRIMARY CARE DOCTORS - Provides new investment in training programs to increase the number of primary doctors, nurses, and public health professionals.

[LynneSin]

40. Those 14 things makes this bill a MUST PASS situation

It's not like this time is the last time there will ever be healthcare reform.

[ClarkUSA]

192. I agree.

[Peacetrain]

41. For those who have been denied coverage because of pre existing conditions.. this is a God send

[saracat]

50. But not till 2014. That makes me made. They altered that this week!

[impik]

59. True. But they have an alternative until then.

[Name removed]

62. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[AVID]

43. That is why EVERY DEMOCRATIC SENATOR (left and center) voted to move it along

Thank you.

[HopeOverFear]

45. K & R

[freddie mertz]

56. What is the status of pre-existing conditions in the "January" bill?

Will the ban kick in at once, or in 2014, as some are claiming?

I'd like to hear from the OP on this, if possible, since it has not been addressed so far.

[vaberella]

60. What ban? Last I heard pre-existing conditions are supposed to lifted from being a problem. nt

[freddie mertz]

66. Useless answer. Next.

[Name removed]

68. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[vaberella]

95. You said "ban" you never answered the question. So I should say you gave a useless answer. nt

[freddie mertz]

91. Check THIS link

http://www.democraticunderground.com/discuss/duboard.ph...

[vaberella]

97. From my understanding the "January" bill or whatever your asking hasn't been drafted.

Based on the information on the PO or even interim----pre-existing conditions are not denied automatically. The 2013 is for all other private insurance companies or those with individual plans that deny on pre-existing conditions.

[freddie mertz]

99. Yes, these are all still in process

JUST like the list posted in the OP above.

I suppose there is still room for improvement, but who would be willing to bet that the law against denial for pre-existing conditions is likely to to come into effect any EARLIER than 2013?

What is worrisome is the possibility that many people will be denied in the years leading up to the law taking effect.

As has happened, as we all know, with the new credit card bill.

[Name removed]

61. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[impik]

57. I don't get why nobody knows about this

Democrats lack of ability to PR themselves is so frustrating.

[kid a]

159. kicking back to the top

[yurbud]

74. disclosure is not enough to control prices. Premium caps and overhead caps would

And denial of claims should not be a decision of the insurance companies.

[ClarkUSA]

75. Both the House and Senate bills have measures that would take place later.

<<And denial of claims should not be a decision of the insurance companies.>>

Denial of claims will not be a decision of the insurance companies unless there's a case of fraud, according to the language in both the House and Senate bills. As you may already know, the Senate Bill S. 1679 is the Affordable Health Choices Act. The language of the bill prohibits discrimination against individual participants and beneficiaries based on health status. Coverage terms cannot be based upon an individuals health status, medical condition (including physical and mental illness) or disability. I hope the final bill will hew to these guidelines.

[fasttense]

82. But the insurance corporations use fraud as an excuse for denial of coverage.

Here is their logic as I understand it. If you get breast cancer and you failed to disclose that you had acne as a teenager, then you committed fraud and therefore the insurance corporation can deny your claim because of your fraudulent withholding of medical information.

So basically denial of coverage is based on supposed fraud.

So, I fail to see how this stops insurance corporations from continuing their practices. Though if denial of care had to be approved by a board then maybe it would stop, but only if that board could NOT be bought off.

Anyway, it's all hypothetical until the final bill is passed and signed.

This would have been 100% easier if they had just passed a Medicare part E - for everyone.

[ClarkUSA]

109. Greater consumer protection will go hand-in-hand with guaranteed coverage.

<<Anyway, it's all hypothetical until the final bill is passed and signed.>>

I agree. That's been my attitude all along.

[kid a]

77. kickin to the top and sharing on facebook

[ClarkUSA]

195. Thanks! And that's a great idea.

[Lydia Leftcoast]

78. Will the lifting of lifetime caps be retroactive?

If the insurance companies are still allowed to base premiums on the age of the insured, what makes you think they won't make up for being forbidden to charge based on pre-existing conditions by GOUGING people over 50? (They already do that, to a certain extent.)

Also, in HUMANE, DECENT countries, premiums are either based on income or are the same for everyone.

None of this age discrimination garbage.

[ClarkUSA]

120. There is nothing in the bill to suggest otherwise.

Of course, we'll have to see what the final reconciled bill looks like before being sure.

[dflprincess]

79. Any word on what the penalties for price gouging will be?

I guessing it will amount to a slap on the wrist that the insurance companies will consider part of the cost of doing business (like Walmart and labor law violations).

And, for the workers who get to keep COBRA - will they continue to receive help paying for it? Most people can't afford the full cost.

[katkat]

80. Clark, thanks

Thanks for posting this.

I had hopes of the donut hole being closed entirely, but any progress is better than no progress.

Is it known if Medicare will get the right to negotiate med prices like private insurance companies do? If not, that's a sign that the cretinous lobbyists owned the Congress slime on that one.

[ClarkUSA]

121. You're welcome, katkat.

<<I had hopes of the donut hole being closed entirely, but any progress is better than no progress.>>

That's the idea. Both the Senate and House bill will fill donut hole over time, though.

<<Is it known if Medicare will get the right to negotiate med prices like private insurance companies do?
If not, that's a sign that the cretinous lobbyists owned the Congress slime on that one.>>

Not that I know of. However, I do believe that as with FDR's Social Security and LBJ's Medicare, major
positive tweaks will occur over time, given a Democratic Congress and President. That's what we have
to strive for and vote for in the years to come.

[tavalon]

83. There is a lot not to like about the HCR winding through the congressional halls,

but these are some fine things. Thank you for reminding us about the good stuff our fellow Americans will hopefully be getting.

I have health insurance through my work, so none of the healthcare reform will impact me directly, but first, I care about my fellow Americans, even the crazy fucks demanding that they not be forced to have healthcare and indirectly, it will impact where I work. I'm a nurse, in a hospital and we will see healthier people because of this and that's a good thing.

[mdmc]

84. Those reforms don't help me at all.. in fact my ins. costs just went up..

So now I have $40.oo co-pays.. will my co-pays go up to an even $50.oo?

Where is my public option? Where is my health care savings?

I've stated from the beginning that I am down with whatever Obama can call a health care reform "victory". I guess this is a victory..

[Phoebe Loosinhouse]

85. This is the press release from Pelosi about the bill passed in the HOUSE

These are all great - the big question is how many will make it into the final bill?
My understanding is that the Senate Bill is nowhere near as comprehensive as the House bill and the Senate is trying as hard as it can to water down the bill to get approval from those a!@ Bluedogs that are holding up the train of progress for everyone.

[ClarkUSA]

93. The Senate bill S. 1679 has similar language as the House bill.

The language of the bill prohibits discrimination against individual participants and beneficiaries based on health status. Coverage terms cannot be based upon an individuals health status, medical condition (including physical and mental illness) or disability, etc. Hopefully, the final bill will have these elements still in it. I'm HOPEful, though.

[N_E_1 for Tennis]

87. NEW REPUB. HOUSE HEALTH CARE PROPOSAL, details below

Sorry for posting this here, I'm new to posting on DU and needed to get this out to the public. Not enuf posts to start my own.
Thank you for letting me "tailgate".

While we are fighting for our lives here in Michigan, our esteemed Rep. Thad McCotter has gone to the dogs.
No doubt this a good and maybe even a much needed bill, but not now, not now when we are struggling to exist here in Michigan.
I am an animal lover, but health care for animals? We, the ranks of the uninsured humans, rate lower in the eyes of our Representative.
This needs to go viral. The article come from The Oakland Press, a conservative paper, here in Southeast Michigan.

Thank you for your understanding.

Read below or at: http://www.theoaklandpress.com/articles/2009/11/23/opin...



"By The Oakland Press

With everything going on in Washington these days, there are a lot of Americans who think Congress has gone to the dogs.

Well, it just so happens that if a Michigan congressman gets his way, that description could be taken literally.

U.S. Rep. Thaddeus McCotter, RLivonia, wants a tax break for veterinary expenses.

His proposal is called HAPPY, an acronym for the Humanity and Pets Partnered Through the Years Act.

“No matter the age of the owner, pets have been shown to reduce stress, safeguard against depression, improve social skills and even ease loss,” McCotter wrote in a letter to other members of Congress.

HAPPY would cover everything from procedures such as declawing and fixing broken bones to treatment for common ailments like worms and parasites.

In addition, popular surgeries such as spaying and neutering would be completely tax deductible, possibly making animal overpopulation easier to control.

“Although we can’t say for sure, if this bill led to fewer animals on the streets that would be fantastic,” George Carr, a lobbyist for the Okemos-based Michigan Veterinary Association, said in a report by The Associated Press.

We don’t want to seem like we don’t like dogs, cats or other household pets, but seriously, there’s a logic problem with HAPPY.

If your dog injures a leg, you’ll get a tax break for veterinarian fees.

But if your child breaks a leg playing football, you’re stuck with whatever costs aren’t covered by a health insurance plan, if you are lucky enough in this tough economy to have insurance.

And yes, we realize pets can reduce stress and depression, but so can a number of legal drugs, which also are not tax deductible.

And while HAPPY has picked up support from some organizations and animal societies, no one has even attempted to determine how much federal tax revenue would be lost if the bill becomes law.

As Congress struggles with health care reform, should tax breaks be given for our pets?

We don’t think so.

But we will note that there are insurance policies that can be purchased that cover the care of animals.

Many people frequently say that pets — particularly dogs — live better lives than some children.

That is, obviously, a reference to kids who are from poor families that are finding it hard to make ends meet.

That’s why it’s ironic that while Washington endlessly debates health care reform and seems to put people at the bottom of the priority list, there’s legislation to help animals. We’re all for the humane treatment of animals, pets or otherwise. And we’ll concede that the congressman is supporting this bill with only the best of intentions. But it also cries out as a example of misplaced priorities. We need to focus on health care for humans. Animals can take a back seat at this time. We praise McCotter for the hard work and dedication. He has proven that he is an independent thinker and will vote his conscience, even if it means taking an unpopular stance. But in this case, we believe the congressman is not quite on track. Currently, this bill seems stalled in the Ways and Means Committee. It’s probably best if it never makes it out."

[AVID]

158. kick

[deacon]

90. Why aren't Democrats selling the truth that the GOP are against 31 mill. being insured???

Why, why, why, and why?

The GOP are dishing out, continually a bunch of filthy lies. They are filthy liars when it comes to health care.

This wouldn't be a problem if out media had one ounce of integrity.

[Nicholas D Wolfwood]

104. Because if the people cared about the 31 million uninsured...

we'd already have universal health care. That argument will not win one single vote that we don't already have. People are scared about THEIR health insurance. They're worried THEY won't have access to doctors and that THEIR fees will go up. That's what we need to combat.

[proud2BlibKansan]

92. My son turns 27 in May and was kicked off our policy 3 years ago

Will we be able to put him back on in Jan?

[ClarkUSA]

108. Yes... if the reconciled bill that passes the Senate includes the provision.

That's why I think all of us who support HCR should call our reps to demand that these 14 provisions are included.
The House and Senate bills contain similar language but Senate Republicans have 800+ amendments that the entire
Senate will have to vote aye or nay on, so no one knows what the final bill will look like.

Every bit of encouragement will help. So will LTTE.

[NorthCarolina]

100. The Insurance Loophole for ending recissions is the term "Fraud"

as you can bet that the Insurance company will define what constitutes "Fraud" with a broad brush.

[ClarkUSA]

110. Under HCR, insurance companies will no longer have the egregious latitude they have now.

The House and Senate bills both assure better consumer protections. Of course, we need to see the final bill before making further comment.

[quiet.american]

105. Excellent. Thank you! nt

[ClarkUSA]

151. You're welcome, quiet.american.

[RepublicanElephant]

114. thanks for this list. nt

[ClarkUSA]

189. You're welcome, RepublicanElephant.

I like your sig.

[kid a]

118. k

[Hekate]

124. Thank you, ClarkUSA.

[ClarkUSA]

137. You're welcome, Hekate.

[Jakes Progress]

125. And we have always been at war with Oceana. nt

[Name removed]

127. Deleted message

Message removed by moderator. Click here to review the message board rules.

[unhappycamper]

128. Kicking to put at the top of GDP.

Please do NOT start any more flamewars.

[Cha]

136. Thank you, unhappycamper!

[ClarkUSA]

141. Thanks and I hope you had a Happy Thanksgiving.

[kid a]

150. kick

[Number23]

131. Yay, it's back! Maybe the mods/admins are starting to see how feverishly fiendish

and fervently foolish so much of the anti-Obama rhetoric has become here?? One can dream, right???

[Cha]

133. Well knock me over with a feather and call

me Scarlet!

[ClarkUSA]

146. The OP is good so I'm glad it's back.

Yes. We. Can.

[sudopod]

132. Kckd

[Cha]

138. Kick for pertinent

information.

[R. P. McMurphy]

139. k & r n/t

[davidpdx]

140. Nice work Clark

Just keep that little dragon in line or I'll send my cat to eat him. LOL

[Cha]

142. lol..I'll

just tag on here to keep this kicked.

[Cha]

143. Time for another

high kick

[Cha]

144. Again..

to keep the information available.

[Aramchek]

145. we need to post this in a new thread every couple of days so it can stay on the greatest page

ad infinitum

[Cha]

149. We can also just keep kicking it

to stay front and center..it's my pleasure.

And, thank you for your help.

[AVID]

161. like this

[ClarkUSA]

171. And this.

[Aramchek]

147. the Truth will set us free, and provide Medical coverage, too

[Cha]

152. Facts are facts..now matter how many

want to distort to plump up their own private agenda.

[Cha]

153. Kick to keep it at the

top!

[Cha]

154. KICK!

[AVID]

155. Keeping this on the front page

[ClarkUSA]

176. Thanks, AVID!

[cry baby]

156. Glad to hear this!! can you post a link to this info so I can pass it on, please? nt

[ClarkUSA]

186. Sure... see reply #181.

[Aramchek]

162. judo chop!

[Cha]

163. Bonzai!

[ClarkUSA]

167. ....

[mkultra]

165. its amazing how much good the downers must ignore

to be the sad little eggs.

[ClarkUSA]

170. Yeah, it must suck to be them.

But it's good to be us.

[Cha]

166. Kick to First Page.

[ClarkUSA]

188. Thanks, Cha!

[Ikonoklast]

168. What a crappy bill, a complete and total failure, a disaster in the making.

I just wanted to type that just to see how stupid it looks stacked up against the reality of just how enormous a change for the good this bill is.

The Fail Club that hates Obama and all he accomplishes must live in an alternate reality, where what they *think* is happening has nothing to do with facts.

But then again, many of them aren't even Democrats, they just play one on the internets.


K&R.

[ClarkUSA]

169. "I just wanted to type that just to see how stupid it looks stacked up against... reality"

Thanks for the reality check on the Failers on this thread and too many others.

<<The Fail Club that hates Obama and all he accomplishes must live in an alternate reality, where what they *think*
is happening has nothing to do with facts.>>

They're either sociopathic liars or mentally deranged. Either way, they're always wrong on the FACTS.

<<then again, many of them aren't even Democrats, they just play one on the internets.>>

Sure, though I recognize so many who are bitter sore losers who will never forgive Barack Obama for ending
up the Democratic presidential nominee and a few others who are one-issue haters who resent their not getting
their pony NOW and blame Pres. Obama for not doing enough, saying enough to their narcissistic satisfaction.

[DailyGrind51]

172. Thank you! I plan to forward this to my regular contacts.

[ClarkUSA]

173. You're welcome and thanks in return. That's the main reason I posted the OP.

[Zoeisright]

174. Nothing about pre-existing conditions?

And eliminating recession is great - but what's the 'fraud' clause? Do the insurance companies get to decide what 'fraud' is?

Like they decided an undeclared case of acne discover when a patient needed breast cancer treatment was 'fraud'??

[ClarkUSA]

175. Please read through the thread.

Your questions have been asked by others, more or less, and answered to the best of my ability relevant to available facts as they relate to the bill.

[Moochy]

177. It's all ClarkUSA all the time here at DU!

K&R because im tired of reading posts by other du'ers!!!1111

[Cha]

180. It's you with a nonsensical personal attack bc you don't like the message.

[Moochy]

178. K&R

ClarkUSAUnderground rules!

[cry baby]

179. Could you please post a link to this info so I can pass it on? thx!!!

[ClarkUSA]

181. Source: Committee on Education and Labor (link -->)

http://www.enewspf.com/index.php?option=com_content&vie...

[cry baby]

182. Thank you! Is there a list like Pelosi's on the senate version of HCR that you know of?

[ClarkUSA]

183. The Senate bill S.1679 has similar language as the House bill.

The language of the bill prohibits discrimination against individual participants and beneficiaries based on health status. Coverage terms cannot be based upon an individuals health status, medical condition (including physical and mental illness) or disability, etc. Hopefully, the final bill will have these elements still in it after all the debate dies down, as I mentioned in my OP. So far, there's nothing to indicate otherwise from Pelosi, Reid or the press.

[Cha]

184. Thanks for that, Clark.

[ClarkUSA]

185. You're welcome, Cha.

[Divine Discontent]

187. it's a start!

[ima_sinnic]

191. I'm still afraid of it because of how much I am going to be FORCED to pay

I'm in category 2, self-employed, uninsured, "older" (63), and with at least one "pre-existing condition" (and since I haven't seen a doctor in about 8 years, I have undoubtedly developed other "conditions").

I don't see any kind of guidelines about how much this will cost consumers. As predicted, it simply makes insurance "available." It also does not mention that everybody is REQUIRED to buy it--are they hiding that fact--or is there yet hope that it won't be "mandatory," like car insurance? Since I am in that leper category, I assume my rate will be a huge gouge and I might even rather just go to jail than pay it.

I really don't understand being ecstatic over knowing I now "can" buy *insurance" without even knowing the cost.

[Milo_Bloom]

193. Not much of REAL value there.

"BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE - Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1. 2010"

Nothing to stop prices from rising before this takes effect.

"IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POLL)"

Keyword: TEMPORARY.

"BANS LIFETIME LIMITS ON COVERAGE"

Does nothing to control costs.

"ENDS RESCISSIONS"

See fraud claims increase 200%

"EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENT'S INSURANCE"

Does nothing to control COSTS.


etc... etc..

In short, there are easy outs of ALL OF THESE for the insurance companies, since the bill does nothing to stop stiff price increases by an industry controlled by a few monopolies, who tend to act in concert.

And if you think forcing them to public previous prices is going to "discourage" price gouging, you haven't paid attention to history on "sunshine provisions" in pricing.

[ClarkUSA]

197. Uh huh. They look good to me and many other Americans.

I only hope the final bill follows these guidelines and passes this year.

[kjackson227]

194. K & R

[Cha]

198. kr