Thank you so much to Kristin of Dragondreamer's Lair for posting the link to her opinion on the healthcare reform bill which includes a link to the bill itself. I actually did read a large portion of it to see what I thought about her and others' comments on the bill. Thanks so much because I've been wanting to find it, but kept getting only news reports in my searches. And I love Kristin's ideas on Nationwide Medical Insurance Plans!
Here are my interpretations of the Bill and a few other related things. Please please feel free to correct me if I am way off base, as much of it is in legal-ease, which does NOT facilitate ease of reading. I had to look up several definitions and supporting articles (along with conferring with Hub) to figure out what I thought it meant. Feel free to read the Bill and see if you agree!
In reference to that piece, I do want to say that you can have other insurance or pay out of pocket even if you are eligible for Medicare. The part of Medicare that you are automatically enrolled in is Plan A - which only includes hospitalization and is generally free if you have reached 65 and paid into the system (or a myriad of other combinations). You may pay for Plan A if you choose if not eligible for a free plan, and you may pay to add the further plans (medical, drug benefits etc) to your Medicare insurance if you choose. Medicare is meant as either a back-up, a supplemental insurance or full coverage depending on your needs and eligibility. My Grandfather maintained his military pension insurance and his Medicare simultaneously as far as I understand, and his wife now continues that coverage. I got my information here amongst other sources that explained how it works similarly, but I felt the Medicare page itself was probably the most credible.
In the bill, I could not find anything about not being allowed to have other insurance or being assessed fees or fines for paying out of pocket or using other insurance. On the contrary, I found sections that said you may stay in your preexisting insurance plan regardless of the new quality controls if you enrolled before the Bill became law. On page 28, line 19 this document begins a description of how enrollment would be managed by the government for insurance. From what I understood, it basically says that the government will help people who are not covered by health care and help them find "qualifying health care" (which appears to mean they meet certain standards - read the bill for more info) whether that be a Federal program of any type including Medicaid and CHIP or private insurance company. Page 34, line 1 appears to address choice in the program in a more extensive manner, and it seems as if there is a fair amount of free choice. I couldn't find anything that said you would be forced into the system. (Please correct me if you find otherwise.)
Some points I found that may be troubling for companies or others if I am correct in my interpretation:
Page 16, line 20 says to me basically that an employer cannot self insure if it has 250 enrollees in the group or under. I do not understand the financial savings of self insuring, or the ramifications of taking away that option for a smaller "group," but I assume this could cause concern. I also think it probably wouldn't be the government's place to make this ruling.
On page 26, line 15 the Bill discusses the administrative fees to cover the government's assessments of each insurer. Fees are always a concern to companies, though as far as I know, they already incur governmental administrative fees. This copy of the Bill was very vague as to if these fees would be more or less and did not include details.
Page 27, line 1 gave me some trouble. I think I may have figured it out, but again, help if you can! It seems to me that companies would incur a fee if they employ an incorrect assessment of the risk their enrollees have in comparison to the average calculation of all the other qualified insurers? Again, this was really confusing for me.
And something that did concern me greatly for small business owners... page 96, section 1 states that there will be a penalty charged to employers that do not OFFER insurance to employees. I assume that means to ANY employees. If this is the case, that could be distressing for struggling, small businesses. Is this right?
Overall, the spirit of this bill seems to be streamlining costs, oversight, trying to offer insurance to those who need it in whatever way possible and trying to weed out overspending and inefficiency. I really really do not see that it is trying to become a true universal government run health care system. It doesn't seem like it would run private insurers out of business, but I am by no means any sort of expert. It seems to be more of an options thing. Despite that, I am still not convinced we can implement the full extent of the bill Obama wants with our current financial situation, and am concerned about the government not paying healthcare providers what they need to operate properly. But as I've said before, I can barely wrap my brain around what this stuff entails, let alone understand the complex economic impacts. One of my other big concerns is what happens when all the people currently not getting medical care flood into our existing hospitals and care centers. Are we equipped to handle the patient load? Believe me, I am definitely one who wants us to improve the amount of care offered to our citizens, but I want it to be done well.
The bill in the link Kristin provided appears to me to be only 167 pages, and I know that I've heard it's longer than that in many arenas, so I don't know if it's complete. If you know of a more complete version, leave a link in the comments!
