Thursday, August 06, 2009

Why No Congressman Wants to Talk About HR 3200

I have a headache. This is because I have been reading the full text of HR 3200, with the self-described “simple” title of “America’s Affordable Health Choices Act of 2009”.

Ow.

Remember how some genius created non-alcoholic beer, and in so doing managed to create a beverage with rotten taste, no nutrition, no buzz, and a higher-than-beer price tag, thereby creating something which no sane person would ever wish to purchase, much less imbibe? Well, this bill might be the legislative version of that concoction. It’s frankly very nasty stuff. Want proof? OK, here is the list of definitions of terms from Section 100 of the 1,017-page monster. Read it through and see how well your noggin likes it:

“GENERAL DEFINITIONS.—Except as otherwise provided, in this division:
(1) ACCEPTABLE COVERAGE.—The term ‘‘acceptable coverage’’ has the meaning given such term 5 in section 202(d)(2).
(2) BASIC PLAN.—The term ‘‘basic plan’’ has the meaning given such term in section 203(c).
(3) COMMISSIONER.—The term ‘‘Commissioner’’ means the Health Choices Commissioner established under section 141.
(4) COST-SHARING.—The term ‘‘cost-sharing’’ includes deductibles, coinsurance, copayments, and similar charges but does not include premiums or any network payment differential for covered services or spending for non-covered services.
(5) DEPENDENT.—The term ‘‘dependent’’ has the meaning given such term by the Commissioner and includes a spouse.
(6) EMPLOYMENT-BASED HEALTH PLAN.—The term ‘‘employment-based health plan’’—
(A) means a group health plan (as defined in section 733(a)(1) of the Employee Retirement Income Security Act of 1974); and
(B) includes such a plan that is the following:
(i) FEDERAL, STATE, AND TRIBAL GOVERNMENTAL PLANS.—A governmental plan (as defined in section 3(32) of the Employee Retirement Income Security Act of 1974), including a health benefits plan offered under chapter 89 of title 5, United States Code.
(ii) CHURCH PLANS.—A church plan (as defined in section 3(33) of the Employee Retirement Income Security Act of 1974).
(7) ENHANCED PLAN.—The term ‘‘enhanced plan’’ has the meaning given such term in section 203(c).
(8) ESSENTIAL BENEFITS PACKAGE.—The term ‘‘essential benefits package’’ is defined in section 122(a).
(9) FAMILY.—The term ‘‘family’’ means an individual and includes the individual’s dependents.
(10) FEDERAL POVERTY LEVEL; FPL.—The terms ‘‘Federal poverty level’’ and ‘‘FPL’’ have the meaning given the term ‘‘poverty line’’ in section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision required by such section.
(11) HEALTH BENEFITS PLAN.—The terms ‘‘health benefits plan’’ means health insurance coverage and an employment-based health plan and includes the public health insurance option.
(12) HEALTH INSURANCE COVERAGE; HEALTH INSURANCE ISSUER.—The terms ‘‘health insurance coverage’’ and ‘‘health insurance issuer’’ have the meanings given such terms in section 2791 of the Public Health Service Act.
(13) HEALTH INSURANCE EXCHANGE.—The term ‘‘Health Insurance Exchange’’ means the Health Insurance Exchange established under section 201.
(14) MEDICAID.—The term ‘‘Medicaid’’ means a State plan under title XIX of the Social Security Act (whether or not the plan is operating under a 6 waiver under section 1115 of such Act).
(15) MEDICARE.—The term ‘‘Medicare’’ means the health insurance programs under title XVIII of the Social Security Act.
(16) PLAN SPONSOR.—The term ‘‘plan sponsor’’ has the meaning given such term in section 3(16)(B) of the Employee Retirement Income Security Act of 1974.
(17) PLAN YEAR.—The term ‘‘plan year’’ means—
(A) with respect to an employment-based health plan, a plan year as specified under such plan; or
(B) with respect to a health benefits plan other than an employment-based health plan, a 12-month period as specified by the Commissioner.
(18) PREMIUM PLAN; PREMIUM-PLUS PLAN.— The terms ‘‘premium plan’’ and ‘‘premium-plus plan’’ have the meanings given such terms in section 203(c).
(19) QHBP OFFERING ENTITY.—The terms ‘‘QHBP offering entity’’ means, with respect to a health benefits plan that is—
(A) a group health plan (as defined, subject to subsection (d), in section 733(a)(1) of the Employee Retirement Income Security Act of 1974), the plan sponsor in relation to such group health plan, except that, in the case of a plan maintained jointly by 1 or more employers and 1 or more employee organizations and with respect to which an employer is the primary source of financing, such term means such employer;
(B) health insurance coverage, the health insurance issuer offering the coverage;
(C) the public health insurance option, the Secretary of Health and Human Services;
(D) a non-Federal governmental plan (as defined in section 2791(d) of the Public Health Service Act), the State or political subdivision of a State (or agency or instrumentality of such State or subdivision) which establishes or maintains such plan; or
(E) a Federal governmental plan (as defined in section 2791(d) of the Public Health Service Act), the appropriate Federal official.
(20) QUALIFIED HEALTH BENEFITS PLAN.— The term ‘‘qualified health benefits plan’’ means a health benefits plan that meets the requirements for such a plan under title I and includes the public health insurance option.
(21) PUBLIC HEALTH INSURANCE OPTION.— The term ‘‘public health insurance option’’ means the public health insurance option as provided under subtitle B of title II.
(22) SERVICE AREA; PREMIUM RATING AREA.— The terms ‘‘service area’’ and ‘‘premium rating area’’ mean with respect to health insurance coverage—
(A) offered other than through the Health Insurance Exchange, such an area as established by the QHBP offering entity of such coverage in accordance with applicable State law; and
(B) offered through the Health Insurance Exchange, such an area as established by such entity in accordance with applicable State law and applicable rules of the Commissioner for Exchange-participating health benefits plans.
(23) STATE.—The term ‘‘State’’ means the 50 States and the District of Columbia.
(24) STATE MEDICAID AGENCY.— The term ‘‘State Medicaid agency’’ means, with respect to a Medicaid plan, the single State agency responsible for administering such plan under title XIX of the Social Security Act.
(25) Y1, Y2, ETC.—The terms ‘‘Y1’’ , ‘‘Y2’’, ‘‘Y3’’, ‘‘Y4’’, ‘‘Y5’’, and similar subsequently numbered terms, mean 2013 and subsequent years, respectively."

If that all makes sense to you and your head is not screaming for relief, see your doctor as soon as the government tells you you are allowed to do so.

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