Notes on HR 3200: A response to Rick Joyner's "Special Bulletin: National Health Scare"

The health care reform debate is a huge topic right now and there is much heated rhetoric flying back and forth. But how do we know who is right? How do we know what to believe?

Dana and I have been interested in health care reform for about 2 years now and support a single payer system. We see fundamental problems with how the profit motive has conflicted with quality health care in the US private insurance market.

In the past few days we have received a link to something that Rick Joyner wrote about the health care bill being currently considered in the House of Representatives. It contains a number of claims that Dana and I find to be suspicious - especially the claim that this bill would encourage euthanasia and set a massive bureaucracy which would decide who lives and who dies (i.e. what care will be given or not). Rick likened this bill to Nazi Germany or Stalinist Russia.
These are big claims and must be examined. At the end of the bulletin is an "outline of this bill [HR 3200] put together by Mat Staver of the Freedom Foundation and Liberty Counsel"

This outline of the bill is what prompted me to actually read the bill. Dana and I support change to the health care system, but we really should be looking at what exactly the bill actually says. The Devil is in the details.

Therefore what follows are links to the house bill, the afore-mentioned Bulletin and a set of notes I will be taking as I read through the bill.

Links:
Special Bulletin: National Health Scare by Rick Joyner
Text of HR 3200 (PDF)

Huffington Post also has HR 3200 available for reading online where one can leave specific questions or comments about lines in the text. The Link is:
http://www.huffingtonpost.com/2009/07/14/health-care-bill-released_n_232206.html

Notes:

• Pages 1-5 outline the purpose of the bill.
• Pages 5-8 lay out the contents of the bill.
• pp.8-14 - definitions.

• p.15 - January 1st 2013 is when government regulations begin for "Qualified Health Benefit Plans" (QHBPs) - all new health insurance plans, public or private, would be regulated for "affordable coverage," "essential benefits," and "consumer protection"

• p.16 - all insurance plans that began before Jan. 1 2013 will be "grandfathered" into the system.
  
• p.17

  • "RESTRICTIONS ON PREMIUM INCREASES.—The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner."
  • In other words, insurance premiums cannot be increased for any individual without also increasing the premiums for all others in the same "risk group"

• p.17 - Grandfathered plans will have 5 years grace period to comply with new regulations.
• p.18 deals with exceptions

"Subtitle B—Standards Guaranteeing Access to Affordable Coverage"

• p.19 - (IMPORTANT!!!) This Law (if passed) will prevent health insurance companies from denying coverage to patients on the basis that they have some preexisting condition or other health problems.
• p.20 - Health insurance companies will not be able to dump coverage of a patient without notice.

  "Rescissions of such coverage shall be prohibited except in cases of fraud as defined..."

• p.21 - sets up regulations on price variations by age, area, and individual vs. family rates so that the prices can't be excessively high for one group.
• p.22 - sets out rules on how the health commissioner will study the effects of this health reform bill and report to congress after a year and a half.
• p.23&24 - This section empowers the health commissioner to lay out rules to prevent discrimination in health benefits.

• p.24 - (IMPORTANT!!!) The Health Comissioner will set a minimum "medical loss ratio" - the percentage of each dollar from insurance premiums that insurers spend on actual health care. If the company spends less on health care than the minimum medical loss ratio then they have to refund their clients.

• For instance, if the comissioner requires 90% of each dollar to be spent on actual medical care (instead of overhead costs or profits) but an insurance company only uses 80% of their income on providing medical care, then they would have to repay their customers the 10% not used on actual health care.

• The commissioner is to set the "highest level medical loss ratio possible ... to ensure adequate participation ... competition in the health insurance market ... and value for consumers so that their premiums are used for services."

Subtitle C—Standards Guaranteeing Access to Essential Benefits

• pp.26-7 - Limits cost-sharing, gets rid of annual or lifetime limits on insurance payments.
• pp.27-8 - Essential Benefits include: hospitalization, outpatient and emergency services, prescription drugs, rehabilitation, mental health & substance abuse services, preventative health, vaccines, maternity care, baby & child care...

• p.29 - (IMPORTANT!) Contrary to the claim made in Rick Joyner's bulletin that page 29 in the health care bill establishes health care rationing, this section of the bill actually caps the amount of pocket money a person must put out for medical treatment and stops the use of "co-insurance" where the insurance company only pays a percentage of a medical bill.
  

• pp.30-7 - Establishes an "advisory committee" of "medical and other experts" (who will not be Federal Employees!) called the "Health Benefits Advisory Committee." They will "recommend covered benefits and essential, enhanced, and premium plans." Members of the board are to be drawn from all parties involved (doctors, consumers, insurance companies, unions, employers, financial experts, etc.) so as to "represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee."
• (IMPORTANT!) Contrary to the portrayal in Rick Joyner's bulletin of a "government committee that decides what treatments/benefits you get," this committee will actually be composed primarily of non-government sector experts who will be establishing minimum standards of care that insurance companies may not go below.
  
• The way the system operates now is that insurance companies regularly deny coverage of, or restrict treatments in order to save as much money as possible (their real goal is the maximization of profits after all). This bill has set up a correction for this problem. Pages 26-8 set out minimum requirements for care and pages 30-5 merely establish a committee which will be responsible for updating and clarifying these minimum standards.
• pp.36-7 - Adoption of Advisory Committee's Recommendations - The Secretary of Health and Human Services will either adopt the standards set by the committee or send back the recommendation for review.
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