Problems in Health Care Bill HR3200-
Although I’ll continue my analysis of the health care bill, for this entry I am restricting my comments to:
Any provisions that would effectively eliminate our freedom to choose health insurance coverage, cost sharing (deductible, co-pays, and co-insurance). President Obama has said and is still saying that “you can keep the coverage that you have.” However, what he is not saying is for how long we can keep it.
Well….. let’s just check that out!
SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
(a) Grandfathered Health Insurance Coverage Defined- Subject …the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 (first year after passage of the law) if the following conditions are met:
(1) LIMITATION ON NEW ENROLLMENT-
(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
My Opinion: This means that the insurance company cannot add new clients to its list of customers. The result of this provision would be that the insurance company would have an increasing group of clients who are aging and whose medical costs increase year by year. With no new client premiums it would crash. Sounds like medicare’s future doesn’t it?
The dirty truth is that an insurance company faced with that future would liquidate while they still have assets to distribute to their stockholders thus forcing all policy holders into the national health plan. So much for keeping what you have!
Competition and choice would be further eliminated because an individual policy holder could not shop around for a better plan in terms of coverage or premium or both! Again, not a good deal.
(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.
My Opinion: This mean that all changes would invalidate the ‘grandfathering’. Not a good deal. For example take a single male who did not buy maternity coverage for obvious reasons then got married and wanted that coverage. Or, take a young family whose budget was stressed and took a low deductible and 100% coverage. Then later in life when they prospered and were healthy wanted to save premium dollars by selecting a higher deductible and 80% coinsurance. That change would invalidate 'grandfathering'.
(3) 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.
My Opinion: This provision was written by someone who thinks all health insurance benefit plans are exactly the same. That isn’t even close to being factual. It would be nearly impossible for an insurance company to comply with this restriction because of the variation of benefits within a specified risk group. Policies do not have the same coverage benefits (some include maternity, dental, vision, and some have special care for heart attack, cancer, …etc).
Finally, what makes our current distribution system great is that a healthy family can shop each and every year for the best rate and coverage selection available to them by multiple insurance companies.
This option is fully available for individual policy holders under the HRA.
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