The Healthcare Loophole: No discrimination against pre-existing conditions is out the window!

[Better Believe It]

The Ensign Healthcare Loophole
posted by Greg Kaufmann
January 8, 2010

Taken at face value, Senator John Ensign's amendment which was included in the final Senate healthcare bill sounds pretty decent: by meeting "wellness" standards people can receive discounts on their employer-based healthcare premiums. Stop smoking--pay less. Hit a certain weight--pay less. Meet a cholesterol target--you get the idea.

Dems probably should have stopped and realized since the amendment was offered by Ensign it probably wasn't motivated by "wellness" at heart.

In fact, it allows premiums to be raised from current levels, and then "discounts" would reduce the premiums to current rates. People who don't meet the insurance companies' targets could pay up to 30 percent more for coverage, roughly $4000 based on the average cost of family coverage. The amount could increase to 50 percent which is over $6,600 for a family.

There is also the problem that this is biased against people with a genetic predisposition to high blood sugar, hypertension, high cholesterol, being overweight and a host of other often hereditary conditions. It's also biased against a lower-income person working two to three jobs to pay the bills, who has to stop and chow down some fast food between jobs rather than get to the gym where he or she can't afford a membership anyway. It's even biased against communities that don't have grocery stores where they can find fresh fruits and vegetables.

So what does this all mean? Remember a central promise of healthcare reform--even the watered down version--how people with preexisting conditions weren't supposed to be denied coverage or forced to pay more for their insurance? That all sounded pretty good, right? Well, guess again.

"Incentives quickly become penalties for those who cannot meet the target," said Sue Nelson, vice president for federal advocacy at the American Heart Association (AHA). The AHA has led a coalition of more than 200 health and consumer organizations who oppose this Senate provision, including the National Organization for Women, American Cancer Society, the American Diabetes Association, and many mental health groups. "A wellness program could consist solely of a premium surcharge based on a blood cholesterol count over 200. are significant potential unintended consequences such as burdening sicker employees and their families with significant increases in healthcare costs thereby making coverage unaffordable for those who need it the most."

Read the full article at:

http://www.thenation.com/blogs/notion/514042/the_ensign_healthcare_loophole

[pnwmom]

1. Only if people don't speak up. Urge your reps to remove it from the bill!

That's what your headline should have said.

[Better Believe It]

5. We have been. It seems we are being pretty much ignored, but, we should continue our efforts

[MindPilot]

15. Yeah we should call and urge their support

of the Insurance Company Profit Enhancement and Protection Act of 2010. We should thank them for making sure our precious health insurance companies will not have to suffer any loses by having to pay claims.

We should reward their willingness to sacrifice us to the greater corporate good by sending them money and voting for them over and over because they are after all better than the alternative.

[midnight]

44. What you said.....

[Jakes Progress]

42. But, but. We were told to shut up.

Right after we were told that the admin wanted to hear from us, we were told to shut up and stop agitatin'.

[inna]

2. What's the point of including Republican amendments, anyway??

"The spirit of bipartisanship"?? :wtf: None of them are going to vote for this bill, anyway.

[TheKentuckian]

3. They accepted literally HUNDREDS of Republican amendments

and thats aside from the Republicans with a (D) beside their names.

They did it because this is the bill they wanted or have you forgotten the "Gang of Sev...err...six, after Hatch bounced"? Liberals and all but one moderate were excluded because they wanted a corporatist/"centrist" bill not a liberal, moderate, or even a conservative market reform.

[Sebastian Doyle]

4. Can anyone still defend this worthless piece of shit bill?

Seems that the supposed elimination of "pre existing conditions" was the justification most of the apologists were using here to still call this steaming pile of shit "reform".


Now what?

Seriously, can anybody come up with a single logical reason as to why this fucking joke should pass?

[Better Believe It]

6. I can! It will keep insurance company claim adjusters working!

[Sebastian Doyle]

7. Nah, they could always work for the government entity that administered the PO/single payer

The insurance criminal executives would be out of work, of course, but I don't think they're going to be standing in the soup lines any time soon.

[Better Believe It]

10. True, however they wouldn't be able to deny sick people medical treatment!

[Sebastian Doyle]

12. Well, if they really get off on denying requests

they could always transfer over to the budget office and start reviewing "defense" contracts. Plenty of room for denials there.

[Better Believe It]

13. What, and help the terriorists and not support our troops?

Are you some sort of pinko terriorist?

[cutlassmama]

17. I can't! This is the biggest piece of fucking crap I've read this week

I am SO pissed off right now. We disregarded EVERYTHING to get pre-existing conditions put in.

This should NOT pass then.

[stuart68]

39. It's historic !

We're making history ! An historic POS, but history none the less...

[SandWalker1984]

8. The facts are in - we've been screwed --- by Democrats!

The more information that comes out on the Senate bill, the worse it becomes.

The health insurance industry is still exempt from anti-trust legislation.

Loopholes to get around charging more for pre-existing conditions.

NO public plan to provide even a sliver of competition.

No meaningful regulation or cost controls on premiums.


Oh yeah, there are the MANDATES to force every American to buy garbage plans, with high deductibles, with high copays, that probably will do everything in their power to deny claims and pay little if you actually can afford to use the insurance.

But hey, the White House doesn't think we are going to remember in 2010 or 2012 elections what they've done to us.


Want to take that bet to Vegas?

[GreenMetalFlake]

24. 6 of 1, half a dozen of the other

[Odin2005]

9. Kill this fucking bill. Kill it now. This is a disgrace, it really is.

Who do they think we are? Idiots? Chumps?

[Angleae]

21. No, they think we're sheep.

Coming blindly to slaughter. Doing whatever they say. Drooling at their feet.

[Quantess]

11. This bill is such a mess.

Anyone in the private sector would have done the only reasonable thing: they would have thrown it out and started over.

[bluethruandthru]

14. The "Wellness Standards" are crap.

Aside from pre-existing conditions...there should absolutely not be any additional charges or higher rates for people who smoke, are obese, or whatever. If that happens then people who ride motorcycles should pay more, people who ride bikes should pay more, people who ski should pay more, people who put salt on their food should pay more, people who walk their dogs at night should pay more...and on and on and on.

[TwixVoy]

16. Jesus christ on a cross

WTF?

This was one of the few good things.

This is nothing more than a cash BAIL OUT to health insurance corporations.

[Skittles]

18. which is exactly what it was always intended to be

[SammyWinstonJack]

28. +1

CHANGE! :silly: :rofl:

[Kansas Wyatt]

20. It always has been.... Why else would Obama start out with what he hoped to get in the end?

When you start out with what you hope to finally get in the end, it will be compromised and conceded down to NOTHING beneficial for the American People and a lottery jackpot for the Insurance Industry in the end.

Obama KNEW there would have to be compromises and concessions along the way, yet he started out with what he had hoped to get in the end anyway, instead of starting out with the most any American could ever hope for with room to negotiate down.

It is a disgraceful scam being played on the American People by the New DemoRAT Party, which is the DLC. After all, the Democratic Party had a mandate and large majorities in Congress to get REAL Health Care Reform.

I will never accept the bullshit line that 'this is the best we could do,' because it's a LIE.

[laughingliberal]

19. This is not only another huge loophole to allow denials of care or price gouging

it is also a huge hit on privacy rights. This amendment is only possible because of Bush's last minute executive order that allows employers the right to your private health information. This was an executive order I would have expected a Democratic president to have immediately reversed. I called the White House, today, and said so. The gentleman with whom I spoke was very nice and after telling him I had been worried about this amendment for several weeks he asked what I thought of the bill overall. I told him if the bill was not significantly changed from the Senate version, specifically the 'cadillac plan tax' removed, the community ratings model from the House bill adopted, the loopholes for rescissions closed, there was no way I felt the country would be better off than they are now. He then asked if I would prefer no bill to the Senate bill and I responded that, as hard as it was for me to say after 25 years as an RN and 36 years a registered Democrat, I would have to say I would prefer no bill to passing the bill from the Senate as it stands. We talked some more and I explained that I felt the insurance companies are entering a time of eventual demise if we do nothing and that if we do not pass the bill they will have to come back to us, within a very few years, and ask us to reform the system to save them. I was on the phone for about 45 minutes with him and he kept saying. "Wow, you're very well informed." I ended by saying the election of this president who I supported in the caucuses and the general election had been one of the happiest and most hopeful moments of my life since we lost Bobby Kennedy and that this move to the right on the HCR bill had dashed all my hopes for the American people to ever have a responsive and affordable health care system and that I hoped the president would consider putting some of his weight behind the better provisions in the House bill.

[inna]

22. was he going to take that all to the President?

are you even sure he was actually listening to you for the entire 45 minutes?

[laughingliberal]

25. I'm sure he was listening because he was asking follow up questions

which were pertinent to the comments I was making. Of course he said he would let the President know of my comments but what does that really mean? Anyway, it was different than other calls I've made where there was something of air of indifference.

[dreamnightwind]

43. Great work!

I'm impressed. Now that's effective citizen participation. It's a shame we have to spend 8000 or whatever hours of our precious time to understand these complex issues and call BS on our reps when that's what we're paying THEM to do, but that's what it's come to. Anyone capable of doing so and actually going for it has my highest respect.

I make calls now and then, nothing to this extent though, usually just make a couple of points, feel pretty silly thinking that anyone even listens, and go on my way.

If you can really get into the detail level with them like this, one thing it does for sure is it lets them know that there are people out here who are truly paying attention, and it may put that little inkling of accountability in their minds when they're making policy.

[uponit7771]

23. ******OBAMA HAS A 3rd ARM ATTACHED TO HIS LEG!!!****** I'm just as factual as this artcle

...seeing there's no bill that has been passed.

[laughingliberal]

26. Well, of course, there is no bill passed yet but after watching this debate since July

and hearing, at every step, to calm down because there's no final bill and watching one awful proposal after another make it into the bill, that just isn't working anymore. The amendment is in the Senate bill. It was left in there through the writing of the blended bill and the debate following that. The House will, likely, be forced to cave on most of their issues and we are likely to see the Senate bill with one or 2 small changes. Of course, there is a possibility of defeating the bill but if it passes I fully expect this to be left in unless there is a public outcry of some magnitude. Hell, 70% of the public wanted a PO and we can't have it. So, BOHICA.

[Better Believe It]

27. What points do you disagree with in the article? We all know the Senate bill was passed by

the Senate with 60 votes and may be subject to some minor changes during discussions with the House leadership so what's your point?

[Bluenorthwest]

29. Again with the caps as if caps make bad law into good policy

If only, if only.

[mdmc]

34. Perhaps they might sneak single payer in at the last second?

Safe money is on pre-existing conditions being penalized even after this bill is passed.

[donco6]

38. So now we can only comment on bills that have been passed.

What's next? We can't comment until they're SIGNED? IMPLEMENTED? REVISED?

[Paper Roses]

30. This decision will make things even worse. Those if fear of losing

all they have because of a pre-existing condition will not go to the Doctor because they fear the bill.

This healthcare bill is like a recipe. If you keep tinkering with the good parts and changing it around, you run the risk of making such a mess that it should be thrown out. Start over with the good, and don't tinker with it. Maybe then the end result would be worth serving.

[Javaman]

31. Yayyyyy!!!!

Yayyyyy!!!!

Please, sir, pile more shit on my head! Put more lead weights in my already strained backpack!!! Please, make my legs lame, to make it that much more difficult to live!!!!
Please, force me to pay a higher company store tax!!!

Yayyyyy!!!!

Orwell was an optimist.

[xchrom]

32. Recommend

[Rozlee]

33. Why the hell did I go panting so enthusiastically to the polls for early voting

back in Nov. 08? If I'd known then what I know now, I would have stayed in bed.



:banghead:

[shopgreen]

37. you had HOPE

[Faryn Balyncd]

35. Is there anything left in this bill?

k and r

[Xithras]

36. Yes. You're still required to buy it. And if you've got good benefits, to pay taxes on it.

So, yeah, there's still some benefit there. If you're an insurance company stockholder anyway.

[puebloknot]

40. The whole damned idea behind health insurance is *shared risk*!

To *encourage* people to wellness is one thing; to penalize them so much they can't afford health care is draconian, criminal!

[amborin]

41. it was bogus anyway