Does the healthcare bill have a mandate?

[Klukie]

If it has a mandate, then I don't see how it can be helpful without a alternative choice. I sure as hell wouldn't want to be forced into a crappy, expensive plan that I couldn't afford with no other alternatives. I have a hard time accepting a mandate without a public option.

[Oregone]

1. Is the sky blue?

[lumberjack_jeff]

2. Of course it does.

"Universal coverage" is the whole point.

[tridim]

3. Type "HCR exchange" into google and get back to us.

Why haven't you read the bill or a summary of the bill yet?

[Klukie]

9. How do the exchanges lower the costs and maintain the benefits?

[tridim]

10. I'm not doing your homework for you.

[Klukie]

12. maybe because you can't

[tridim]

16. This stuff has been covered by myself and many others on DU for months.

Do your fucking homework or don't. Either way it's not my problem, it's yours.

Why are you so proud of your ignorance?

[Raineyb]

14. It doesn't. But they'll lie and say it does. n/t

[grantcart]

31. see reply 21 for the exact reference in the Senate bill

26 million will become eligible for the same plans that Fed employees get, or because of the size of the bill even better.

[bvar22]

19. The much ballyhooed "Exchange".

Have you ever been to a cattle auction?

If there is no Publicly Owned/Government Administered Public Option, there IS no "competition".
The Big 5 Health Insurance Corporations will sit in their air conditioned Corporate Suite above the "exchange pens",
divide up the 45 Million Americans,
and then go on to the shearing.

They already KNOW how to do this.
They will NOT "undercut" each other.
They WILL "make the pie taller" for themselves.
THAT is "The Uniquely American Solution."
:patriot:

They WILL "Divide Up the Herd, and Go about the Shearing."


45 Million MANDATED NEW "customers" who MUST buy their "product".
Champaign Corks will be a-popping in the Boardrooms and Corporate Suites the day this bill passes.

[grantcart]

4. lol this just in during the 1990s there were steroids in baseball

Rather late to start learning the basics.

For the record if you remove the insurance company's ability to discriminate on pre-existing conditions then you have to have mandates to avoid adverse selection.

All single payer systems have mandates.

To learn about adverse selection go here:

http://en.wikipedia.org/wiki/Adverse_selection

[Klukie]

11. no problem with the mandate...

more of a problem with no viable alternatives. Seems like this will box a lot of folks into really crappy expensive plans.

[grantcart]

21. Obviously you don't know the alternatives that are being offered

You probably have heard some politician say, "Why don't we just allow Americans to buy the same plans that Federal employees have?".

That is essentially what the Senate bill does and why every single progressive supports it.

The OPM will dictate price, MLR and even profit margins of these 'crappy plans'. They do a pretty fantastic job with federal employees and I for one will run like hell to sign up for one of these crappy plans.

Unless you have one of the cadillac plans these plans will be better than the one you now have but you weren't really interested in the facts were you, or you would have studied the bill and not simply repeated what you heard.

Here is the part of the bill that gives the federal government expansive powers and provides that everyone have an option at a not for profit plan

http://journals.democraticunderground.com/grantcart/256

q) Part IV of subtitle D of title I of this Act is
19 amended by adding at the end the following:
20 ‘‘SEC. 1334. MULTI-STATE PLANS.
21 ‘‘(a) OVERSIGHT BY THE OFFICE OF PERSONNEL
22 MANAGEMENT.—
23 ‘‘(1) IN GENERAL.— The Director of the Office
24 of Personnel Management (referred to in this section
25 as the ‘Director’) shall enter into contracts with

snip

7 (at) least 2 multi-State qualified health plans through
8 each Exchange in each State. Such plans shall pro
9 vide individual, or in the case of small employers,
10 group coverage.
11 ‘‘(2) TERMS.—Each contract entered into
12 under paragraph (1) shall be for a uniform term of
13 at least 1 year, but may be made automatically re
14 newable from term to term in the absence of notice
15 of termination by either party. In entering into such
16 contracts, the Director shall ensure that health bene
17 fits coverage is provided in accordance with the
18 types of coverage provided for under section
19 2701(a)(1)(A)(i) of the Public Health Service Act.
20 ‘‘(3) NON-PROFIT ENTITIES.—In entering into
21 contracts under paragraph (1), the Director shall
22 ensure that at least one contract is entered into with
23 a non-profit entity.
24 ‘‘(4) ADMINISTRATION.—The Director shall im25
plement this subsection in a manner similar to the
56
BAI09R08 S.L.C.
1 manner in which the Director implements the con
2 tracting provisions with respect to carriers under the
3 Federal employees health benefit program under
4 chapter 89 of title 5, United States Code, including
5 (through negotiating with each multi-state plan)—
6 ‘‘(A) a medical loss ratio;
7 ‘‘(B) a profit margin;
8 ‘‘(C) the premiums to be charged; and
9 ‘‘(D) such other terms and conditions of
10 coverage as are in the interests of enrollees in
11 such plans.
12 ‘‘(5) AUTHORITY TO PROTECT CONSUMERS.—
13 The Director may prohibit the offering of any multi-
14 State health plan that does not meet the terms and
15 conditions defined by the Director with respect to
16 the elements described in subparagraphs (A)



Here is where you can go and see what those 'crappy plans' are like;

Pretend that your a federal employee and put in your zip code, those are typical of the OPM plans

http://www.opm.gov/insure/health/search/plansearch.aspx

I work with thousands of federal employees and they all value their health plan. Lots of federal employees stay working for the government simply because of their health plan, that would include about half of the postal service.

That is why all of the progressive Senators and Congressman are voting for this plan

[Klukie]

22. Who is eligible for these exchanges?

They don't appear to be open to everyone? Are they available to the guy who works at walmart who is eligible for their crappy, expensive plan?

[grantcart]

24. Don't know exactly

CBO is projecting 26 million will sign up for it.

http://cboblog.cbo.gov/?p=446

By 2019, CBO and JCT estimate, the number of nonelderly people who are uninsured would be reduced by about 31 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent. Approximately 26 million people would purchase their own coverage through the new insurance exchanges and there would be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law. Relative to currently projected levels, the number of people purchasing individual coverage outside the exchanges would decline by about 5 million. The number of people obtaining coverage through their employer would be about 4 million lower in 2019 under the legislation, CBO and JCT estimate.

The proposal would call on OPM to contract for two national or multi-state health insurance plans—one of which would have to be nonprofit—that would be offered through the insurance exchanges.



Maybe the guy at Walmart will not be eligible but his unemployed wife will be able to sign up and he can drop the Walmart coverage.

In any case it is 26 million more than can get it now.

Once you creat a constituency of 26 million and they like it others will demand it as well.

This is why the insurance companies are so terrified of this bill. While it will help them in the begining it will create more competition and in the end good non profits will crowd them out and a public option will crowd out not for profit plans. Eventually it will lead to single payer. In the same way that Canada did not institute a national plan overnight but started with a small provincial plan expanded it, made it nationwide, expanded it, and expanded it more. The process there took more than 20 years after the first initial start.

[Klukie]

26. How can the CBO project anything when the terms have not been defined?

[grantcart]

27. See this is why its a waste of time to talk with opponents of health care

First they don't know what is in the plan and just pass on misinformation.

Then when corrected they want to see where in the legislation it really says that tens of millions of people will get a benefit.

Then they want to know if the guy in Walmart is going to get it.

Then when they are shown the CBO statistics that show a lot of people are going to get it but can't discern if Bill down at Walmart gets it they want to do a peer review analysis of CBO's methodology.

They get it directly from the wizards in the Adromeda Galaxy.

Actually CBO's methodology is based on the best peer review statistical modeling that is based on the latest economic research, much of this type of economic modeling has earned numbers Nobel prizes for Economics. I can't tell you how a car works, I just know how to drive it.

I know I know how does the Nobel committee select its prize winners for Economics.

[Klukie]

28. I am definately not an opponent of healthcare reform...

I just worry that the guy on the bottom is going to get screwed somehow. I question everything and I always will and i understand that this is a complicated issue with no easy solutions and if it was up to me I would cap the profits of all insurance companies to remove the temptation of profiting at the expense of someones health but I don't get to make the rules.....I only get to question them. I really do want to know if the guy working at Walmart is going to get it...that is important to me.

[grantcart]

29. But we are in the 9th inning

You want to cap profits of plans in the exchange - the bill does that. OPM controls not only the MLR but the profit level.

[Klukie]

33. I'd like to cap profits across the board...

but that is my own fantasy. I worry that if the bill limits the access to the exchange right out of the gate then many folks will be trapped in bad plans through their employers. I would feel much better about the exchange if they would define the terms.

[HopeHoops]

5. "mandate" - "MAN DATE" - "RED ALERT! 24x7 COVERAGE ON FOX, LIVE FROM ARUBA!"

"Obamacare REQUIRES men to date. This socialist Nazi tax-and-spend big-government takeover will REQUIRE MEN TO DATE! Here's some guy who's and expert on something having to do with man dates."

[Klukie]

7. I don't have a problem with mandates

just a problem with no cost effective alternatives to balance the mandate.

[Individualist]

6. How else would the DLC reward insurance companies?

[kenny blankenship]

8. Democrats have a message for millions of Americans just like you:

SUCK ON IT!

[DrDan]

13. unfortunately you are in the minority

the mandate is perfectly acceptable here. How else can we continue to guarantee those increasing profits. It is all about the corporations and the quarterly statements.

[Echo In Light]

15. The mind fucking boggles

[CreekDog]

25. I was thinking this would be a perfect place to discuss the reasoning behind mandates

but do you really want to reason it out here, or do you just want to yell in every direction and have your way?

[grantcart]

30. mandates are a necessity in any scheme that eliminates pre conditions

that is an economic fact of life that is called adverse selection.

All single payer systems have mandates.

As for me I will be happy to take a plan in the health exchange where the government controls the profit, the MLR and the coverage. Not as good as a public option but a whole lot fucking better than what exists now.

[slipslidingaway]

17. Yes and many will be stuck with their employer's insurance because

they cannot use the exchange and there are no subsidies unless you get your insurance from the exchange.

Your employer has moved to a higher deductible plan - too bad because you are stuck if you want to keep that job.

[grantcart]

32. not true about the only subsidies are in the exchanges

Subsidies go to people based on income period.

For this reason the administration is promoting this as a tax break to some small businesses because the subsidy will actually cover the cost that the company is paying for some lower income employees.

[Hello_Kitty]

34. You get subsidized over 9.8% of your premiums

But you can't get into a plan on the Exchange.

[bvar22]

18. You, and over 65% of the rest of America.

Less than 35% of ALL Americans support Mandates without a Public Option.

Who are the Democrats working for anyway? :shrug:

Good Luck selling this shit in 2010/2012.
I won't be buying.


"There are forces within the Democratic Party who want us to sound like kinder, gentler Republicans."---Paul Wellstone

[Orangepeel]

20. there will be choices. how good they are remains to be seen.

the bill creates an "exchange" that will allow people picking from it to choose from among options, some of which will be nonprofit. That's the way it works for federal employees.

I'd be very happy if buying into Medicare was one those options. It isn't, but I hope it will be in the future.

[Klukie]

23. who will be eligible for the exchanges

If a certain faction of people are ineligible for the exchanges because they can obtain it from their employers, how does that help them?