Coverage Now for Sick Children? Check Fine Print

[MannyGoldstein]

Source: The NY Times

WASHINGTON — Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.

Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”

The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.

To insurance companies, the language of the law is not so clear.

Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.

Read more: http://www.nytimes.com/2010/03/29/health/policy/29health.html?hp

---

The Third Way Express has left the station, and is roarin' down the tracks. And you're tied to the track, chump!

All kinds of fun surprises hidden in the 2,700-page version of RomneyCare.

[katandmoon]

1. As awful as that is, how is it any more awful than forcing ADULTS to wait until 2014?

[scentopine]

35. It is much worse because...

children are in a developmental stage. Illness and disease untreated early in life can lead to much more severe developmental consequences later in life and at that stage the cost for treatment is way way up. The stress of getting good grades in school, a working parent just for afford the $500 it costs for 15 minutes of treatment and a sick child is an almost unbearable burden.

Children are also not articulate about their symptoms and problems. No parent should be forced to live with a chronically ill child in the house and not have access to quality health care. No child should have to live with the thought that their illness is causing hardship and keeping a family in poverty.

And it troubles me deeply that anyone would ask this question even though I am sure it was an innocent question except that ADULTS were in caps as if amplifying the equivalence between an adult and a child. There is a subtle form of cruelty behind this question although I can't quite think of the right word for it - callous or cynical or in the best case naive, maybe.

Unfortunately its how many democrats are thinking these days. We are all the same - children, adults, just meat for the insurance market.

[Raineyb]

85. That's ugly.

I don't care how old you are no one should have to beg borrow and steal to get health care. That you think that adults with preexisting conditions should take short shrift and like it says a hell of a lot about you.

It's fucking callous as hell for all your complaints about the question being callous.

[scentopine]

102. No - I disagree, you are way off

Here is the question: "As awful as that is, how is it any more awful than forcing ADULTS to wait until 2014?"

Here are "all my complaints"

"There is a subtle form of cruelty behind this question although I can't quite think of the right word for it - callous or cynical or in the best case naive, maybe."

And I even admit to having difficulty with the sentiment behind the question. You, on the other hand, show no shortage of confidence in your absolute opinion of me.

Sometimes I miss the point and will apologize if I am not being fair. There was a question asked, I answered it fairly in my reply. No apologies.

Many families make sacrifices for their children and their needs will come first. On the scale of government responsibilities, for example, should we demand that women and infants and children programs treat all adults as well? Should Head Start enlist adults? Should school lunch programs be extended to cover adults who don't have a good lunch? Should an adult use the food stamps for themselves and let the children figure out how to get their own food stamps?

When an adult see a doctor he/she may go themselves (excluding kids that are not in school, etc) When a child sees a doctor extra sacrifices and expenses are involved - a day off of work, etc. There is no equivalence here.

I simply answered the question and do not believe it to be a rhetorical question. And if your complaint is that given the difficult choice of giving children a bigger share of the money pie for health care, and that I am advocating for children - I don't think I would disagree.

Single payer and making for-profit health care illegal is the only ethical solution for health care. However, that doesn't erase the fact that programs the take care of children provide a return on investment that no other social program can match for adults. Getting to quality health care with a child is valuable for both parent and child.

But since the majority of democrats, centrists and other conservatives decided this bill is something to celebrate we will be facing choices like this in the future. Its all about the "free market" and survival of the fittest. As one recent post put it, we are turning feral. This question lends credence to the idea.

I answered the question with introspection and explored the moral and ethical boundaries of the topic.

The question is still disturbing to me on many different levels and can't even imagine someone asking it.

But, no hard feelings and I'll happily accept your apology for jumping the shark.

[Raineyb]

105. Apology? You'll be waiting a long time for one as there won't be one forthcoming.

First off, I am a human being. NOT an investment. And I don't appreciate being told that I am not worth the effort or money it would take to make sure that my preexisting condition doesn't end up killing me. You have a problem with that. Why?

Oh, I see why:

Many families make sacrifices for their children and their needs will come first. On the scale of government responsibilities, for example, should we demand that women and infants and children programs treat all adults as well? Should Head Start enlist adults? Should school lunch programs be extended to cover adults who don't have a good lunch? Should an adult use the food stamps for themselves and let the children figure out how to get their own food stamps?

Nobody is saying that they should cover adults and leave children to fend for themselves. NO ONE has said that. Where you got this from I don't know. Unless your point is to make the opposing argument sound as ridiculous as possible. Well you've done that. Too bad that's not the argument you're opposing.

As to your talk of sacrifice, you talk as if those without children haven't made any sacrifices. Here's the thing, I wouldn't mind having a family but for some reason I insist on being responsible. As I can't afford to have kids I made damn sure I didn't have any. You seem to think that the sacrifice involved in having kids one cannot afford is somehow more worthy of reward than the sacrifice of not bringing children into the world because you cannot afford it. (And yes for this discussion I will consider the benefit to PARENT and child as you pointed out as a reward) So much so that my life and the lives of others like me are considered acceptable sacrifice. Of course you didn't bother to ask me if I was willing to sacrifice myself (I am not by the way) nor did you even think that perhaps the reason why some of us don't have children is because we can't afford them. I didn't ask to be put into this world any more than those children did. And I damn sure have no intention of leaving it any earlier and I don't appreciate people like you telling me that my life isn't worthy enough to save. Because when you boil down all the rhetoric THAT is what you're saying. Is it selfish to expect a health care bill that is supposed to fix the system as it is to cover you despite not being a child as well? I don't think so. But if you do then I'd posit that it's a hell of a lot less selfish than bringing children into the world that you cannot care for and you have seem to have no problem whatsoever with that bit of selfishness. So I'm not even sure what your problem is. Surely your problem cannot be that there are people who object to being told that they must sacrifice as though they'd not sacrificed at all up until now. Do you think that the decision not to have children is made so that people can have more time to hang out online or play video games? (That's not even going into those who don't have children because they are simply unable to. Not that it matters in the long run since you don't consider them worthy of "investment" either apparently.)

As to this extra sacrifice involved in taking a child to the doctor, that is complete bunk. The adult taking themselves to the doctor is losing a day of work just as surely as the parent is. The difference is that the employer is more likely to be sympathetic to the parent than they are to the single person since apparently in the workplace the single person is not expected to have a personal life worthy of not spending extra time on the job. But that's not really the point here so I won't go on.

My problem with your original answer is the same as it is now. You complain about a bit of callousness while not at all acknowledging the callousness of your position. Do you really consider it less cruel to tell an adult that they will have to go without health care because they're not under 18 anymore? I find the way people have been discussing adults with preexisting conditions to be completely callous which is utterly ironic when those same people complain about the callousness of people saying "I have a preexisting condition and I need coverage. Why am I being forced to wait four years?" People with preexisting conditions are the most vulnerable people under discussion since we are currently discussing the health insurance companies. The refusal to acknowledge that and then act as though the people who are being left to the mercy of the insurance companies are the ones being callous is something I find utterly gross in this discussion. And then to add insult to injury the answer to people who say "I need a plan that can keep my condition under control and this bill doesn't do that" is to say "suck it up." Well, I can't get on board with that. Your answer was slightly less blunt than that but it is still the same answer. And it's not one that's acceptable.

[scentopine]

103. One other point I should make although

my spidey sense tells me I will regret it.

My children are all adopted. I took full advantage of tax deductions for the expenses involved. I make no apologies for taking advantage of something that isn't available to what the community calls birth parents (aka ADULTS). I also have a family member has a chronic medical condition and it looks like the new health plan does nothing to help us with the 15 to 20k a year expense for medication that has been around for over 20 years and easily mass produced at this time. My spouse has extensive background working with head start and other early childhood programs. I generally know the infrastructure domain from the point of view of children, poverty, and physical and intellectual development. I took all of these things into account when I relied.

Also - anyone who posts a one liner question like that is of course, looking for trouble. By not providing context or any point of view, all interpretations are possible. It isn't enough to be a democrat any more, today's typical democratic politician is frighteningly similar to an early Reagan neo-con. I've watch people with chronic health issues being called whiners and cry babies (on this board).

I have now answered the original question and your reply with more than adequate dignity and fairness.

[katandmoon]

104. So, if your insurer denied you coverage for a life-saving operation because you had a preexisting

condition, you would not worry about who would take care of your kids?

That's a rhetorical question by the way.

[kestrel91316]

2. Notice how the INSURANCE COMPANIES are in the position of looking like

complete assholes. This will continue daily until people wise up and demand single payer. Obama and the Dems have set it up so the insurance cos will bring about their own downfall.

[pocoloco]

8. Or vise versa?

[golddigger]

70. +1?

[depakid]

9. Unfortunately, what the Dems have now done is associate themselves with this behavior

and I agree- the abuses and the double digit premium increases will continue.

[AlbertCat]

50. Dems have now done is associate themselves with this behavior

In a way....

But now all that "bipartisanship" and gang-of-sixes and on air conferences makes it look like BOTH parties are associated.... and things can be called "conservative" and, perhaps, revised and stripped.

Of course, the Dems look like a bunch of people with varying and different ideas.... but the Repugs look like a single mass (with no ideas). So SOME Dems can be associated with it. The GOP just looks like no help at all.

But I agree with the sentiment that now single payer is something that can be compared with the current system en mass....a lot more people will be paying attention.

[Edweird]

13. LOL

[dflprincess]

14. Oh please, if the Democrats were interested in the insurance companies' downfall

they would not have dug the crooks in deeper by handing them millions of new victims to fleece and found a way to transfer billions in tax dollars to them.

[emilyg]

15. Yes.

[Nikki Stone1]

42. +10,000

And Amen.

[freddie mertz]

78. + 100000 or so.

Some people will try to defend any stupid thing as "intentional."

[waiting for hope]

45. Are you for real?

Guess the last year and a half working for REFORM wasn't really needed, since according to you, they are just now showing their asses.

[pattmarty]

48. You're not really serious?

[Nite Owl]

49. Insurance companies don't give a damn

what kind of assholes that they look like it's about the bottom line. Their business is to make money not provide service that would cost them money. The WH and Congress are merely enablers of this behavior.

[jeff47]

67. That's kinda the point

When their reputation is that of your friendly neighbors who are helping you out when you get sick, they are unassailable.

The more of this sleaze that comes out, the easier it is to eliminate them.

[No Elephants]

75. Meh. Plenty of sleaze was out already. And more could have been brought out.

[Arkansas Granny]

107. The insurance companies have looked like complete assholes for years,

but I haven't seen that it has had any appreciable effect on them or how they do business.

[boppers]

3. Insurance companies will continue to act like, well, insurance companies.

They're just making the public option more desirable, and in effect, creating a "trigger" where none existed.

[grahamhgreen]

23. So let's keep the heat on for real reform, Thanks!

[Zhade]

4. Wish I couldn't say "told you so". I'd have rather been wrong about the HIR bill.

Sadly, once again, I wasn't.

[awoke_in_2003]

11. The Dutch...

were forced to buy insurance, but the government tightly regulates said insurance companies, and the primary motive is not profit. This reform was set up wrong from the get go.

[No Elephants]

73. When the first step in the process is health insurers, PHRMA and Big Health Care meeting with the WH

[amborin]

100. it's downhill from there

[grahamhgreen]

24. And this is before they've been gifted trillions in mandated funds....

[grahamhgreen]

25. And this is before they've been gifted trillions in mandated funds....

[Jumping John]

5. The insurance industry did write the law after all. n/t

[Edweird]

6. This is only the beginning. November is a long way off.

[HughMoran]

20. Hate

Inc.

[Edweird]

27. Reality

Inc.

Far right policy is still far right policy even if it's passed by a Dem. The sooner you come to grips with that, the easier the political fallout of this will be for you to understand.

[HughMoran]

34. Despicable

rotten hate.

[Edweird]

80. I do hate far right policy. No argument there. You should educate yourself about the history of the

'mandate' and 'subsidy' before making accusations.

[laughingliberal]

99. Yes, I HATE this loophole riddled sham of a bill and before it's over everyone will hate it

This loophole is coming to light now cause it's a part of the bill slated to take effect relatively soon. All the other lovely turd bombs are yet to be revealed as each phase of the law takes effect.

I have plenty of threads bookmarked where some of us warned about the loopholes that the talking points didn't point out. And they're all right there showing those who denied the truth of it. The insurance company wrote the bill. And for every 'good' regulation we were told was in it, there is a loophole allowing them to weasel out of it.

[unkachuck]

7. "...they must cover pre-existing conditions."

"But, they say, the law does not require them to write insurance for the child..."

....if I'm understanding this correctly, does that mean that our fascist health insurance companies will likewise interpet HCRs temporary coverage for those uninsurable with pre-existing conditions, to take effect in 90 days, in the same way?

....we'll cover your pre-existing condition, but we won't cover you....

....what a fine bill this is....

[virgogal]

10. Madness,absolute madness.

[Iowa]

12. This is probably just the tip of the iceberg...

What other fine-print weasel-words has this health insurance bill been loaded with?

[grahamhgreen]

26. The rescission clause is ineffective, as well.

[Crowman1979]

16. This is why we needed a public option!

Because no matter how many regulations we place on the private insurance industry, they're always going to find a loophole or some other way to avoid compliance.

[progressoid]

17. But we WON!

Didn't ya know that? It was all over the news.

[Name removed]

18. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Name removed]

19. Deleted message

Message removed by moderator. Click here to review the message board rules.

[MannyGoldstein]

28. No, It All Works As Intended

That's the problem.

[HughMoran]

36. In your world

I'd die first.

[Edweird]

83. What you're not 'getting', HughMoran, is that despite the hate filled rhetoric of the 'centrists'

and DLC'ers, those of us on the Left that opposed the Senate bill did so because we saw what a RW POS it was. It was not because we wanted to deny people care, it was because WE KNEW THIS WAS COMING. In other words, HughMoran, we were trying to look out for you. For that, we were called 'freepers', 'haters', 'teabaggers' and all kinds of names.
What you are seeing, HughMoran, are the fruits of the bill YOU supported. Enjoy it. Relish it. Celebrate it. You won. This is YOUR WORLD, HughMoran. The weaseling the insurance companies are doing is exactly what you wanted, as indicated by your support for the bill. So if you "die first", HughMoran, at least it will be with the knowledge that you 'won'.

I wanted single payer, but would have settled for a strong public option.
The passage of the Senate bill pretty much makes that impossible in my lifetime.

[laughingliberal]

91. Amen!

They need to really enjoy their 'first step.'

[seafan]

21. FDL, March 25: Insurers Immediately Try to Game Health Care Regulations

Just two days after this health insurance reform bill was signed. It was only a matter of time.


David Dayen at Firedoglake writes:



Thursday March 25, 2010 12:17 pm

This is almost funny, if it weren’t so potentially tragic:

The DeSoto, Texas, mom had hoped the new health overhaul law that President Barack Obama signed Tuesday would immediately stop insurers from denying coverage to children with pre-existing medical conditions. Several speeches by Obama and explanations of the bill issued by congressional Democrats left the impression the law would do just that.

But health advocates and some insurers say the law does not clearly state that such protection starts this year. If it doesn’t, uninsured children with pre-existing conditions might not get help until 2014, when the law requires insurers to issue policies for all applicants regardless of health condition. There is no doubt that for children who are enrolled in insurance plans, the new law bars insurers from excluding coverage of any pre-existing conditions.

Responding to the concerns, Obama administration officials said Wednesday the law does prohibit insurers from denying children coverage starting this year, but they will issue clarifying regulations. “The law is clear: Insurance plans that cover children cannot deny coverage to a child because he or she has a pre-existing condition,” Health and Human Services spokesman Nick Papas said. “To ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term “pre-existing exclusion” applies to both a child’s access to a plan and to his or her benefits once he or she is in the plan.”

What’s going on here is that some insurance company – or the trade group, AHIP – read the language in the bill and interpreted it favorably to their industry. They’re trying to wiggle off the hook of offering coverage for children with pre-existing conditions TWO DAYS after signage of the law.

There’s another part to this:

One thing is clear: The law does nothing to stop insurers from charging higher rates for children with pre-existing illnesses until 2014 when insurers can no longer use health status in setting premiums.

They mandated guaranteed issue for children immediately without mandating community rating. So as a result, families with a child with bad medical histories will get charged an astronomical amount for coverage.

If you don’t think this will happen for virtually every insurance regulation in the bill, you’re crazy. And on some of these less high-profile than the children’s exclusion, insurers will win.

The challenges facing the Affordable Care Act have really only just begun.

Glad to see the NY Times is now reporting on this. Thanks to MannyGoldstein for posting it.



Coverage Now for Sick Children? Check Fine Print


By ROBERT PEAR
March 28, 2010

WASHINGTON — Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.

.....

To insurance companies, the language of the law is not so clear.

Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.

William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”

Congressional Democrats were furious when they learned that some insurers disagreed with their interpretation of the law.

.....

Consumer advocates worry that instead of refusing to cover treatment for a specific pre-existing condition, an insurer might simply deny coverage for the child or the family.

“If you have a sick kid, the individual insurance market will continue to be a scary place,” said Karen L. Pollitz, a research professor at the Health Policy Institute at Georgetown University.

Experts at the National Association of Insurance Commissioners share that concern.

“I would like to see the kids covered,” said Sandy Praeger, the insurance commissioner of Kansas. “But without guaranteed issue of insurance, I am not sure companies will be required to take children under 19.”

A White House spokesman said the administration planned to issue regulations setting forth its view that “the term ‘pre-existing’ applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.” But lawyers said the rules could be challenged in court if they went beyond the law or were inconsistent with it.

.....

Get ready for the barrage of bad news about this insurance reform bill.



And kudos to Firedoglake for being among the first to search out and report the truth about it.

[grahamhgreen]

22. This is the fate of all the reforms unless we KILL THE MANDATE, and put big insurance on the ropes.

[jeff47]

30. The mandate is necessary

The mandate is required for health insurance to function at all. We need some way to have healthy people buy insurance.

With the (eventual) demise of pre-existing conditions, there would be nothing preventing healthy people from waiting to buy their insurance until they arrived at the Emergency Room/Were diagnosed with cancer/etc.

No healthy people in the pool, no cost sharing. No cost sharing, and the sick have to shoulder the entire burden themselves.

Now, we could change the form of the mandate. The ideal would be a mandate through taxes and have those taxes go to single payer. The other ways to do it is either a public option or heavy regulation.

But even with single-payer, the PO or regulation, there has to be a mandate.

[Hoyt]

39. +1

Agree with that.

I also think Obama's admin better set the insurance companies straight on this interpretation, or come up with with something that makes them reconsider their position. I don't think that is what anyone voted for, sounds like a pretty narrow reading of the law by the insurance company folks.

[RBitt]

61. The mandate?

Only if you think that health insurance is insurance in the first place, which it is not. Insurance is protection against unforeseen risk. In health insurance, it is a payment scheme, nothing more. We will all die, and doing so is expensive. So we will all use way more than we put in, but guess what? The insurance companies, after taking a life time of payments from you gets to shove you off on the federal government just at the time you start to really get expensive.
They provide nothing of value but they skim up 35% off the top, that's how it works. Duh. This reform is a joke, get used to it.

[jeff47]

66. You're welcome to explain how it would work without a mandate

And remember, taxes are just another form of the mandate.

[laughingliberal]

101. The only way the mandate does not result in more oppression of people by the industry

is if we pass a strong public option open to anyone who wants to choose it. That way, the insurers do have to provide reasonable premiums and follow through with coverage for people who buy the policies. The threat of a public who could vote with their feet and deny them their coveted profits was always the only hope we had of having this type of system turn out fair for people.

Yes, every system needs everyone in the pool. But the system needed a check on the industry and it didn't get one. All we've done now is create a country full of slaves to AHIP profits.

Dean told us we could not give the insurance companies a seat at the table because they would eat all the food. And that's what happened.

[jeff47]

29. Good

The more screwing over done by the insurance companies, the easier it is to get single-payer.

Yes, it sucks for those who are getting screwed. But if the D's have to be dragged kicking and screaming into doing what's right, there's gonna be a lot of folks screwed until we finish the job.

[dflprincess]

31. The insurance companies have done nothing but screw us over for years

so I doubt that their continuing to do so is going to get us single payer - not as long as they're writing big checks to "our" representatives.

[jeff47]

32. You're forgetting where we've come from

Yes, the screwing has happened for a long time, but it was a relatively low-level screwing. Insurance companies created a 'good enough' system such that health insurance reform was "off the table" from 1994 until about 2006.

Then they got greedy and amped up the screwing. That brought us the HIR bill. And when that fails to fix the problem, options that are currently "extreme" become wise.

[dflprincess]

41. No - the screwing started way before 1994 and it was not low level

but about the only person talking about it was Ted Kennedy. He wrote about it in his book "In Critical Condition" which came out sometime in the '70s.

They've always been greedy but managed to stay under the radar because the media never covered the problems they were causing and we, the screwees, didn't have a good way to get together and discuss it. As with many issues, the net roots has been what is getting things into the open and talked about.

[jeff47]

51. You're agreeing with me.

Whether we call it "low level" or "under the radar" is just semantics.

You'll also note I didn't claim the screwing started in 1994. I said they managed to keep their greed from drawing enough political attention from 1994 through about 2006.

[unapatriciated]

106. Insurance companies created a 'good enough' system such that health insurance reform was "off the ta

Sorry they were screwing people big time in California from 1990 and are still doing it.
They were just as greedy then as they are now. California was one of the first states to put forth regulations on pre-existing conditions and denials and reviews (Fair Claims Practice Act and a 90 waiting period on pre-existing conditions).
The Insurance Industry has kept California tired up in court regarding the loopholes (they helped write) in these regulations.
We should have learned from those mistakes and not repeated them in this bill.
But once again we were ignored and the Insurance Industry helped to write this bill loopholes and all.
You can have all the regulations you want but without any meaningful penalties they are worthless.

The screwing my son and family endured (1990-2005) were not what I would call "relatively low-level screwing", it cost us our home and unnecessarily crippled my son.

Sicko exposed their 'good enough' system and "relatively low-level screwing" in 2007 yet we once again gave them a seat at the table and ignored the wishes of the majority.
http://www.youtube.com/watch?v=xlDAUKSh9CQ

[madamesilverspurs]

33. Such lovely people, those insurers!

-

[Jefferson23]

37. If the insurance companies deny the meaning of the bill, as they appear

to here, then I say, let them use this rope and hang themselves for good with it.

If no single payer, then PUBLIC OPTION.

[laughingliberal]

98. They aren't denying the meaning of the bill. It's very clear

If they write any policies for families with children who have preexisting conditions they must cover the preexisting conditions. There is nothing in the law which requires them to write such a policy for any family who has been without coverage for more than 60 days. Quite clear. Guaranteed issue begins in 2014. And they aren't going to write a single policy that does not benefit them if they don't have to until 2014.

[MadMaddie]

38. Well let the insurance companies continue with this behavior

and there will be no choice but to implement single payer or public option. Let's also move to make health care a non-profit business that will end the bullshit for once and for all.



Idiots!

[garthranzz]

40. Talking Points will win Public Opinion battle, which will determine

if they get away with it.

1. Republicans: This proves the bill is too big, a fraud, an imposition, etc. We should repeal the bill that gives children health insurance because the insurance industry won't cover them anyway. Oh, wait, w'ere funded by the insurance industry. So we didn't want to give children health insurance in the first place. Never mind.

2. Insurance. We're not evil. We just want your money and control of your life. At least we're not doing the railroad track thing. Bwhahaha

3. Democrats. We will enforce the intent as well as the letter of the law. Or we won't. (Depends on how strong you think Obama is, I guess.)

[GameChanger]

43. A fake fight over fake health care reform

That's the title of an article I read yesterday. This thread seems like a good place to post the link.

It's worth going there just to see the cartoon drawing that explains how the so called health care reform was actually done. One picture IS worth a 1000 words in this case.

Bruce A. Dixon wrote the article. Here's some of the more important ideas he shared:

The fifteen month running battle between Obama Democrats and tea party Republicans was never much more real than televised professional wrestling. Like the opposing wrestlers, both sides work for the same bosses, for Big Pharma, Big Insurance, and the biggest medical providers. The real health care fight waged by the Obama administration has not been against Republicans, who never had the votes to stop, let alone dictate or pass anything.

The administration's effort all along has been to pass the worst bill possible, with the greatest amounts of corporate welfare and loopholes, and the fewest protections for patients, while silencing, neutering and coercing the voices of most Democrats, who have favored some form of single payer, or Medicare For All from the beginning.

The Fake Reform

On the whole, the Obama health care legislation is just plain bad. It's fake reform. Most of the people getting medical coverage for the first time under its provisions will get through an expansion of Medicaid. The Medicaid expansion and inclusion of children in their parents' policies till the age of 24 are perhaps the only unambiguously positive aspects of the bill, and both these could have been passed through the House and Senate at any time since the end of 2006.

Supposedly, insurers can't refuse to insure anybody, or jack prices on the basis of pre-existing conditions, and can't revoke policies when people get sick enough to actually use them. But so many loopholes and end runs have been written into the legislation that these and other widely ballyhooed provisions to safeguard the interests of patients are in fact meaningless. The ban on pre-existing conditions for example is negated by allowing insurers to offer “wellness” discounts. The older, the fatter, the less physically fit and the already sick need not apply for these discounts, and the fit will lose them when they gain a few pounds.


Here's the link: http://blackagendareport.com/?q=content/obama-democrats-vs-tea-party-republicans-fake-fight-over-fake-reform


Fake health care reform. He nailed it.

[MannyGoldstein]

44. +1 nt

[Nite Owl]

53. Good article

Says what many of us have been saying all along.

[bluestateguy]

46. HHS can write regulations to to clarify the law to the Administration's wishes

Sadly, this type of gaming the system was to be expected by maintaining the existence of private insurance. But people keep saying that they don't want single payer.

[laughingliberal]

87. It's not going to work. The bill will have to be amended

The insurance companies will argue, and win, that the administration can not write regulations which go beyond the intent of the bill. Even if this would work, which it won't, the insurance companies will tie it up in court until the 2014 part of the law which includes guaranteed issue goes into effect. If Congress does not amend the bill, not one child with a preexisting condition who has been without insurance for over 60 days will get coverage.

[pattmarty]

47. Is it too early to say "I told ya so"? What did anyone expect?........

..........The bill is still warm from being signed and they (the fucking insurance companies) are already looking for the "wiggle room". At the VERY least it should have had a PO. What should have been done is "Medicare for all" and we wouldn't be having this discussion.

[jeff47]

52. What made you think this bill was the end?

This bill was a good step forward.

But one doesn't complete a marathon in a single step.

[pattmarty]

55. "Trust me", it's the end for at least another ten years and I am too...........

........tired from all the back and forth of the last 15 months to tell you why if you don't know already.

[jeff47]

63. The fact that you've given up doesn't stop the rest of us from pushing forward

Take a break. We'll be here when you're ready to fight again and you can take over for someone else who's fatigued.

[pattmarty]

72. I think you are hopelessly naive.

[laughingliberal]

88. Oh, it's not nearly the end. The business interests already have their attorneys in place to gut the

parts they don't like. I fully expect changes to the bill. I just don't expect the changes to be in our favor.

[usregimechange]

54. On to court

[laughingliberal]

89. where the insurance companies will win. It is clear there is no guaranteed issue in this bill until

2014. Children whose parents manage to obtain insurance through their jobs will get coverage for their preexisting conditions but those in the individual market? More screwed than they were before. Prior to this law passing, some insurance companies might have issued a family policy which would have excluded coverage for the preexisting condition. Now? They'll just refuse to issue any policy.

[Kweli4Real]

56. Wouldn't it be Great ...

If the plan the whole timewas for the insurance companies to pull the loop hole shit so that PRESIDENT OBAMA, the Demsin congress and the electorate, in general, would say "F it We have the fix forall this BS. Next stop, Medicare for ALL."

[alp227]

57. F the insurance industry! Let the Supreme Court clarify this for them!

The industry once again shows it cares more about profit than anything even if it means letting a sick child die.

[laughingliberal]

97. Sure. It should work its way through the courts by the time guaranteed issue is the law for everyone

in 2014.

They have no problem letting sick children or anyone else die. I think some of us pointed out we wanted the loopholes closed before passing the bill.

[CreekDog]

58. Okay, if they want to play it that way, let it be known to them that the law doesn't stop me from

pushing for the outright elimination of for profit insurance companies, period.

if they want to play hardball with little kids and say the law allows it,

well then i can play hardball too because the law doesn't stop me from hating insurance companies and trying to make it so that this form of making money is gone forever.

[The_Casual_Observer]

59. Does this article actually describe who is arguing this & if it has any merit?

[jeff47]

64. Doesn't really matter

They can interpret the law however they want to. The HHS regulations are what they'll be held to.

Unless they want to pay for a lengthy court battle where they have to keep fighting for profits by "killing children".

Nothing would get us single payer faster, and unfortunately they aren't that stupid.

[Tx4obama]

60. This is going to be great!

The insurance companies will be saying in public "we refuse to write policies for kids"
The American public will see them for what they really are - money grubbing bastards.
Congressman Grayson and/or Sanders will push their 'Medicare for All' bills ....
Weiner will be pushing Public Option...
Soon we will have Health Care for ALL Americans - due to the greed of the insurance companies! ;)

[No Elephants]

76. No matter how many more kids have to die first?

[Name removed]

62. Deleted message

Message removed by moderator. Click here to review the message board rules.

[girl gone mad]

69. I think we had our own Office of Special Plans.

..catapult the propaganda.


:(

[truthisfreedom]

65. Time for some law-fixin'.

Now.

[superconnected]

68. We knew the insurance companies were going to pull this crap, but more importantly we knew that

it's all leading to having to regulate them. Really regulate them. Eventually they'll see well needed price caps and finally profit margin caps and eventually they'll see that they have to play the gov's way or no longer exist. But for now, the monster is too stupid to realize it's making itself a giant target for public opinion to really be against it, and support the caps and laws, when the real regulation comes. The real regulation will come. The bill Obama signed was more regulation than they've seen in 40 years, and it is only the start.

[laughingliberal]

94. The people who wrote the bill got all the regulations they wanted and made sure there was a loophole

for every one of them. It's been my argument all along and we will see more as each phase of the bill is enacted.

Some here seem to think all the loopholes are an oversight or an accident. Lol.

[OmmmSweetOmmm]

71. THANK GOD IT PASSED!!!!!!

:sarcasm:

[Lyric]

74. I recall someone here predicting this evasion technique.

Can't remember who, but... :(

[No Elephants]

77. Put an amendment on the table. See if the Rethugs have the wherewithal to vote againstt it.

[laughingliberal]

92. Yes, all we need is a Democrat with the wherewithal to offer one and 60 votes to get it through the

Senate. Easy.

Lol. Like Bayh, Baucus, Nelson, Lieberman and the rest of the insurance company fellators were not aware of this from jump street.

[amborin]

79. K&R

[ProSense]

81. Insurance companies are banned from denying coverage for children

No matter how much the insurance companies try to get around it.

MR. GIBBS: No, the law is clear, Ed, that insurance companies cannot deny coverage to a child based on a preexisting condition. Under the act, the plan includes -- plans that include coverage for children cannot deny coverage based on a preexisting condition. To ensure that there is no ambiguity on this, the Secretary of Health and Human Services, Kathleen Sebelius, is preparing to issue regulations next month making sure that the term “preexisting” applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.

link

[Edweird]

84. They wrote the law and that means they know it better than you.You only supported it for them.

[laughingliberal]

93. No, they are not

They can not refuse to cover children's preexisting conditions for whom they issue policies but NOTHING in this law forces them to issue policies. There is no guaranteed issue for anyone in this bill until 2014. Period.

They have to amend the bill or this will stand. The insurance companies will argue, and win, that the administration can not issue regulations which go beyond the intent of the law. Even if there was any chance they'd lose this fight in court (and there is not a chance of that) it will be in the courts for several years anyway. How do you add guaranteed issue to this bill when it's not there?

[eridani]

82. Yes, let's give the insurance parasites a trillion in public funds so that they can

--be much more effective in mounting legal challenges to such piddling regulations as managed to get passed at all.

[Raineyb]

86. I guess they'll have to wait four years like the rest of us. But this bill is a first step

so it's not really much of a sacrifice. After all, they'll get the coverage they need. Eventually.

[laughingliberal]

90. Heh! Wait til we see all that other 'change' we were told about in the bill and the loopholes it's

all shot through with. We're just hearing about this one because it's due to take effect soon. The rest we'll find out about as the law is phased in.

And, at each stage, we'll hear it's a first step, not much of a sacrifice.....

[Raineyb]

95. Indeed. Funny thing is I remember people mentioning past history of insurance

companies, and loopholes and the response was for people to STFU lest they end up allied with tea baggers. And as soon as the ink is dry on the law the insurance companies find a loophole you can drive a truck through. But we were supposed to cheer rather than insist that they FIX the bill. Not it's law and the Democrats have bet their futures on it. They 'd better hope they can fix it otherwise when people are screwed they will blame the Democratic party.

Of course the loyalists will blame progressives as they always do because apparently they are impervious to reality but I can't really do anything about that.

[laughingliberal]

96. Right on target. We were the teabaggers and haters for pointing out the loopholes in the bill

and trying to get people to see this is was not all that and a box of chocolates. This bill was never really going to affect me one way or the other. I don't have insurance without it and I likely will not have insurance with it.

Hope they enjoy their 'win.' They can try to blame whoever they like. I have dozens of threads bookmarked for the day when all the loopholes people told me I was wrong about are brought out into the light as more of the law is phased in. Will not change the nature of the bill one bit and they can answer to all those who thought they'd be helped but won't be.

[tedk_355]

108. single-payer can't come soon enough..