Public Option as it currently stands in the bill..

[and-justice-for-all]

http://docs.house.gov/rules/health/111_ahcaa.pdf

Is it 'robust' enough? is Kucinich right, that the bill does not go far enough??

The Public Option begins on page 211.

5 Subtitle B—Public Health

6 Insurance Option

7 SEC. 321. ESTABLISHMENT AND ADMINISTRATION OF A

8 PUBLIC HEALTH INSURANCE OPTION AS AN

9 EXCHANGE-QUALIFIED HEALTH BENEFITS

10 PLAN.

11 (a) ESTABLISHMENT.—For years beginning with Y1,

12 the Secretary of Health and Human Services (in this sub13
title referred to as the ‘‘Secretary’’) shall provide for the

14 offering of an Exchange-participating health benefits plan

15 (in this division referred to as the ‘‘public health insurance

16 option’’) that ensures choice, competition, and stability of

17 affordable, high quality coverage throughout the United

18 States in accordance with this subtitle. In designing the

19 option, the Secretary’s primary responsibility is to create

20 a low-cost plan without compromising quality or access to
21 care.

22 (b) OFFERING AS AN EXCHANGE-PARTICIPATING

23 HEALTH BENEFITS PLAN.—

24 (1) EXCLUSIVE TO THE EXCHANGE.—The pub25
lic health insurance option shall only be made avail26
able through the Health Insurance Exchange.
VerDate Nov 24 2008 12:56 Oct 30, 2009 Jkt 089200 PO 00000 Frm 00211 Fmt 6652 Sfmt 6201 E:\BILLS\H3962.IH H3962 rmajette on DSK29S0YB1PROD with BILLS
212

•HR 3962 IH
1 (2) ENSURING A LEVEL PLAYING FIELD.—Con2
sistent with this subtitle, the public health insurance

3 option shall comply with requirements that are ap4
plicable under this title to an Exchange-participating

5 health benefits plan, including requirements related

6 to benefits, benefit levels, provider networks, notices,

7 consumer protections, and cost-sharing.

8 (3) PROVISION OF BENEFIT LEVELS.—The pub9
lic health insurance option—

10 (A) shall offer basic, enhanced, and pre11
mium plans; and

12 (B) may offer premium-plus plans.

13 (c) ADMINISTRATIVE CONTRACTING.—The Secretary

14 may enter into contracts for the purpose of performing

15 administrative functions (including functions described in

16 subsection (a)(4) of section 1874A of the Social Security

17 Act) with respect to the public health insurance option in

18 the same manner as the Secretary may enter into con19
tracts under subsection (a)(1) of such section. The Sec20
retary has the same authority with respect to the public

21 health insurance option as the Secretary has under sub22
sections (a)(1) and (b) of section 1874A of the Social Se23
curity Act with respect to title XVIII of such Act. Con24
tracts under this subsection shall not involve the transfer

25 of insurance risk to such entity.
VerDate Nov 24 2008 12:56 Oct 30, 2009 Jkt 089200 PO 00000 Frm 00212 Fmt 6652 Sfmt 6201 E:\BILLS\H3962.IH H3962 rmajette on DSK29S0YB1PROD with BILLS
213

•HR 3962 IH
1 (d) OMBUDSMAN.—The Secretary shall establish an

2 office of the ombudsman for the public health insurance

3 option which shall have duties with respect to the public

4 health insurance option similar to the duties of the Medi5
care Beneficiary Ombudsman under section 1808(c)(2) of

6 the Social Security Act.

7 (e) DATA COLLECTION.—The Secretary shall collect

8 such data as may be required to establish premiums and

9 payment rates for the public health insurance option and

10 for other purposes under this subtitle, including to im11
prove quality and to reduce racial, ethnic, and other dis12
parities in health and health care. Nothing in this subtitle

13 may be construed as authorizing the Secretary (or any em14
ployee or contractor) to create or maintain lists of non15
medical personal property.

16 (f) TREATMENT OF PUBLIC HEALTH INSURANCE OP17
TION.—With respect to the public health insurance option,

18 the Secretary shall be treated as a QHBP offering entity

19 offering an Exchange-participating health benefits plan.

20 (g) ACCESS TO FEDERAL COURTS.—The provisions

21 of Medicare (and related provisions of title II of the Social

22 Security Act) relating to access of Medicare beneficiaries

23 to Federal courts for the enforcement of rights under

24 Medicare, including with respect to amounts in con25
troversy, shall apply to the public health insurance option
VerDate Nov 24 2008 12:56 Oct 30, 2009 Jkt 089200 PO 00000 Frm 00213 Fmt 6652 Sfmt 6201 E:\BILLS\H3962.IH H3962 rmajette on DSK29S0YB1PROD with BILLS
214

•HR 3962 IH
1 and individuals enrolled under such option under this title

2 in the same manner as such provisions apply to Medicare

3 and Medicare beneficiaries.

[vaberella]

1. What defines robust at this point?! We need to know what each level plan offers.

I don't see anything in the post that says it's robust and really to say it's not Robust. I like the fact they have different levels and you can go as high as premium-plus levels (hopefully they'll have that---whatever that means).

So far if Kucinich is against this because it's not robust enough. I want to know what would have made it robust enough.

[and-justice-for-all]

5. It is not the entire context...

it is suggesting that you go and read it and then answer the proposed questions.

[vaberella]

6. I'm going through it now. n/t

[Proud Liberal Dem]

12. If memory serves

Didn't the House Bill HAVE a public option but it was trashed by many people here as not "robust" enough or that it would cover too few people? Nothing short of single-payer would seem to satisfy a lot of people here (not that I necessarily disagree with the idea but I just don't think it's reasonable to expect that to happen right now).

[vaberella]

14. You are correct and that is my point.

That was actually pretty robust too. But for many here..not enough. I gave up at that point.

[MarjorieG]

2. Level playing field tied to market rates not Medicare rates not enough savings, but we're not going

to get either. I opt for Medicare to 55, immediately, plays well and solves a lot for permanently underemployed and unemployed class.

[vaberella]

4. Where in the bill does it say it's tied to Medicare rates? n/t

[MarjorieG]

7. Sorry for confusion, but Medicare rates is first stronger option and what others still want.

Either not going to happen, and we need to push for Medicare lowering to 55 for good care and better politics for midterms.

[vaberella]

8. Aye...but what does this have to do with the Public Option?

This is separate from the public option. Unless you're suggesting that the public option be a lowering of medicare to 55?! But that has nothing to do with a public option. It was a suggestion on lowering the age of medicare. I don't know how effective that would be. I remember when I read the other details in the House bill of the PO, I was able to get health insurance right away and since I fell into the conditions. However, I'm not 55, and so well I'm not up for medicare at all. I just see your proposal as a good addition since I supported that measure when proposed but I'm not looking for it to replace the PO.

[MarjorieG]

9. Option tied to Medicare rates-about the option. Though Medicare to 55 better policy now.

[vaberella]

10. But that's what I was asking...where does it say the PO is tied to medicare rates.

I can't find it in the text. If you can point it out, it would be great.

[MarjorieG]

13. It isn't now, and wasn't saying it was still that stronger option. Sorry.

[vaberella]

3. I didn't know that HRC addresses American Indian tribes. Cool.

I don't get why Repubs want to start over, I'm sure they ignored those people.

[depakid]

11. It ain't Australia- where everyone gets a choice and no one goes bankrupt over medical bills

BUT it is a foot in the door toward a more efficient mechanism to compete with insurance companies and will help to deter the annual outrages that Americans would otherwise expect to continue- and over time could and would be expanded into their market share.