KEY PROVISIONS THAT TAKE EFFECT IMMEDIATELY...RECONCILIATION BILL

[ProSense]

KEY PROVISIONS THAT TAKE EFFECT IMMEDIATELY

UNDER SENATE BILL AS AMENDED BY RECONCILIATION BILL

Below are some of the key provisions that will take effect immediately, under the legislative package the House will consider later this week (the Senate health bill as amended by the reconciliation bill). The reconciliation bill is based largely on the improvements put forward by the President’s proposal – moving towards the House bill in certain critical areas.

1. SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
   
2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
   
3. FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
   
4. HELP FOR EARLY RETIREES—Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55‐64. Effective 90 days after enactment
   
5. ENDS RESCISSIONS—Bans insurance companies from dropping people from coverage when they get sick. Effective 6 months after enactment.
   
6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS—Prohibits health insurers from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
   
7. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health insurance companies from placing lifetime caps on coverage. Effective 6 months after enactment.
   
8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
   
9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS—Requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)
   
10. NEW, INDEPENDENT APPEALS PROCESS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.
    
11. ENSURING VALUE FOR PREMIUM PAYMENTS—Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
    
12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment.
    
13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.
    
14. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.
    
15. INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.
    
16. PROHIBITING DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.
    
17. HEALTH INSURANCE CONSUMER INFORMATION—Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.
    
18. CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM—Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

[havocmom]

1. any chance it comes with VOLUME CONTROL

[BadgerKid]

8. FWIW, it was rather helpful for skimming purposes. n/t

[havocmom]

13. didn't say it wasn't

It's the self important CAPS shouting that is rude and unnecessary.

[nickinSTL]

36. yeah, but if you look at the link -

the OP wasn't responsible for the all caps, the Energy and Commerce Committee of the US House was - they put together the document. (or posted it, at least, can't be sure they put it together, I suppose)

[Frances]

2. Sounds very good to me

One of my grandsons was born with a heart condition. I'm glad insurance companies can't refuse him insurance because of a pre-existing condition.

[girl gone mad]

3. What's with all the..

Big Fonts and BOLD ALL CAPS today?

Is it crazy font day on DU??

[Cha]

5. There's always something for you to complain about.

[SnoopDog]

4. Don't really see anything beneficial for the majority of us....

If a bill doesn't immediately help a majority of us... it seems to be a pile of horse crap of a bill....

[ChimpersMcSmirkers]

7. Ya know sometimes it's isn't about you. This bill probably won't help me.

It will help my fully employed brother who hasn't been able to afford insurance, but will finally be able to.

[mindwalker_i]

10. Yeah, if you just want something for you...

That's what the republican party is all about. This bill probably won't directly help me, but it will help a lot of other people, who then won't die, might be able to work more, etc. and other things that indirectly help me. And us.

[eridani]

23. And he won't be able to afford to use it for actual care unless he is pretty affluent n/t

[MellowDem]

11. You have to be kidding...

Noone can be denied for pre-existing conditions or get dropped for being sick. Those are two huge things that helps everyone right there.

[pattmarty]

29. I think he/she was talking about deductibles and copays.

[Hekate]

15. I hope it will help my fully-employed 30-something kids with their "pre-existing conditions"...

My son has insurance through his employer now, but if he loses his job for any reason he will be up a creek without a paddle. Last year he developed a seizure disorder, and meds don't 100% control it, so his neurologist is talking surgery. On his brain.

My daughter has no insurance at all that I know of, though her little boy and baby girl are now on SCHIP, I think. She and her husband are self-employed and work all the time. She's got so-called pre-existing conditions related to being a WOMAN.

So you know what? This isn't about you -- or me and my husband. It's about people like my kids and my grandkids.

Hekate

[eridani]

21. It will if they don't die before 2014. n/t

[impik]

16. I'm sure parents to sick children with pre-existing condition will agree with you, you selfish

[Raineyb]

32. So adults with preexisting conditions should what? Pray? That's a real effective

health care plan there.

:sarcasm:

[whistler162]

34. Depends number 1 in the list might help you

a lot if you employee or are employed by a business with 24 or less "FTE - full time equivilant" employees.

[Cha]

6. Thanks Pro Sense..glad you have it nice and big

so it can be seen.

[denimgirly]

9. So premium hikes are limited by #11?

I am trying to figure out how insurers wont jack up rates to compensate for these new rules and so when i see #11 it seems to say 80-80% must go to medical services and so does this mean this is what will prevent them?

[Jennicut]

12. Sounds like it, or else they have to provide a rebate.

[eridani]

22. Like hell they will. Who provides the government with the data used to calculate MLR?

Now do you see why that has been a total and complete failure in the 15 states that have already tried it?

[denimgirly]

14. Was Reading the Clinton Health Plan '93 and Wow that thing was Ambitious But felt doomed...

I may not be reading the old plan right but from the sounds of it it seemed abitious and complex. I understand that it failed because of how it was managed and presented to congress but the actual plan seemed like a lot. I find it is far superior to the one going up for vote on Sunday but at the same time i honestly coudln't see the '93 plan making any progress today if we are fighting over just including a Public Option.

That being said, i think i am starting to see Obama not as weak (afraid to fight) but as a pragmatist and although he likely wishes for a Single Payer (or even a Public Option) i think he views Washington and special interests as too powerful and any attempt to even consider something like a PO at the very least would scuttle the entire hopes by these groups immediately. The Clinton plan was handled poorly but also seemed frightening to an easily frigthened nation (republican would have and probably did have a field day scaring the public on its details).

So i think Obama's approach to winning the healthcare debate is to make incremental steps. I hate this approach and many of you know i have been very negative about this plan but viewing it from this view point i can actually see why he is doing it. And now i am starting to think he isnt as weak as i thought. My guess is he might re-visit healthcare in his 2nd term to go for a PO amendment. THis is assuming the republicans dont regain control.

Wellp, anyway, i am now more open about this bill and have new faith in Obama....let's hope i am right...i hate weak leaders.

[jeanpalmer]

17. "Free preventive care"?

How can it be free if people will pay for it through higher premiums?

[eridani]

18. " employers that provide health benefits for retirees age 55‐64."

And if your employer doesn't or won't pay your particular doctor, fuck you very much.

[eridani]

19. MLR regulation attempt = total and complete BULLSHIT

15 states have tried it and failed. Why would the Feds succeed?

[eridani]

20. Recissions will not be ended. No mechanism for enforcement

CA has an anti-recission law that they don't enforce because they can't afford it. Recission still allowed in case of "fraud" = they'll rescind anyone they damned well fee like rescinding, and the remedy against that is likely to come after you die. Ask the Sarkisians.

[jeanpalmer]

24. Ultimately we have to get to single payer at a minimum

The Senate Bill as amended by reconciliation locks the overpriced private insurance system in place. And from that position, there's no way to get back to single payer because the insurance interests will be entrenched. That monster system once in place will not be reversed

We should hold out for single payer system just for the uninsured. They're not insured now, so the whole argument against single payer for them -- the disruption of our current system -- doesn't hold up because there's no insurance system in place for them to be disrupted. It's an ideal group for which to create a single payer system. And the good thing about that would be that as others saw how well that system would function, everyone would start clamoring to join it, and within a short period we'd get Medicare for All.

Instead, Obama is saving an insurance system that's on the verge of imploding, from rising prices and cancellations of insurance by individuals priced out of the market. If the private marhet were allowed to self-destruct, a movement could take hold to supplant it with a less costly system that works -- single payer. But a crisis point does have to be reached, and it won't be reached with a highly subsidized insurance scheme. It will merely prolong and deepen the crisis. Obama has saved a dinosaur from extinction temporarily.

[ShortnFiery]

25. Putting threads in all CAPS doesn't make this give-away to the Insurance Cartel and Big Pharma ...

anything less than a travesty. :crazy:

[ProSense]

28. Go

here

What do you see?

Information in the OP hasn't been altered from the original, except that it's not in blue.

Good thing I didn't try to recreate the text color because certain clowns would no doubt resort to accusations that I was trying to make the information look pretty.

[mzmolly]

26. K and R. How many false talking points died today?

;)

[lib_wit_it]

27. Thanks using a well accepted, clarifying format to present this summary of info. It's too bad some

sanctimoniousness drives certain people to bristle at *any* use of all caps. Quite Republicanesque an example of oversimplification and poutrage.

[firedupdem]

30. Thanks! I was looking for this! n/t

[crazylikafox]

31. They need to get this info on Medicare improvements out as soon as the bill passes.

I know most people get their checks automatically sent to their checking accounts these days, but they need to send some kind of mass mailing to let the old folks know about the donut hole improvements, preventive care improvements, etc. So many recipients think they're going to lose with HCR & I think they'll be shocked to find out it will help them.

[Warren Stupidity]

33. Can we please support this bill now?

[eridani]

38. No.

I will never support being voted into the category of disposable human garbage.

[Glenda]

35. Thanks for the summary! n/t

[smalll]

37. The Senate will do nothing after Sunday's High Noon at Demon Pass --

then the President will sign the Senate bill. And that's it.

Reconcilliation? That's a laugh and a half. Once the House passes what it faces on Sunday, the President will finally have a "stack of paper with 'Health Care' on it" that he can sign. It's all about getting "the Win."

Who would have guessed, a couple of years ago, that we would work so hard to get rid of one useless "W" just so that we could get another one.