House Health Care Reform Bill Released

Sio, do you know if the 14 provisions that take place immediately are only if the Bill passes?

Sio, do you know if the 14 provisions that take place immediately are only if the Bill passes?

The short answer is yes. Nothing in this bill would take place until after it passes the House and Senate. Changes to this bill can and will occur during the debate in the House before it is passed. Then the Senate will either take the passed bill and debate it in the Senate and vote on it with no changes (highly unlikely), make changes to this bill and vote on it, or vote on their own bill (most likely). If the Senate passes a bill that is different then the bill passed by the House, it will have to be "conferenced." Conferencing would involve members picked by the House and Senate leadership creating a compromise bill. That compromised bill would then have to be voted on again by the House and Senate.

of the nearly 2000 pages that have been released, its amazing how much government intervention, tax increases and penalties that come with this plan.

if most people read this bill, most would understand this isnt the way to go or even close.

there is no tort reform or freedom of purchasing insurance over state lines in this bill. both of which both parties have acknowledged are a must in order to reform health programs.

this is driven by the far left of the dem party and is cleary for political gain and nanny state addictions..... will never pass the senate-period. more wasted time while our system is falling apart before our eyes.

Thanks BeachSi02 for the new thread

I downloaded and forwarded the both the 14 Provisions and 10 Changes sections of it to my family and friends--I will also post on Facebook and ask folks to forward it to their fb friends as well. I am very excited now...

It is not perfect, but I am obviously more optimistic than kkddbb in post #4 . And, after watching all the crap that led up to this, the scary "death panels," seniors being put out on the street like the garbage, the possible death of the insurance industry, etc., I am now very hopeful that this will pass as is...Sounds like large quantifiable savings in several areas, in time, over the current system for those frantically worried about their children's burden and having to deal with their parents debt....

I am very optimistic!

Here are some more supplemental docs released by House Dems taken from The Hill.

1. A timeline of when various portions of the bill would take effect.

2. An outline of the changes between the individual House Committee bills and the final bill.

3. A basic summary of the bill.

4. An outline of the "immediate investments" the bill will make.
5. The official revenue estimate from the Joint Committee on Taxation.

6. A description of each section of the bill.

What happened to the provision to tax high perks health plans? I guess that was only in the Senate - this bill generates all it's revenue from a tax on the rich and a medical device tax. (The latter seems to go contrary to the whole idea of improving our heathcare doesn't it?)

can anyone tell me what about these provisions costs less and provides better health coverage and most importantly health quality? it seams most people are interested more on when it begins than anything else. noone seams to look at the details and the cost of this.

there are some good things in this bill, but......

1) it doesnt insure more people for less money. there will still be an estimated 30million people without insurance. there are already approx. 30million people unisured now. nearly 18% are unregistered citizens and there is a estimated 12% that can afford it, but chose not to purchase.

2) how do we pay for this? by penalities and charging the rich? its the rich that is keeping south walton alive right now, along with most communities. less money for them, less money for them to build additions, build new, buy tv's etc etc etc etc. penalties? at least the dnc can say they didnt raise taxes on the middle class on the campaign trail as promised, instead they will penalize them. can anyone tell me the difference?

3) why no tort reform or the oppurtunity to purchase insurance over state lines like every other insurance policy ie car and home. it will drive prices down overnight, why not do it? thats too easy to answer......

4) medicare gets cut by approx. $500 billion. is that looking out for the elderly? how does that help better the system?

this is simply a giant government run system being shoved down our throats during a certain time during a certain administration. its a way to say to the folks before election day how they saved health care. by the time this bill really starts having an effect, many of these people will have been re-elected and likely someone else in these elected positions to take the heat. can anyone tell me a gov system that ran well and was economically sound?

i want reform ,but like usual there are many out there that are taking the bait from politically driven politicians. once again real change is something the american people wont get, but we'll hear about it constantly

kkddbb, there have to be cuts to Medicare, either now or in the future, better to do it now. What we have in place is unsustainable. Our budget is creaking under the weight of it.

As for the device tax, 30ashopper, I don't know a ton about it, but I do know there were lobbyists working very hard against it and apparently got the government to slash it in half, from $4 billion to $2 billion. The initial amount was a shock. I don't know if the final amount is fair or not. It may force some layoffs and pay cuts but maybe won't affect innovation quite as much. I do know that the companies were expected to benefit somewhat from having more people on the healthcare rolls; maybe the addition of new patients will make it close to a wash. Raising prices to offset the tax won't be an option.

I have no other thoughts at the moment, haven't even attempted to read a summary yet, but I hope we can all keep in mind the complexity of all the give and take involved.

kkddbb, there have to be cuts to Medicare, either now or in the future, better to do it now. What we have in place is unsustainable. Our budget is creaking under the weight of it.

As for the device tax, 30ashopper, I don't know a ton about it, but I do know there were lobbyists working very hard against it and apparently got the government to slash it in half, from $4 billion to $2 billion. The initial amount was a shock. I don't know if the final amount is fair or not. It may force some layoffs and pay cuts but maybe won't affect innovation quite as much. I do know that the companies were expected to benefit somewhat from having more people on the healthcare rolls; maybe the addition of new patients will make it close to a wash. Raising prices to offset the tax won't be an option.

I have no other thoughts at the moment, haven't even attempted to read a summary yet, but I hope we can all keep in mind the complexity of all the give and take involved.

i agree with you that cuts will be needed. but, the dems shouldnt be going out there blaming the opposition because they say medicare recipients wont get nearly the quality coverage they have now under this bill when its exactly what will happen. medicare is already over budget because of the size of people benefiting from it. and then it will only increase as the babyboomers age and begin taking advantage of medicare. if anything we should increase it, but we cant because of the waste. waste isnt even top priority in either of these bills. they ignore waste and penalize the middle-class while saying no taxed increases. we wont even begin to talk about what will happen when rationing begins which economics 101 in this country. this will absolutely lead to that, not now but no doubt in the future. amtrak yesterday released a study that they lose $6 dollars per ticket. need i say more......

its beyond ticking me off that a real bill that will actually better our system cant be proposed. the gop has offered a great plan, but the media and the dnc dont want it because its not political expediant. they are certainly not looking out for the folks thats for sure....

2) how do we pay for this? by penalities and charging the rich? its the rich that is keeping south walton alive right now, along with most communities. less money for them, less money for them to build additions, build new, buy tv's etc etc etc etc. penalties? at least the dnc can say they didnt raise taxes on the middle class on the campaign trail as promised, instead they will penalize them. can anyone tell me the difference?

All I am reading in the documents is a surchage tax on individuals making of $500,000 yr. and couple making over $1,000,000 yr.

This, according to the documents, will affect only the top .3% of the wealthiest. Right now, the top 1.0 % of the wealthiest have more money that the bottom 90% in the country ! (I guess the top .03% are the "super" wealthy??)

They won't feel it then--but they will feel the "warm and fuzzies" helping out the REST OF AMERICA! Yes, level the healthcare playing field, they won't even feel a thing... doctor.

All I am reading in the documents is a surchage tax on individuals making of $500,000 yr. and couple making over $1,000,000 yr.

This, according to the documents, will affect only the top .3% of the wealthiest. Right now, the top 1.0 % of the wealthiest have more money that the bottom 90% in the country ! (I guess the top .03% are the "super" wealthy??)

They won't feel it then--but they will feel the "warm and fuzzies" helping out the REST OF AMERICA! Yes, level the healthcare playing field, they won't even feel a thing... doctor.

this is just one of the ways they will get this money. the only cutting from what i can see on a large basis is cutting medicare? what say you?

its those top 3% that are doing any kind of building in this county, etc. what say you?

i just read another stat on "cash for clunkers"...another gov run program. it cost the american taxpayer $24K for each vehicle. of the 690K sold, only 125k were credited to cash for clunkers. go back and see what they promised us for political gain versus the after the fact reality. and youre still going to trust the gov to run things? thats not what made us the economic power we are and have been since our founding. every gov program exceeds and most over exceeds the estimate yet some will still believe what they are told by these people.

im betting you wont see this on liberal news......its not politically expedient

this is driven by the far left of the dem party and is cleary for political gain and nanny state addictions..... .

i want reform ,but like usual there are many out there that are taking the bait from politically driven politicians. once again real change is something the american people wont get, but we'll hear about it constantly

the gop has offered a great plan, but the media and the dnc dont want it because its not political expediant. they are certainly not looking out for the folks thats for sure....

im betting you wont see this on liberal news......its not politically expedient

notice how you smear as usual and provide zero substance. i spoke fact. if you dont like it than im sorry, but facts are facts. if its not politically expedient for you than thats whats wrong with our nation today.

instead youll say im against all reform and want to kill grandma because i dont want this big gov plan. thats typical liberal smearing and its that kind of nonsense that prevents real change.

i do a ton of research because it not only effects me, but my employees and im a small business. a small biz that goes to great lengths to provide full coverage to everyone. and the polls clearly show the people dont it either. its pure politics and your assisting in it.

when your up there in the clouds, could you drop some rain because my gov funded money tree needs watering....

notice how you smear as usual and provide zero substance. i spoke fact. if you dont like it than im sorry, but facts are facts. if its not politically expedient for you than thats whats wrong with our nation today.

instead youll say im against all reform and want to kill grandma because i dont want this big gov plan. thats typical liberal smearing and its that kind of nonsense that prevents real change.

i do a ton of research because it not only effects me, but my employees and im a small business. a small biz that goes to great lengths to provide full coverage to everyone. and the polls clearly show the people dont it either. its pure politics and your assisting in it.

when your up there in the clouds, could you drop some rain because my gov funded money tree needs watering....

notice how you smear as usual and provide zero substance. i spoke fact. if you dont like it than im sorry, but facts are facts. if its not politically expedient for you than thats whats wrong with our nation today.

That's really amazing that one SoWal board member could have such a powerful effect on the state of our nation!!

i agree with you that cuts will be needed. but, the dems shouldnt be going out there blaming the opposition because they say medicare recipients wont get nearly the quality coverage they have now under this bill when its exactly what will happen. medicare is already over budget because of the size of people benefiting from it. and then it will only increase as the babyboomers age and begin taking advantage of medicare. if anything we should increase it, but we cant because of the waste. waste isnt even top priority in either of these bills. they ignore waste and penalize the middle-class while saying no taxed increases. we wont even begin to talk about what will happen when rationing begins which economics 101 in this country. this will absolutely lead to that, not now but no doubt in the future. amtrak yesterday released a study that they lose $6 dollars per ticket. need i say more......

its beyond ticking me off that a real bill that will actually better our system cant be proposed. the gop has offered a great plan, but the media and the dnc dont want it because its not political expediant. they are certainly not looking out for the folks thats for sure....

have you looked into ssri programs? you could benefit from this.

have you looked into ssri programs? you could benefit from this.

Or maybe this new wonder drug - - - -

http://images.google.com/imgres?img...q=fukitol&hl=en&rlz=1R2ADFA_enUS345&sa=X&um=1

Or maybe this new wonder drug - - - -

http://images.google.com/imgres?img...q=fukitol&hl=en&rlz=1R2ADFA_enUS345&sa=X&um=1

ummm, where can i get a bottle of this ?

Do the authors really think they can pay for this soaking the uber-rich and telling granny she can't go to the doctor every week? This is protection for the trial lawyers and government flunkies.

Additional Information

Below is a summary that I received from an industry group with whom I am affiliated. I think (and hope that you agree) that they tried to provide some specifics without editorial content. I have read it, but not studied each issue at great length. I think it's going to be pretty onerous on medium sized businesses, and may incent companies to limit expansion in order to keep payroll below the limits. I am also disappointed in the lack of tort reform.

Date: October 29, 2009

Action Taken: House leadership, led by Speaker Nancy Pelosi (D-CA), today announced completion of a health reform bill that combines the efforts of the House?s Committees on Education & Labor, Energy & Commerce, and Ways & Means.

Below is a summary of its major provisions.

Government/Public Plan Option: The bill contains a government/public plan option, based on rates to be negotiated by a new government agency (the Health Choices Commission, or HCC). The government plan option would be one of many (the bill?s authors hope) choices available to those who buy their insurance through an exchange. The government/public plan option would be subject to the same rules (e.g., insurance reform, essential benefits packages) as the private insurance sold through the exchange.

Exchange: The bill would create a national exchange. It would allow states to instead set up their own exchanges. Exchanges would offer private health insurance to individuals not otherwise covered by ?acceptable? insurance, and to small businesses.

The exchange would be set up and administered by a new government agency, the Health Choices Commission (HCA). The HCA would promulgate nondiscrimination and parity (mental health) rules.


States would be required to assist groups who want to establish ?Consumer Operated and Oriented Plan Programs,? or ?co-ops? as options for health insurance that would be offered through the exchange.

Insurance Reforms: Beginning in 2010, a number of insurance reforms are mandated. They include:

? No rescissions except for fraud
? Guaranteed issue and renewability
? Limit on premium costs based on age to no more than a two to one ratio
? Community rating
? No use of health history or preexisting conditions (full prohibition against preexisting conditions becomes effective as of 1/1/13; between now and then, the look-back period is limited to 30 days; and exclusion of coverage due to preexisting conditions would be allowable for three rather than 12 months)
? No annual or lifetime benefit limits
? Parents could continue to cover their children on their health insurance policies up through age 26
? Insurance companies could have no more than an 85 percent loss ratio. If loss ratios fall below the 85 percent level, the excess would have to be rebated to policyholders. There is some flexibility built into this rule with respect to the individual market if market disruption results from the 85 percent loss ratio requirement.
? As of the date of enactment, employers would not be allowed to reduce retiree health benefits unless they are also reducing the same benefits for active employees
? Health insurers would have to provide at least 90 days notice prior to a premium increase

Long-Term Care Benefits: The melded House bill contains a new federal long term care program which would require employers to automatically enroll their workers (subject to an opt-out) in a program that would provide about $50/day in benefits in the event that the worker became unable (at least five years after beginning participation) to perform at least two activities of daily living. The employee-paid premium for the program?known as the CLASS Act?would be required to be actuarially sound, but is expected to be about $65/month, at least initially.

Individual Mandates: The bill contains an individual mandate that will require all individuals to carry health insurance. Failure to comply with this rule would result in an additional 2.5 percent tax on modified adjusted gross income. There would be a hardship exemption (based on affordability). There is language that specifies that those eligible for Medicaid, CHIP, Veterans Affairs (VA) coverage and other government health insurance programs would be deemed to have acceptable coverage.

Employer Mandate: The melded bill requires employers to offer and pay for health insurance for their workers. The rules are:

? Employers with payrolls of $750,000 or more would be subject to the mandate
? Employers subject to the mandate would have to pay at least 72.5 percent of the cost of individual coverage, and 65 percent of the cost of dependent coverage. ?Proportional? employer contributions to the premium would be required for ?non fulltime? workers.
? Employers with payrolls of $500,000 or less would be exempt from the employer mandate
? Failure to comply with the mandate would result in a tax of eight percent of payroll in excess of $750,000. A two percent tax would apply to payroll starting at $500,000, and the tax would graduate, in two percent increments, up to a payroll size of $750,000.
? There would be a two-year tax credit for small employers electing to offer health insurance to their workers. The credit would be equal to 50 percent of the cost of the insurance for employers with 9 or fewer workers. The credit would phase down for employers with 10 to 25 workers. It would not be available to employers with 26 or more workers.

Essential Benefits Package: For health insurance to count as satisfying the health insurance mandates, it must include at least the ?essential benefits package.? The rules include:

? The package would have to be offered on a nondiscriminatory basis
? It would be recommended by a new government entity, the Benefits Advisory Committee (BAC), and then approved by the Department of Health and Human Services (HHS)
? Cost sharing would be limited, and could not exceed $5,000 in out of pocket spending for individual coverage, or $10,000 in dependent care coverage.
? The essential benefits package must have an actuarial value of at least 70 percent
? There could be no abortion benefits in an essential benefits package
? For policies that provide abortion benefits, there must be strict separation of private vs federal funds, and no federal funds could be used for abortion benefits

National Risk Pool: Between date of enactment and the date the exchange is up and operating (2013) there would be a national high risk pool program. Per this program, Congress would authorize $5 million to insure people who have been denied coverage due to preexisting conditions and/or who have been without coverage for ?several months.? The program would stop if and when the $5 million authorized is used up.

Antitrust Exemption: The bill states that the antitrust exemption available to health insurers and medical malpractice insurers would no longer be available for purposes of fixing prices, monopolizing markets, or dividing market territories.

Taxes (Offsets): The bill is principally offset by savings in Medicare (including Medicare Advantage) and new taxes. The new taxes include:

? An indexed annual cap of $2,500 on contributions to flexible spending accounts (FSAs)
? An increase from 10 percent to 20 percent in the penalty tax for early (prior to age 65) withdrawals (for nonmedical expenses) from health savings accounts (HSAs)
? Modification of rules for permissible tax-free withdrawals from HSAs, FSAs and/or health reimbursement accounts (HRAs) to disallow use of HRA/FSA/HSA tax-free funds for over-the-counter medicines, unless those medicines are obtained via prescription
? A 5.4 percent surcharge on modified adjusted gross income in excess of $500,000 for individuals and $1 million for married couples filing joint tax returns
? Elimination of the tax deduction for employers receiving government subsidies for providing retiree prescription drug coverage
? Tax parity for employer-provided health coverage for domestic partners and other non-dependents
? Information reporting for payments made to corporations
? A 2.5 percent excise tax on the sale of medical devises (excluding resales and retail sales) for use in the United States

Medical Malpractice: The bill contains a limited incentive to States to set up alternatives to litigation in cases of medical malpractice (e.g., ?early offer? or ?certificate of merit? programs).

Interstate Sales of Insurance: The bill would allow States to enter into compacts for purposes of sale of health insurance across state lines.

COBRA Extension: The bill would extend COBRA eligibility (from 18 or 36 months as under current law) for the period between the health reform bill?s enactment and the date by which the exchange would be up and operating.

Medicare: The bill cuts Medicare Advantage programs, and makes the Medicare Part D prescription drug program available to those in the ?donut hole??those with incomes above certain levels, but below other levels?starting in 2010.

Wellness/Information Technology: The bill also includes incentives for employers that offer wellness programs, so long as the programs are offered on a nondiscriminatory basis; and authorization for information technology programs.

Next Steps: The legislation is still subject to change via a still-emerging ?manager?s amendment?. The bill's full text and manager?s amendment will be publically available for 72 hours before Members are asked to vote. The bill could go to the House floor for a vote by late next week (November 5 or 6), although that target date could slip.

Thanks for that post redmars. Very good summaries.
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In news reports this afternoon, Rep. George Miller (D-Calif) stated that there is a possibility of NO amendments to be allowed on the House floor. He is a very close ally to Speaker Pelosi so his comments carry more weight then many since it is up to the Rules Committee to decide, and they are appointed by Pelosi.

The dilemma is that there are a handful of groups who have stated that they will torpedo the bill if their amendments aren't voted on. The three biggest are the pro-life democrats who want to vote on whether or not federal funding can be used for abortions, the hispanic caucus who wants to vote on health benefits constraints to legal, documented immigrants, and the public option democrats who want to vote on the "robust option." It will be interesting politics to see if any of these amendments are actually allowed on the floor.

its beyond ticking me off that a real bill that will actually better our system cant be proposed. the gop has offered a great plan, but the media and the dnc dont want it because its not political expediant. they are certainly not looking out for the folks thats for sure....

Is this the great plan?


YouTube - Boehner's empty talk on health reform

I think you can get more information on the GOP plan here.

Is this the great plan?


YouTube - Boehner's empty talk on health reform

What is that you don't understand regarding the fact that there is NO PLAN yet, whether you're a Democrat or Republican supporter? The film clip says exactly that.
Representative Boehner is absolutely correct when he states, as he as on many occasions, that the GOP has made many suggestions for real healthcare reform, both in committee and individually. None of these suggestions, including tort reform, have been accepted by the Democratic leadership. So much for partisanship. When there is a plan actually ready to be voted on by both the House and Senate we will have something to really comment on. Until then everything any of us has to say is pure conjecture.