Here's the Health Care Bill

There's a lot of talk back and forth about what is and isn't in the
bill. Lots of finger pointing and people accusing each other of lying.
Find out for yourself what's in the bill. This looks like it might be
useful to that end. It cites where the information is in the bill so
we can verify its authenticity
http://www.classicalideals.com/HR3200.htm

The Health Care Bill: What HR 3200, ''America's Affordable Health
Choices Act of 2009," Says

John David Lewis

August 6, 2009

What does the bill, HR 3200, short-titled ''America's Affordable
Health Choices Act of 2009," actually say about major health care
issues? I here pose a few questions in no particular order, citing
relevant passages and offering a brief evaluation after each set of
passages.

This bill is 1017 pages long. It is knee-deep in legalese and
references to other federal regulations and laws. I have only touched
pieces of the bill here. For instance, I have not considered the
establishment of (1) "Health Choices Commissio0ner" (Section 141); (2)
a "Health Insurance Exchange," (Section 201), basically a government
run insurance scheme to coordinate all insurance activity; (3) a
Public Health Insurance Option (Section 221); and similar provisions.

This is the evaluation of someone who is neither a physician nor a
legal professional. I am citizen, concerned about this bill's effects
on my freedom as an American. I would rather have used my time in
other ways—but this is too important to ignore.

We may answer one question up front: How will the government will pay
for all this? Higher taxes, more borrowing, printing money, cutting
payments, or rationing services—there are no other options. We will
all pay for this, enrolled in the government "option" or not.

(All bold type within the text of the bill is added for emphasis.)

1. 1. WILL THE PLAN RATION MEDICAL CARE?

This is what the bill says, pages 284-288, SEC. 1151. REDUCING
POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:

'(ii) EXCLUSION OF CERTAIN READMISSIONS.—For purposes of clause (i),
with respect to a hospital, excess readmissions shall not include
readmissions for an applicable condition for which there are fewer
than a minimum number (as determined by the Secretary) of discharges
for such applicable condition for the applicable period and such
hospital.

and, under "Definitions":

''(A) APPLICABLE CONDITION.—The term 'applicable condition' means,
subject to subparagraph (B), a condition or procedure selected by the
Secretary . . .

and:

''(E) READMISSION.—The term 'readmission' means, in the case of an
individual who is discharged from an applicable hospital, the
admission of the individual to the same or another applicable hospital
within a time period specified by the Secretary from the date of such
discharge.

and:

''(6) LIMITATIONS ON REVIEW.—There shall be no administrative or
judicial review under section 1869, section 1878, or otherwise of— . .
.

''(C) the measures of readmissions . . .

EVALUATION OF THE PASSAGES:

1. This section amends the Social Security Act

2. The government has the power to determine what constitutes an
"applicable [medical] condition."

3. The government has the power to determine who is allowed
readmission into a hospital.

4. This determination will be made by statistics: when enough
people have been discharged for the same condition, an individual may
be readmitted.

5. This is government rationing, pure, simple, and straight up.

6. There can be no judicial review of decisions made here. The
Secretary is above the courts.

7. The plan also allows the government to prohibit hospitals from
expanding without federal permission: page 317-318.

2. Will the plan punish Americans who try to opt out?

What the bill says, pages 167-168, section 401, TAX ON INDIVIDUALS
WITHOUT ACCEPTABLE HEALTH CARE COVERAGE:

''(a) TAX IMPOSED.—In the case of any individual who does not meet
the requirements of subsection (d) at any time during the taxable
year, there is hereby imposed a tax equal to 2.5 percent of the excess
of—

(1) the taxpayer's modified adjusted gross income for the taxable year, over

(2) the amount of gross income specified in section 6012(a)(1) with
respect to the taxpayer. . . ."

EVALUATION OF THE PASSAGE:

1. This section amends the Internal Revenue Code.

2. Anyone caught without acceptable coverage and not in the
government plan will pay a special tax.

3. The IRS will be a major enforcement mechanism for the plan.

3. what constitutes "acceptable" coverage?

Here is what the bill says, pages 26-30, SEC. 122, ESSENTIAL BENEFITS
PACKAGE DEFINED:

(a) IN GENERAL.—In this division, the term ''essential benefits
package'' means health benefits coverage, consistent with standards
adopted under section 124 to ensure the provision of quality health
care and financial security . . .

(b) MINIMUM SERVICES TO BE COVERED.—The items and services described
in this subsection are the following:

(1) Hospitalization.

(2) Outpatient hospital and outpatient clinic services . . .

(3) Professional services of physicians and other health professionals.

(4) Such services, equipment, and supplies incident to the services
of a physician's or a health professional's delivery of care . . .

(5) Prescription drugs.

(6) Rehabilitative and habilitative services.

(7) Mental health and substance use disorder services.

(8) Preventive services . . .

(9) Maternity care.

(10) Well baby and well child care . . .

(c) REQUIREMENTS RELATING TO COST-SHARING AND MINIMUM ACTUARIAL VALUE . . .

(3) MINIMUM ACTUARIAL VALUE.—

(A) IN GENERAL.—The cost-sharing under the essential benefits package
shall be designed to provide a level of coverage that is designed to
provide benefits that are actuarially equivalent to approximately 70
percent of the full actuarial value of the benefits provided under the
reference benefits package described in subparagraph (B).

EVALUATION OF THE PASSAGES:

1. The bill defines "acceptable coverage" and leaves no room for
choice in this regard.

2. By setting a minimum 70% actuarial value of benefits, the
bill makes health plans in which individuals pay for routine services,
but carry insurance only for catastrophic events, (such as Health
Savings Accounts) illegal.

4. Will the PLAN destroy private health insurance?

Here is what it requires, for businesses with payrolls greater than
$400,000 per year. (The bill uses "contribution" to refer to mandatory
payments to the government plan.) Pages 149-150, SEC. 313, EMPLOYER
CONTRIBUTIONS IN LIEU OF COVERAGE

(a) IN GENERAL.—A contribution is made in accordance with this section
with respect to an employee if such contribution is equal to an amount
equal to 8 percent of the average wages paid by the employer during
the period of enrollment (determined by taking into account all
employees of the employer and in such manner as the Commissioner
provides, including rules providing for the appropriate aggregation of
related employers). Any such contribution—

(1) shall be paid to the Health Choices Commissioner for deposit into
the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the
Exchange-participating health benefits plan in which the employee is
enrolled.

(The bill then includes a sliding scale of payments for business with
less than $400,000 in annual payroll.)

The Bill also reserves, for the government, the power to determine an
acceptable benefits plan: page 24, SEC. 115. ENSURING ADEQUACY OF
PROVIDER NETWORKS.

5 (a) IN GENERAL.—A qualified health benefits plan that uses a
provider network for items and services shall meet such standards
respecting provider networks as the Commissioner may establish to
assure the adequacy of such networks in ensuring enrollee access to
such items and services and transparency in the cost-sharing
differentials between in-network coverage and out-of-network coverage.

EVALUATION OF THE PASSAGES:

1. The bill does not prohibit a person from buying private insurance.

2. Small businesses—with say 8-10 employees—will either have to
provide insurance to federal standards, or pay an 8% payroll tax.
Business costs for health care are higher than this, especially
considering administrative costs. Any competitive business that tries
to stay with a private plan will face a payroll disadvantage against
competitors who go with the government "option."

3. The pressure for business owners to terminate the private
plans will be enormous.

4. With employers ending plans, millions of Americans will lose
their private coverage, and fewer companies will offer it.

5. The Commissioner (meaning, always, the bureaucrats) will
determine whether a particular network of physicians, hospitals and
insurance is acceptable.

6. With private insurance starved, many people enrolled in the
government "option" will have no place else to go.

5. Does the plan TAX successful Americans more THAN OTHERS?

Here is what the bill says, pages 197-198, SEC. 441. SURCHARGE ON HIGH
INCOME INDIVIDUALS

''SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.

''(a) GENERAL RULE.—In the case of a taxpayer other than a
corporation, there is hereby imposed (in addition to any other tax
imposed by this subtitle) a tax equal to—

''(1) 1 percent of so much of the modified adjusted gross income of
the taxpayer as exceeds $350,000 but does not exceed $500,000,

''(2) 1.5 percent of so much of the modified adjusted gross income of
the taxpayer as exceeds $500,000 but does not exceed $1,000,000, and

''(3) 5.4 percent of so much of the modified adjusted gross income of
the taxpayer as exceeds $1,000,000.

EVALUATION OF THE PASSAGE:

1. This bill amends the Internal Revenue Code.

2. Tax surcharges are levied on those with the highest incomes.

3. The plan manipulates the tax code to redistribute their wealth.

4. Successful business owners will bear the highest cost of this plan.

6. 6. Does THE PLAN ALLOW THE GOVERNMENT TO set FEES FOR SERVICES?

What it says, page 124, Sec. 223, PAYMENT RATES FOR ITEMS AND SERVICES:

(d) CONSTRUCTION.—Nothing in this subtitle shall be construed as
limiting the Secretary's authority to correct for payments that are
excessive or deficient, taking into account the provisions of section
221(a) and the amounts paid for similar health care providers and
services under other Exchange-participating health benefits plans.

(e) CONSTRUCTION.—Nothing in this subtitle shall be construed as
affecting the authority of the Secretary to establish payment rates,
including payments to provide for the more efficient delivery of
services, such as the initiatives provided for under section 224.

EVALUATION OF THE PASSAGES:

1. The government's authority to set payments is basically unlimited.
2. The official will decide what constitutes "excessive,"
"deficient," and "efficient" payments and services.

7. Will THE PLAN increase the power of government
officials to SCRUTINIZE our private affairs?

What it says, pages 195-196, SEC. 431. DISCLOSURES TO CARRY OUT HEALTH
INSURANCE EXCHANGE SUBSIDIES.

''(A) IN GENERAL.—The Secretary, upon written request from the Health
Choices Commissioner or the head of a State-based health insurance
exchange approved for operation under section 208 of the America's
Affordable Health Choices Act of 2009, shall disclose to officers and
employees of the Health Choices Administration or such State-based
health insurance exchange, as the case may be, return information of
any taxpayer whose income is relevant in determining any affordability
credit described in subtitle C of title II of the America's Affordable
Health Choices Act of 2009. Such return information shall be limited
to—

''(i) taxpayer identity information with respect to such taxpayer,

''(ii) the filing status of such taxpayer,

''(iii) the modified adjusted gross income of such taxpayer (as
defined in section 59B(e)(5)),

''(iv) the number of dependents of the taxpayer,

''(v) such other information as is prescribed by the Secretary by
regulation as might indicate whether the taxpayer is eligible for such
affordability credits (and the amount thereof), and

''(vi) the taxable year with respect to which the preceding
information relates or, if applicable, the fact that such information
is not available.

And, page 145, section 312, EMPLOYER RESPONSIBILITY TO CONTRIBUTE
TOWARDS EMPLOYEE AND DEPENDENT COVERAGE:

(3) PROVISION OF INFORMATION.—The employer provides the Health Choices
Commissioner, the Secretary of Labor, the Secretary of Health and
Human Services, and the Secretary of the Treasury, as applicable, with
such information as the Commissioner may require to ascertain
compliance with the requirements of this section.

EVALUATION OF THE PASSAGE:

1. This section amends the Internal Revenue Code

2. The bill opens up income tax return information to federal officials.

3. Any stated "limits" to such information are circumvented by
item (v), which allows federal officials to decide what information is
needed.

4. Employers are required to report whatever information the
government says it needs to enforce the plan.

8. 8. Does the plan automatically enroll Americans in the GOVERNMENT plan?

What it says, page 102, Section 205, Outreach and enrollment of
Exchange-eligible individuals and employers in Exchange-participating
health benefits plan:

(3) AUTOMATIC ENROLLMENT OF MEDICAID ELIGIBLE INDIVIDUALS INTO
MEDICAID.—The Commissioner shall provide for a process under which an
individual who is described in section 202(d)(3) and has not elected
to enroll in an Exchange-participating health benefits plan is
automatically enrolled under Medicaid.

And, page 145, section 312:

(4) AUTOENROLLMENT OF EMPLOYEES.—The employer provides for
autoenrollment of the employee in accordance with subsection (c).

EVALUATION OF THE PASSAGES:

1. Do nothing and you are in.

2. Employers are responsible for automatically enrolling people
who still work.

9. 9. Does THE PLAN exempt federal OFFICIALS from COURT REVIEW?

What it says, page 124, Section 223, PAYMENT RATES FOR ITEMS AND SERVICES:

(f) LIMITATIONS ON REVIEW.—There shall be no administrative or
judicial review of a payment rate or methodology established under
this section or under section 224.

And, page 256, SEC. 1123. PAYMENTS FOR EFFICIENT AREAS.

''(C) LIMITATION ON REVIEW.—There shall be no administrative or
judicial review under section 1869, 1878, or otherwise, respecting—

''(i) the identification of a county or other area under subparagraph (A); or

''(ii) the assignment of a postal ZIP Code to a county or other area
under subparagraph (B).

EVALUATION OF THE PASSAGES:

1. Sec. 1123 amends the Social Security Act, to allow the
Secretary to identify areas of the country that underutilize the
government's plan "based on per capita spending."

2. Parts of the plan are set above the review of the courts.