Another major defeat with this bill: states can't regulate HMO's

[murdoch]

The HMOs have fought for years to try to remove state regulation of HMOs. This includes state laws that cover the basic needs that plans must cover, or the approval of an HMO bureaucrat before you can go to a specialist.

For example, I have had a doctor for a long time, who is a very good doctor. I have also been on five different insurance plans with five different companies over the past years, none of which he is on. So if I go to him and he says I have to go to a cardiologist, without state laws the HMO can make me get a second opinion from one of their bureaucrats, who is more likely to tell me I don't need to go to a cardiologist. The new "reform" monstrosity does away with state laws like this, states are no longer allowed to regulate HMOs. This has been a dream of the HMOs for a long time.


http://www.washingtonpost.com/wp-dyn/content/article/2009/12/19/AR2009121900797.html?hpid=topnews

[uberblonde]

1. That isn't what the bill does.

It says that either federal or state laws will apply - whichever one is tougher.

[ananda]

2. This bill needs to die a fast death.

nt

[pinto]

3. I don't see any mention of HMO's in the article you cited? Maybe a different link or source?

I may have missed it, WaPo has become hard to navigate of late.

Thanks.

[murdoch]

4. here

"Instead of a public option, the final bill would allow private firms for the first time to offer national insurance policies to all Americans across state lines."

The "private firms" are HMO's. Who have been pushing this for years.

As it says, this is the first time they have national insurance policies. Why have they never offered them before? Because previously states could regulate insurance policies.

[pinto]

5. Disagree. The term "private firms" refers to licensed health insurance companies in general,

not specifically HMO's. In this Section (1333) there is the definition of the term as required in most legislation. This is from an earlier post I made in a discussion about insurance companies offering policies across state lines, yet earlier in the Section, the term "insurance company" is defined for legal purposes. Problem here is sloppy journalism, I think, on a complex bill with myriad clauses and sub-clauses. (A caveat - It's a big pdf file.) ~ pinto

**********************************************************

SEC. 1333. PROVISIONS RELATING TO OFFERING OF PLANS IN MORE THAN ONE STATE.

(a.)(2) STATE AUTHORITY.—

A State may not enter
into an agreement under this subsection unless the
State enacts a law after the date of the enactment
of this title that specifically authorizes the State to
enter into such agreements.

(Pages 219 - 220)

http://democrats.senate.gov/reform/patient-protection-a... (big pdf file)