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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:28 PM
Original message
Avoiding the tax penalty in the HIR bill; per the reconciliation bill.
I was wondering what the bare minimum requirements are going to be, with regard to the health insurance reform bill, in order to avoid the tax penalty.

I went to the online reconciliation bill: H. R. 4872; To provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010. (thomas.gov link. If it doesn't work, go to thomas.gov and search h.r. 4872.)

I looked through for the tax repercussions and the basic requirements for coverage in order to comply with the soon to be legislated mandate. The short question was, what do I need to purchase and how much will it cost me for the bare minimum compliance?

This is how it went.

Search through H.R. 4872 for "tax."

Subpart A--Tax on Individuals Without Acceptable Health Care Coverage

SEC. 59B. 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.

<snip a list of exceptions. I predict church membership increases.>


Search for "acceptable health care coverage."

{Subsection} (d) Acceptable Coverage Requirement-

(1) IN GENERAL- The requirements of this subsection are met with respect to any individual for any period if such individual (and each qualifying child of such individual) is covered by acceptable coverage at all times during such period.

(2) ACCEPTABLE COVERAGE- For purposes of this section, the term `acceptable coverage' means any of the following:
(A) QUALIFIED HEALTH BENEFITS PLAN COVERAGE- Coverage under a qualified health benefits plan (as defined in section 100(c) of the America's Affordable Health Choices Act of 2009).
(B) GRANDFATHERED HEALTH INSURANCE COVERAGE; COVERAGE UNDER GRANDFATHERED EMPLOYMENT-BASED HEALTH PLAN
(C) MEDICARE
(D) MEDICAID
(E) MEMBERS OF THE ARMED FORCES AND DEPENDENTS (INCLUDING TRICARE
(F) VA
(G) OTHER COVERAGE

<details of B through G above, left blank to keep you from going blind>


Search for "section 100."


section 100(c)

(c) General Definitions- Except as otherwise provided, in this division:
(1) ACCEPTABLE COVERAGE- The term `acceptable coverage' has the meaning given such term in section 202(d)(2).
(2) BASIC PLAN- The term `basic plan' has the meaning given such term in section 203(c).

<more snip>


Search for "section 202."


section 202(d)(2)


{Section 202} (d) Individuals-

<snippage>

(2) ACCEPTABLE COVERAGE- For purposes of this division, the term `acceptable coverage' means any of the following:
(A) QUALIFIED HEALTH BENEFITS PLAN COVERAGE- Coverage under a qualified health benefits plan.
(B) GRANDFATHERED HEALTH INSURANCE COVERAGE; COVERAGE UNDER CURRENT GROUP HEALTH PLAN
(C) MEDICARE-.
(D) MEDICAID
(E) MEMBERS OF THE ARMED FORCES AND DEPENDENTS (INCLUDING TRICARE
(F) VA
(G) OTHER COVERAGE

<details of B through G above, left blank to keep you from going blind>


Section 202 says "acceptable coverage" equals a "qualified health benefits plan."

AAAAAAAAAAAAAAAAGGGGGGGGGGGGGGGGGGGGGGGHHHHHHHHHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!! (spaghetti code, FFS!!!!)

Qualified health benefits plan is defined where???? Search for "qualified health benefits plan."


Subtitle D <snippage>
Part 2--Prevention of Tax Avoidance <snippage>
(c) General Definitions- Except as otherwise provided, in this division: <snip 1-19>

(20) QUALIFIED HEALTH BENEFITS PLAN- The term `qualified health benefits plan' means a health benefits plan that meets the requirements for such a plan under title I and includes the public health insurance option and cooperatives under subtitle D of title II.


"Qualified Health Benefits Plan" is defined in Title What? Goto where? Return to what? Loop? Endless? WTF?! If, then, else, loop, if then, rather, this, go to section that, return from section other, find title I and II, under then over or through...

Search for "Title I."

TITLE I--PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS

Subtitle A--General Standards

Sec. 101. Requirements reforming health insurance marketplace.

<lots of snippage>


Okay, Title I, Section 101.

Look, look, I found it! Or...

SEC. 101. REQUIREMENTS REFORMING HEALTH INSURANCE MARKETPLACE.

(a) Purpose- The purpose of this title is to establish standards to ensure that new health insurance coverage and employment-based health plans that are offered meet standards guaranteeing access to affordable coverage, essential benefits, and other consumer protections.
(b) Requirements for Qualified Health Benefits Plans- On or after the first day of Y1, a health benefits plan shall not be a qualified health benefits plan under this division unless the plan meets the applicable requirements of the following subtitles for the type of plan and plan year involved:
(1) Subtitle B (relating to affordable coverage).
(2) Subtitle C (relating to essential benefits).
(3) Subtitle D (relating to consumer protection).



What? Where? Search for "Subtitle C (relating to essential benefits)". Woo hoo! I'm there...um...

Subtitle C--Standards Guaranteeing Access to Essential Benefits

SEC. 121. COVERAGE OF ESSENTIAL BENEFITS PACKAGE.

(a) In General- A qualified health benefits plan shall provide coverage that at least meets the benefit standards adopted under section 124 for the essential benefits package described in section 122 for the plan year involved.

<scroll doooooown and snip to Sec. 122>

SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED. {look! look! there it is!}

(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, that--
(1) provides payment for the items and services described in subsection (b) in accordance with generally accepted standards of medical or other appropriate clinical or professional practice;
(2) limits cost-sharing for such covered health care items and services in accordance with such benefit standards, consistent with subsection (c);
(3) does not impose any annual or lifetime limit on the coverage of covered health care items and services;
(4) complies with section 115(a) (relating to network adequacy); and
(5) is equivalent, as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services, to the average prevailing employer-sponsored coverage.
(b) Minimum Services to Be Covered- Subject to subsection (d), the items and services described in this subsection are the following:
(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department 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 in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services, including behavioral health treatments.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well baby and well child care; treatment of a congenital or developmental deformity, disease, or injury; and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.

<scroll doooown and snip to Sec. 124>

SEC. 124. PROCESS FOR ADOPTION OF RECOMMENDATIONS; ADOPTION OF BENEFIT STANDARDS.

(a) Process for Adoption of Recommendations-
(1) REVIEW OF RECOMMENDED STANDARDS- Not later than 45 days after the date of receipt of benefit standards recommended under section 123 (including such standards as modified under paragraph (2)(B)), the Secretary shall review such standards and shall determine whether to propose adoption of such standards as a package.
(2) DETERMINATION TO ADOPT STANDARDS- If the Secretary determines--
(A) to propose adoption of benefit standards so recommended as a package, the Secretary shall, by regulation under section 553 of title 5, United States Code, propose adoption such {sic} standards; or
(B) not to propose adoption of such standards as a package
{there's a damned typo in the bill?!}, the Secretary shall notify the Health Benefits Advisory Committee in writing of such determination and the reasons for not proposing the adoption of such recommendation and provide the Committee with a further opportunity to modify its previous recommendations and submit new recommendations to the Secretary on a timely basis.
(3) CONTINGENCY- If, because of the application of paragraph (2)(B), the Secretary would otherwise be unable to propose initial adoption of such recommended standards by the deadline specified in subsection (b)(1), the Secretary shall, by regulation under section 553 of title 5, United States Code, propose adoption of initial benefit standards by such deadline.
(4) PUBLICATION- The Secretary shall provide for publication in the Federal Register of all determinations made by the Secretary under this subsection.
(b) Adoption of Standards-
(1) INITIAL STANDARDS- Not later than 18 months after the date of the enactment of this Act, the Secretary shall, through the rulemaking process consistent with subsection (a), adopt an initial set of benefit standards.
(2) PERIODIC UPDATING STANDARDS- Under subsection (a), the Secretary shall provide for the periodic updating of the benefit standards previously adopted under this section.
(3) REQUIREMENT- The Secretary may not adopt any benefit standards for an essential benefits package or for level of cost-sharing that are inconsistent with the requirements for such a package or level under sections 122 (including subsection (d)) and 123(b)(5).


Oh, nevermind. It hasn't been adopted yet. May not be adopted. Could be adopted. Won't know for sure until "Not later than 18 months after the date of the enactment of this Act, the Secretary shall, through the rulemaking process consistent with subsection (a), adopt an initial set of benefit standards." Go to, Title I, Section 124(a).

Alllllllrighty then. Moving on to "basic plan."

section 100(c)
(c) General Definitions- Except as otherwise provided, in this division:
(2) BASIC PLAN- The term `basic plan' has the meaning given such term in section 203(c).


Yeah, right after I stick an ice pick into my right eye and hang my favorite earring off it for decoration.

Ya know, I just don't understand why there aren't more people engaged in the legislative process.




:crazy: :argh: :grr: :nuke: :banghead: :sarcasm:



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midnight Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:30 PM
Response to Original message
1. K&R
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:33 PM
Response to Reply #1
5. Thank you.
Hiccups are welcome, too. :D

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midnight Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:30 PM
Response to Original message
2. oops. Accidental repeat.
Edited on Thu Mar-18-10 03:31 PM by midnight
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:31 PM
Response to Original message
3. And there's 2700 pages like that..


:wow: :crazy:
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:32 PM
Response to Reply #3
4. Yep. Were they to include the text rather than the spaghetti code...
I posit it would be some 20,000 pages.

Of course, right this second my brains are a wee bit scrambled.

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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:35 PM
Response to Reply #4
6. Spaghetti code..
Exactly, perfect description, an incomprehensible collection of Goto and Gosub statements..

You really should post that description as an OP..
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:37 PM
Response to Reply #6
7. I thought about it. Spaghetti code is a rather audience specific phrase.
I wasn't sure how many would get it. LOL

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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:39 PM
Response to Reply #7
8. Wikipedia to the rescue..
http://en.wikipedia.org/wiki/Spaghetti_code

Spaghetti code is a pejorative term for source code which has a complex and tangled control structure, especially one using many GOTOs, exceptions, threads, or other "unstructured" branching constructs. It is named such because program flow tends to look like a bowl of spaghetti, i.e. twisted and tangled. Spaghetti code can be caused by several factors, including inexperienced programmers and a complex program which has been continuously modified over a long life cycle. Structured programming greatly decreased the incidence of spaghetti code.
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:44 PM
Response to Reply #8
11. Perfect! Thanks. n/t
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EFerrari Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:43 PM
Response to Reply #7
10. I like Italian cuisine. Do it!
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:50 PM
Response to Reply #10
13. It'd sure be more entertaining than this little look at
reading legislation.

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NYC_SKP Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:08 PM
Response to Reply #6
18. Western Spaghetti Code.
Tastes like Italian.

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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:18 PM
Response to Reply #18
26. Brought to you with 90% fewer words.
Just sitting here remembering all those films. Watched them all in a short period of time for a class I took.

After going through the bill then thinking of those films, I think I just got brain whiplash.

OW!

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EFerrari Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:43 PM
Response to Original message
9. And I thought "Moby Dick" was a hard slog.
We used to call this padding and obfuscation.

LOL



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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 03:46 PM
Response to Reply #9
12. You don't want to hear what I was calling it as I was searching
and clicking.

I wonder if we put a 25 year moratorium on lawyers in Congress if we could clean up our legislative code.

:evilgrin:

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:00 PM
Response to Original message
14. First, 122 does not equal 123
The standards in question relate to the Advisory Committee and its review of the essential, enhanced and premium plans. The standards in 122 are the bare minimum, but the Admisory Committee and HHS Secretary can adopt benefit plans in excess of those basic standards. It also says in section 124 that the Secretary cannot adopt standards for an essential benefits package that is inconsistent with sections 122 or 123.

I didn't graduate from college, I can understand this, with just another ten minutes of honest perusal.
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:01 PM
Response to Reply #14
16. Then tell us what it says..
What are the minimum requirements?
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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:17 PM
Response to Reply #16
24. They're in the OP
It's really quite clear if you go from 122 to 123 to 124. Click the link in the OP and do it yourself.
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 05:21 PM
Response to Reply #24
33. In other words, you don't know what it says..
Or you could give it in plain English rather than Reverse Polish Beaurocratese..
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:07 PM
Response to Reply #33
35. Hrmph. I always thought it was Reverse Polish Notation.
I copied and pasted "the missing section" below.

I'm not sure what it has to do with the process I went through but I'm sure someone will be along to explain how important it is.

Me? I still can't figure out how much it's going to cost me to avoid a tax penalty.

I guess the vote is Sunday. Maybe by the end of the vote someone will have some real numbers.

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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:26 PM
Response to Reply #35
36. It's RPN when there's actual numbers..
Didn't see too many of those in what you posted..
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:28 PM
Response to Reply #36
37. Psssst. Look closer at who you replied to. (edited)
Edited on Thu Mar-18-10 06:30 PM by Cerridwen
:hi:

edit: or maybe I misunderstood. It's been a long day.

:hi: again

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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:35 PM
Response to Reply #37
38. You misunderstood..
I meant your OP was lacking in actual numbers, not your fault, you copied and pasted..

:hi: backatcha..
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:43 PM
Response to Reply #38
40. Thanks!
Whew! I hate when that happens.

:D

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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:11 PM
Response to Reply #14
20. Who said they did? Hell, I don't remember if I even made it to 123.
Edited on Thu Mar-18-10 04:15 PM by Cerridwen
I was trying to get to minimum requirements.

Spend another 10 minutes and post some fer instances.

Oh, and the "honest" comment. Spit it out.

I posted what I went through to try to find the minimum. You think it's something else. Say it.

edit subject line typo. "I'm don't" Oofduh! Nope; no scrambled brain here.

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:18 PM
Response to Reply #20
25. So you made it to 122 and to 124
But somehow just missed 123??

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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:23 PM
Response to Reply #25
28. Listen, I was looking for something very specific.
What about this are you not understanding?

The advisory committee stuff was not what I was looking for. I was looking for what the bare minimum was so I would have some idea of the costs involved to maintain compliance.

Why the fuck you're trying to make it into some hidden agenda on my part is beyond me.

You don't like what I posted, go do your own work.

People here have been asking about the tax repercussions. I decided to go look. You find something else. Add it. Make your own OP.

But quit trying to make this about some covert attempt on my part, to do whatever the fuck you have in your head.

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:00 PM
Response to Original message
15. hiccup
Edited on Thu Mar-18-10 04:00 PM by sandnsea
dupe
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NYC_SKP Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:06 PM
Response to Original message
17. You saved the rest of us a LOT of work!!! Thanks so much!!!

SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED. {look! look! there it is!}

(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, that--
(1) provides payment for the items and services described in subsection (b) in accordance with generally accepted standards of medical or other appropriate clinical or professional practice;
(2) limits cost-sharing for such covered health care items and services in accordance with such benefit standards, consistent with subsection (c);
(3) does not impose any annual or lifetime limit on the coverage of covered health care items and services;
(4) complies with section 115(a) (relating to network adequacy); and
(5) is equivalent, as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services, to the average prevailing employer-sponsored coverage.
(b) Minimum Services to Be Covered- Subject to subsection (d), the items and services described in this subsection are the following:
(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department 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 in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services, including behavioral health treatments.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well baby and well child care; treatment of a congenital or developmental deformity, disease, or injury; and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:12 PM
Response to Reply #17
21. Maybe. Hopefully. If it's approved.
I'd sure like to know what the hell that's going to cost, though.

I'm not going back in there without a machete and a case of good Uisce beatha (Irish Whiskey).

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:18 PM
Response to Reply #21
27. It costs me and hubby $65.00 a month
With a $500 deductible and very excellent prescription benefits.
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:29 PM
Response to Reply #27
30. Good. Hopefully this will come out like that as well.
Do you have co-pays? Care to share the amounts or percentages?

Not trying to be personal. Trying to suss out costs.

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:40 PM
Response to Reply #30
31. No co-pays, 20% though
I'm lucky in that the nonprofit Catholic system I'm in actually does have a good sliding scale. I do have to work out a payment plan with the lab, but that's about it. No, it's not perfect but it is so much better than anything I ever hoped to have in my life.

My husband just got his one year Hep C screen back. Still clean so it's a 99.9% chance he'll stay clean. I think we paid $40 a month for the medicine that is usually $1,000 a month. The doctor was in the nonprofit system so they didn't charge us any extra. And then the $10 a month I pay to the lab.

I go in Monday for a follow-up mammogram. That's all free. My annual diabetes screen is free.

And if we hadn't had pre-existing conditions, we'd have qualified for a very cheap dental/optical and those issues would be resolved too.

This is a very good first step, if it's done right. I much prefer Kennedy's bill last year because it had more generous subsidies and Medicaid expansion, but we lost that so I hope we move forward before we lose anything else.
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:42 PM
Response to Reply #31
32. Thanks for the additional info.
I appreciate it.

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:16 PM
Response to Reply #17
23. And that is the very basic, Essential Package
The Secretary can't mess with those basic benefits. There will be additional packages offered, and the possibility that the Review Board can add to that Essential Package as well.
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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:10 PM
Response to Original message
19. K&R
Thank you for doing that!

Good grief, you're brave

:-)
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:14 PM
Response to Reply #19
22. Thanks.
LOL

I think there's a fine line between bravery and insanity. I like your take better than what I was thinking.

:rofl:

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Better Believe It Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 04:23 PM
Response to Original message
29. Here's how it will really work in a way everyone, union and non-union alike, will understand.


International Association of Machinists
FOR IMMEDIATE RELEASE

Washington, D.C., January 14, 2010 –

Despite the so-called agreement announced today by various labor organizations, the International Association of Machinists and Aerospace Workers (IAM) reiterated its opposition to any health care reform legislation that is funded by taxing the value of workers’ existing health care benefits.

“The IAM opposes the excise tax, period. We believe it is unfair to our current members and particularly unfair to those members we hope to organize in the future,” said IAM President Tom Buffenbarger. “If a temporary exemption is the best this Congress can offer the American people after the promises of the last election, they will have earned the wrath of voters in the next election."

“By stringing this 'fix' out until 2018, our members will be pressured to agree to benefit cuts year after year in the vain hope they will be able avoid the excise tax. Companies will seek to shift costs while still cutting benefits to avoid eight years of health care premiums accelerating at fifteen to twenty percent per year.

“This is a huge ping pong ball that our elected leaders are trying to shove down the throats of hard-working Americans,” said Buffenbarger. “On the installment plan or all at once, a 40 percent excise tax on their health care benefits is hard to swallow. But the White House and the House and Senate Democratic leadership appear determined to play ping pong with this legislation until they get the votes they need.

“We will continue our opposition to this egregiously unfair tax.”

The IAM is among the largest industrial trade unions in North America, representing nearly 700,000 active and retired members in dozens of industries.

http://www.goiam.org/index.php/news/press-releases/6708-machinists-remain-opposed-to-health-care-excise-tax
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 05:21 PM
Response to Original message
34. Kick and the infamous Sec. 123
SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.

(a) Establishment-
(1) IN GENERAL- There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
(2) CHAIR- The Surgeon General shall be a member and the chair of the Health Benefits Advisory Committee.
(3) MEMBERSHIP- The Health Benefits Advisory Committee shall be composed of the following members, in addition to the Surgeon General:
(A) 9 members who are not Federal employees or officers and who are appointed by the President.
(B) 9 members who are not Federal employees or officers and who are appointed by the Comptroller General of the United States in a manner similar to the manner in which the Comptroller General appoints members to the Medicare Payment Advisory Commission under section 1805(c) of the Social Security Act.
(C) Such even number of members (not to exceed 8) who are Federal employees and officers, as the President may appoint.
The membership of the Committee shall include one or more experts in scientific evidence and clinical practice of integrative health care services. Such initial appointments shall be made not later than 60 days after the date of the enactment of this Act.
(4) TERMS- Each member of the Health Benefits Advisory Committee shall serve a 3-year term on the Committee, except that the terms of the initial members shall be adjusted in order to provide for a staggered term of appointment for all such members.
(5) PARTICIPATION- The membership of the Health Benefits Advisory Committee shall at least reflect providers, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies. and at least one practicing physician or other health professional and an expert on children's health and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee. The membership of the Committee shall also include educated patients, consumer advocates, or both, who shall include persons who represent individuals affected by a specific disease or medical condition, are knowledgeable about the health care system, and have received training regarding health, medical, and scientific matters.
(b) Duties-
(1) RECOMMENDATIONS ON BENEFIT STANDARDS- The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services (in this subtitle referred to as the `Secretary') benefit standards (as defined in paragraph (4)), and periodic updates to such standards. In developing such recommendations, the Committee shall--
(A) take into account innovation in health care,
(B) consider how such standards could reduce health disparities,
(C) take into account integrative health care services, and
(D) take into account typical multiemployer plan benefit structures and the impact of the essential benefit package on such plans.
(2) DEADLINE- The Health Benefits Advisory Committee shall recommend initial benefit standards to the Secretary not later than 1 year after the date of the enactment of this Act.
(3) STATE INPUT- The Health Benefits Advisory Committee shall examine the health coverage laws and benefits of each State in developing recommendations under this subsection and may incorporate such coverage and benefits as the Committee determines to be appropriate and consistent with this Act. The Health Benefits Advisory Committee shall also seek input from the States and consider recommendations on how to ensure that the quality of health coverage does not decline in any State.
(4) PUBLIC INPUT- The Health Benefits Advisory Committee shall allow for public input as a part of developing recommendations under this subsection.
(5) BENEFIT STANDARDS DEFINED- In this subtitle, the term `benefit standards' means standards respecting--
(A) the essential benefits package described in section 122, including categories of covered treatments, items and services within benefit classes, and cost-sharing; and
(B) the cost-sharing levels for enhanced plans and premium plans (as provided under section 203(c)) consistent with paragraph (5).
(6) LEVELS OF COST-SHARING FOR ENHANCED AND PREMIUM PLANS-
(A) ENHANCED PLAN- The level of cost-sharing for enhanced plans shall be designed so that such plans have benefits that are actuarially equivalent to approximately 85 percent of the actuarial value of the benefits provided under the reference benefits package described in section 122(c)(3)(B).
(B) PREMIUM PLAN- The level of cost-sharing for premium plans shall be designed so that such plans have benefits that are actuarially equivalent to approximately 95 percent of the actuarial value of the benefits provided under the reference benefits package described in section 122(c)(3)(B).
(7) RECOMMENDATIONS OF INTEGRATIVE HEALTH CARE SERVICES TASK FORCE-
(A) INCLUSION IN COMMITTEE'S RECOMMENDATIONS- The Health Benefits Advisory Committee shall include in its recommendations under paragraph (1) the recommendations made by the Integrative Health Care Services Task Force established under subparagraph (B).
(B) ESTABLISHMENT OF TASK FORCE- The Health Benefits Advisory Committee shall establish an Integrative Health Care Services Task Force. Such Task Force shall consist of 5 experts with expertise in research in, and practice of, integrative health care. Such experts shall be appointed by the Committee from among experts nominated by the Secretary, in consultation with the National Center for Complementary and Alternative Medicine at the National Institutes of Health. The duty of the Task Force shall be to make recommendations to the Committee on evidence-based, clinically effective, and safe integrative care services.
(c) Operations-
(1) PER DIEM PAY- Each member of the Health Benefits Advisory Committee shall receive travel expenses, including per diem in accordance with applicable provisions under subchapter I of chapter 57 of title 5, United States Code, and shall otherwise serve without additional pay.
(2) MEMBERS NOT TREATED AS FEDERAL EMPLOYEES- Members of the Health Benefits Advisory Committee shall not be considered employees of the Federal government solely by reason of any service on the Committee.
(3) APPLICATION OF FACA- The Federal Advisory Committee Act (5 U.S.C. App.), other than section 14, shall apply to the Health Benefits Advisory Committee.
(d) Publication- The Secretary shall provide for publication in the Federal Register and the posting on the Internet website of the Department of Health and Human Services of all recommendations made by the Health Benefits Advisory Committee under this section.


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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:37 PM
Response to Reply #34
39. I don't see any actual numbers in this either..
Makes it hard to figure out something mathematically when there are no numbers to work with.

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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 06:46 PM
Response to Reply #39
41. I did find some, but they weren't really answering my initial question.
Mostly percentages having to do with federal poverty levels. I haven't/didn't find plan costs.

I guess the insurance companies will let us know what those are once the bill has passed.

There goes my budget.

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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-18-10 08:28 PM
Response to Original message
42. Evening kick.
:kick:

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glitch Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 12:11 PM
Response to Original message
43. Reads like something you'd get from your insurance company.
Or maybe the contraindications list on your pharmaceutical. How strange.
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 01:40 PM
Response to Reply #43
44. Or a piece of legislation written by...
Well, hell, who wrote it?

I joked upthread(?) that we should put a moratorium on lawyers running for Congress. It might lead to some less convoluted language in our legislation. I'm not holding my breath. :D

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Max Stein Donating Member (10 posts) Send PM | Profile | Ignore Fri Mar-19-10 02:10 PM
Response to Original message
45. Good info
Thanks
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Cerridwen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 03:14 PM
Response to Reply #45
46. TSed after posting in my thread.
I hope that's correlation and not causation. LOL

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