Great things added in the final Reid package

[Kurt_and_Hunter]

Spin lesson:

It is implied here that all the things listed are new improvements just added to the senate bill to make it better. "These improvements were bundled together in what’s called a manager’s amendment – and here are some of the highlights:"

Really? Are these all actually last-minute additions? Maybe so, but if so the previous bill must have really sucked! Why were we being encouraged to support a bill that, as of three days ago, supposedly didn't have any of this stuff in it?

...But bringing down the deficit and expanding coverage are only part of what insurance reform will do. And today the Senate introduced a package of changes to their bill that will make critical progress in ensuring competition, providing affordable choices, and holding the insurance companies accountable. These improvements were bundled together in what’s called a manager’s amendment – and here are some of the highlights:

* Penalizing insurers for unfair rate hikes. If insurers who arbitrarily jack up rates before the exchanges come online, they won’t be allowed to participate in them – they’ll miss the opportunity to compete for millions of new customers. That creates a strong incentive to keep premiums low before the exchanges are up and running in 2014.
* Making sure your money goes toward care, not administrative costs. Insurers will be required to spend a greater portion of your premium on the care you receive, rather than administrative costs or salaries. And if they don’t, they’ll have to pay you a rebate.
* Ending discrimination based on pre-existing conditions. Once the exchanges are open in 2014, insurance companies will no longer be able to deny you coverage because you have a pre-existing condition. In the meantime, the legislation immediately creates a high-risk pool where adults with pre-existing conditions can purchase affordable coverage. And for families with kids, the news is even better: insurers will immediately be prohibited from denying coverage to kids with pre-existing conditions. Period.
* Protecting your access to care. Lifetime limits on benefits will be banned right away.
* Annual limits will also be banned once the exchanges are up and running. The manager’s amendment ensures that in the meantime, the use of annual limits will be tightly restricted until we can do away with this unfair practice entirely.
* More help for small business. The bill now includes additional help for small businesses. The health insurance tax credit for small businesses will now start in 2010, eligibility for the credit will be expanded, and small businesses will see improved purchasing power to make sure employees are getting good coverage at a good value.
* Choice and competition. Insurers will now offer multi-state plans under the supervision of the Office of Personnel Management. That means more choice and more competition in your state.
* Focusing on quality, not quantity. Health care providers will be reimbursed by Medicare for the quality of care, not just the quantity of tests and treatments. Shifting the way we reimburse for care is one of the most important things we can do to rein in spiraling health care costs – and it means a renewed focus on what’s best for the patient.

http://www.whitehouse.gov/blog/2009/12/19/making-a-good-bill-even-better

[Frances]

1. I don't mean to be sarcastic

but with Christmas nearing, I have a question: When you got a new bike, did you complain because it didn't have this or that or the other?

[readmoreoften]

3. If it was a bike made out of feces, I'd complain no matter what the chrome accessories.

The American Taxpayers are not children. This is OUR MONEY.

Don't buy me a shit bike with my own money and tell me to like it.

[gardenista]

23. Feces bike! Now there is a fun image!

What a compelling metaphor. This one has legs, keep working it!

[Sebastian Doyle]

31. Don't think I've ever seen a shit bike

But I have seen a poo-choo train!




Howdy Ho, Insurance whores!!

Mr. Hemsley the Christmas Poo?

[johnaries]

2. It doesn't matter WHEN they were added. Only that they are in

the final bill.

I still have trouble supporting a mandate without a Public Option, but it cannot be denied that there are a lot of important things in this bill. I still support the House bill and hope the joint bill resembles it. But whatever happens I will look at both the good and the bad.

[secondwind]

12. I AGREE.

[texanwitch]

4. If and when they get added it will because the White House knows how pissed off Americans are now

They will try to save face by saying they planned it all along.

I am not buying it.

If they wanted it they would have stood for to begin with.

They will have to earn my trust again.

[tblue]

21. Thank you.

You nailed it. It's the lost trust that has been so devastating and, IMHO, unnecessarily so. Not so much each individual stab in the heart (from Rick Warren to John Yoo), but the relentless succession of bad choices leave very little reason to trust that this administration is really on our side. I never dreamed I'd feel this way about a Democratic administration, dammitalltohell. Like you, my trust has been shattered and it's on the president to win it back.

[texanwitch]

25. This is so hard for me to say I don't trust the Democratic administration.

I grew up in a Democratic family.

I am a democratic precinct judge and chair.

I remember last year working the primary in 2008 at early voting.

We had such a huge crowd every day, the line was long before we opened the polls.

So many excited people waiting for 2 or 3 hours to vote.

People who had never voted came, many young people.

They were voting for a change, not the same old crap.

I am very worried for 2010, it might a repeat of 1994 under President Clinton.

I didn't vote for this.

[eleny]

5. Screw "incentives" to keep premiums at a fair level - make them do it

So some of us will get to pay wild rate hikes and hope somebody notices and takes some action. How long will that take? I'd laugh if this wasn't so upsetting.

[tridim]

9. Can the Federal government directly set prices in the private sector?

I assume it's unconstitutional since it would be considered fascist.

Like it or not, incentives are the only way.

[eleny]

10. Not true

The bill already says that they can charge older people 3 times what they charge younger people. That's rate setting in any language.

[tridim]

14. What's not true?

The Federal government can not, and should not dictate retail prices. I wouldn't want to live in a country that did that.

[eleny]

19. Utility companies in some parts of the country are already regulated by government

Xcel energy here in Colorado is regulated by a utility commission. So you already live in such a country.

I don't care if it's the Fed who controls the rates so long as it isn't a hide and seek game like what we evidently have coming on the horizon.

[tridim]

20. Utility companies are regulated monopolies.

That's certainly a problem with insurance in some states, but thankfully the HC exchange addresses it.

[eleny]

26. Yeah, while it throws people my age over a barrel for a royal porking

[treestar]

17. How much more do older people pay now?

Obviously it would be more expensive for older people.

[eleny]

18. That's what I'm so concerned about

I'd be glad to pay some more if everyone was covered in a Medicare for all type insurance. But as it's written, we now get to pay quite a bit more.

[burning rain]

6. "A strong incentive to keep premiums low"...

Um, they're low? OK, good rosy-glasses people!

[Deja Q]

7. K&R #12

Pity the start date is 2 years after doomsday (2012), but it sounds nice. And with that start date, any president coming in will be able to demolish it, but it's all good.

[FrenchieCat]

8. I liked your OP better before you edited to add your OP spin.

Too bad...cause when I read your original OP, in where you said much less of your opinion,
I thought you finally had something constructive that you would let speak for itself,
and that wasn't a back door cynical sneak attack of this administration,
as I have started to expect from you each time you post.

I gave you a rec initially,
but know that upon your edit,
I would note that I was bamboozled into it.

Guess you'll take them anyway that you can get them, hey? :shrug:

[tridim]

11. That was a pretty slick bait and switch.

My rec is only for the article.

[FrenchieCat]

13. I'm sure poster is proud, and will do this more often......

and so we are therefore warned.

[gardenista]

24. When you can't win fair and square...

The quick edit is your friend. For one or two posts, that is...

[Kurt_and_Hunter]

30. Wrong. You obviously don't know what the edit was.

The OP was posted originally to point out a facile lie in the WH PR effort.

When a lot of silent recs rolled in fast (as pro-administration recs usually do) it was plain to me that a lot of people were not taking the time to understand the OP but were just reflex-reccing.

Out of compassion for those folks I edited the OP to make the point of it more unmistakable.

But no meaning was changed.

Recc'ers were recc'ing an OP they didn't bother to read and now complain that it wasn't what they thought they were recc'ing... that's par for the course.

[gardenista]

22. I value the quoted material in this OP. But won't K & R because of edit

Too bad.

[frazzled]

15. Here is what was added to the Senate bill in the Manager's Amendment

So that means it's in the bill. It's the way the Senate works, not some "trick" or promise. It's in the bill that will be voted on (and the amendments cannot be filibustered):

http://democrats.senate.gov/reform/managers-amendment.pdf

An explanation of what's in it from Ezra Klein:

http://voices.washingtonpost.com/ezra-klein/2009/12/change_to_the_senate_bill.html

Here's the summary document Reid's office is sending around on the changes in the manager's amendments. I've bolded the bits I think are important.

Tougher Accountability Policies for Health Insurance Companies

• Stronger medical loss ratios. Health insurers will be required to spend more of their premium revenue on clinical services and quality activities, with less going to administrative costs and profit – or else pay rebates to policyholders. These more rigorous limits will continue even after the Exchanges begin in 2011, and apply to all plans, including grandfathered plans.

• Accountability for excessive rate increases. A health insurer’s participation in the Exchanges will depend on its performance. Insurers that jack up their premiums before the Exchanges begin will be excluded – a powerful incentive to keep premiums affordable.

• Immediate ban on preexisting condition exclusions for children. Health insurers will be immediately prohibited from excluding coverage of preexisting conditions for children.

• Patient protections. Health insurers will have to abide by a set of patient protections that, for example, protect choice of doctors and ensure access to emergency care.

• Ensuring access to needed care. The use of annual limits on benefits will be tightly restricted to ensure access to needed care immediately, and will be prohibited completely beginning in 2014.

• Guaranteed opportunity to appeal coverage denials. All health insurers will be required to implement an internal appeals process for coverage denials, and states will ensure the availability of an external appeals process that is independent and holds insurance companies accountable.

Stronger Policies to Make Health Care Affordable

• Innovation. Medicare will be able to test new models and, if successful, implement them via a stronger Innovation Center, Independent Payment Advisory Board, and other authorities.

• Transparency. New requirements will ensure that insurers and health care providers report on their performance, empowering patients to make the best possible decisions.

• Small businesses. A package of improvements include starting the health insurance tax credit in 2010, expanding eligibility for the credit, and improving the buying power of small businesses.

More Health Insurance Choices

• Multistate option. Health insurance carriers will offer plans under the supervision of the Office of Personnel Management, the same entity that oversees health plans for Members of Congress. At least one plan must be nonprofit, and the plans will be available nationwide. This will promote competition and choice.

• Free choice vouchers. Workers who qualify for an affordability exemption to the individual responsibility policy but do not qualify for tax credits can take their employer contribution and join an exchange plan.

Improved Access to Quality Health Care for Seniors, Children, and Vulnerable Populations

• Quality of care in Medicare. Seniors will benefit when additional health care providers are reimbursed by Medicare for the quality of care they deliver, not the quantity of services they provide.

• Children’s health. Support will be extended for the Children’s Health Insurance Program and the adoption tax credit. Foster care children aging out of Medicaid will be able to retain its comprehensive coverage.

• Community Health Centers. A substantial investment in Community Health Centers will provide funding to expand access to health care in communities where it is most needed.

• Rural and underserved communities. Access will be expanded through funding for rural health care providers and training programs for physician and other types of health care providers.

• Vulnerable populations. A range of new programs will tackle diseases such as cancer, diabetes and children’s congenital heart disease, will improve the Indian Health System and will provide support for pregnant teens and victims of domestic violence.

Identifying Alternatives to Litigation

• Testing new models. States will be eligible for grants to test alternatives to civil tort litigation that emphasize patient safety, disclosure of health care errors, and early resolution of disputes, with a provision for patients to opt-out of these alternatives at any time. Alternatives will be evaluated to determine their effectiveness.

[treestar]

16. This falls into the category: if you can't stand the sight of sausage being

made, don't watch.

If these things are good, then why complain about how they get in?

[m448]

27. it's sour grapes

really

[grantcart]

28. In my opinion they are doing an excellent job of burying the lead

OPM will be contracting for individual plans and will have control over price, coverage and profit.


States can increase the MLR.


There's a lot of good in this bill.

[eridani]

29. I suppose that the insurance companies will define "unfair rate hikes"

And if high risk poos insurance is "affordable," it's a piece of shit that doesn't cover much by definition.