HR3200 : Division A : Day Three : Part One

People amaze me. Over the course of the past two days I have received half a dozen emails from people regarding HR 3200. Why do people think I am against health care reform just because I do not support this bill? I know our current system is flawed. I know our current system needs work. I also know that completely overhauling and replacing our current system, as this bill does, is a ludicrous idea.

The whole idea of reform is to improve upon something, or to change what is wrong with something. When you reform something, or someone, you improve it/them by alteration, substitution or abolition. The key word in reform, is improve.

I’ve yet to see one item in “America’s Affordable Health Choices Act of 2009“, the health care reform bill, that improves anything already in place within our current system. I see where it is going to complicate a lot of things and I see where it’s going to place additional burden on all Americans. I see that it is going to require us to give up some of our personal liberties (such as privacy and financial information), and I see that costs are going to skyrocket. All this, and I’ve covered less than a hundred pages with you. There isn’t much reason to be optimistic in the remaining 900 pages either.

In Division A, Title II, Subtitle A, Section 201, we learn that the “Health Choices Administration”, under the direction of our now famous “Commissioner”, will

facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.

At this point we finally learn what the “Commissioner’s” duties will be, and the “Health Insurance Exchange” is defined. The “Exchange” includes any qualified health benefits plan operating under the health care plan. It sounds to me like this puts private and employer-based health care plans under the government control (else they would not be allowed to participate in the “Exchange” would they).

Section 202 defines “exchange eligible” individuals and employers, how and when they can enroll, and how they will be covered.

Section 203 sets the benefits package levels and states,

The Commissioner shall specify the benefits to be made available under Exchange-participating health benefits plans during each plan year, consistent with subtitle C of title I and this section.

I guess I don’t have to remind you that any benefits package you choose, whether it comes from the soon to be “regulated out of existence” private health care plans to the government created plans, will be defined by the “Commissioner”.

Section 203 goes on to define the requirements for offering basic, enhanced and premium plans as well as repeat the fact that the “Commissioner” will also set the individual benefit levels for each benefit plan.

By giving the “Commissioner” the authority to set the benefit levels for each plan, each year, the bill sets the stage to allow for health care rationing.

As I discussed yesterday, the “no annual or lifetime limits” clause of this bill will send costs skyrocketing, and the only way to control those costs will be to ration the amount of care provided, and as a result, the amount of money spent on health care. Of course, the word ‘rationing’ does not appear in the bill, but Section 203 sets the stage so the “Commissioner” can authorize it without approval of the President, Congress, or the citizens of the United States.

Section 204 defines the contracts for offering exchange-participating health benefits plans. Whew, that’s a mouthful. If you think this 1,018 page bill is intimidating you should wait to see some of the “contracts” that will come out of the “Exchange”.

Section 205 covers the outreach and enrollment of individuals and employers in the exchange-participating health benefits plan.

The Commissioner shall conduct outreach activities consistent with subsection (c), including through use of appropriate entities as described in paragraph (4) of such subsection, to inform and educate individuals and employers about the Health Insurance Exchange and Exchange-participating health benefits plan options. Such outreach shall include outreach specific to vulnerable populations, such as children, individuals with disabilities, individuals with mental illness, and individuals with other cognitive impairments.

Which entities will be considered “appropriate”? Which organizations will be utilized to reach the “vulnerable populations”? Exactly which part of the population is considered “vulnerable” under this plan? It sounds to me like community organizations like ACORN could be tapped for something like this. Maybe Obama will use AmeriCorp resources. Would that be appropriate? Section 205 sure leaves a huge loophole for any number of circus acts (organizations favorable to the “Commissioner” or the administration) to jump through.

Section 205 also allows the “Commissioner” to automatically enroll any Medicaid eligible individual unto 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.

I thought President Obama said this health care “reform” was about keeping our freedom to choose our health care benefits? I thought, if we were happy with our current plan we could keep it? I guess that promise doesn’t apply if you are self-employed, insured through an employer, elderly, unemployed, or eligible for Medicaid. President Obama should really put an asterisk after his statements.

“You can keep your current plan, asterisk”. Then they could use that guy that speaks after every automobile commercial (you know, since he’s a government employee now too), to voice the actual disclaimer and everything, so.

Section 206 sets “other functions” such as the coordination of affordibility credits, coordination of risk pooling, and establishment of yet another new government position as well as the duties for that position.

There is hereby established the Office of the Special Inspector General for the Health Insurance Exchange, to be headed by a Special Inspector General for the Health Insurance Exchange (in this subsection referred to as the “Special Inspector General”) to be appointed by the President, by and with the advice and consent of the Senate.

So, in review, we have created a new “Health Choices Administration” with a “Commissioner” who heads that administration and sets the definitions and requirements for all of our health care plans, as well as the benefit levels of those plans. We have created a new “Qualified Health Benefits Plan Ombudsman” who will receive complaints and grievances, and submit annual reports to Congress and the “Commissioner”. We have created a new office, the Office of the Special Inspector General for the Health Insurance Exchange which will be headed by the “Special Inspector General for the Health Insurance Exchange”.

The “Special Inspector General” will conduct, supervise, and coordinate audits while reporting to both the “Commissioner” and Congress.

Section 207 establishes the Health Insurance Exchange Trust Fund (think Social Security Trust Fund and you’ll pretty much understand this whole section). Haven’t politicians been talking about fixing Social Security for years now? Isn’t Social Security going broke? What makes them think an additional trust fund set up the same way will work this time around?

Section 207 also sets the stage for additional taxes. What? You thought this was going to be free? The only way to fund the health insurance trust fund will be raising taxes. Of course the text of the bill won’t specify it, but how do you think these government trust funds are funded?

In addition to the normal additional taxes you’ll already be paying to cover the cost of this health care bill, if you do not obtain acceptable coverage, or as an employer you do not provide acceptable coverage, you will pay additional taxes.

There is hereby appropriated to the Trust Fund amounts equivalent to the following:

(A) Taxes on individuals not obtaining acceptable coverage.—The amounts received in the Treasury under section 59B of the Internal Revenue Code of 1986 (relating to requirement of health insurance coverage for individuals).

(B) Employment taxes on employers not providing acceptable coverage.—The amounts received in the Treasury under section 3111(c) of the Internal Revenue Code of 1986 (relating to employers electing to not provide health benefits).

(C) Excise tax on failures to meet certain health coverage requirements.—The amounts received in the Treasury under section 4980H(b) (relating to excise tax with respect to failure to meet health coverage participation requirements).

As a small business owner, I won’t have a choice. I won’t be able to afford the government’s new definition of “acceptable coverage” for my smallest of companies, so I am sure I will be paying an additional tax. My wife owns her own small business as well, she won’t be able to afford the government’s new definition of “acceptable coverage” either, so in addition to the additional tax on her as an employer, she’ll also be paying an additional excise tax.

Section 208 removes a States right to offer their own State-based health insurance.


(1) a State (or group of States, subject to the approval of the Commissioner) applies to the Commissioner for approval of a State-based Health Insurance Exchange to operate in the State (or group of States); and

(2) the Commissioner approves such State-based Health Insurance Exchange,

then, subject to subsections (c) and (d), the State-based Health Insurance Exchange shall operate, instead of the Health Insurance Exchange, with respect to such State (or group of States). The Commissioner shall approve a State-based Health Insurance Exchange if it meets the requirements for approval under subsection (b).

The “Commissioner” must approve any State-based “Exchange”, therefore denying States rights granted under the U.S Constitution.

The 10th Amendment to the U.S. Constitution states,

The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.

The U.S. Constitution does not give the United States (the feds) the authority to regulate health care within the borders of the States, and it also doesn’t prohibit the States from doing so, therefore, the United States (the feds) can not legally decide what the States can and cannot do in regard to health care. There is no right side or left side of this argument, it’s written in the Tenth Amendment to the U.S. Constitution.

Who knew reform included completely replacing our current system, creating additional bureacracy, violating the privacy of all Americans, taking away freedoms from all Americans, placing an unfair additional tax burden on a specific group of citizens and violating the U.S. Constitution?

When Barack Obama said he was going to bring fundamental change to America, he wasn’t kidding, was he?

I’ll pick up with Division A, Title II, Subtitle B later today.

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