September 16th, 2009 by B

Author: Andrey Rakhmatullin

Anyone living in the US and territories of the US will be covered under the United States National Health Care (USNHC) and will be given universal “best quality standard of care.” Everyone will receive a card containing a unique number after filling out the United States National Health Insurance form. Coverage of additional benefits, such as cosmetic, not covered under this bill may be sold individually.

Only public or not-for- profit institutions may participate in this program. A for-profit provider switching to not-for-profit will remain privately owned and will be compensated for the switch within a 15 year time frame. For-profit centers will be restricted from being investor owned. Patients will have the ability to choose from the participating physicians, facilities, and hospitals.

At the beginning of each month, this program will pay each provider of health care a lump sum based upon the developed budget. A “simplified fee schedule” will be created to pay doctors, nurses, psychologist, optometrist, and other providers of health care. A uniform payment will be created, regardless of location, to pay professionals (doctors, pharmacists, and other) according to their expertise. H.R. 676 was referred to the House of Representatives.

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August 31st, 2009 by B

Author: les sanders

Regarding Hospital Readmission (Sec. 1151):
The Secretary will reduce payments given to applicable hospitals (those which may have been able to receive $10 million or more) for excess readmissions. The Secretary will have full control in creating readmission rate measurements for hospitals. Physicians who treat patients and go for readmission will be given reduced pay as well. The amount of $25 million, beginning in 2010, will be given to the Secretary of Health and Human Services for the Center for Medicare and Medicaid Services Program Management Account for the section of this bill.

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August 27th, 2009 by B

Author: Keith Frith

Tax on Individuals (Title IV, Sec. 441):
A tax will be imposed on the modified adjusted gross income of a taxpayer for the following income: between $350,001 and $500,000 is an increase of one percent, between $500,001 and $1 million is an increase of 1.5 percent, and over $1 million is an increase of 5.4 percent.

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August 25th, 2009 by B

Author: Albert Lozano

Employer Regulations (Title III, Sec. 806):
An employer who provides health coverage participation but fails to meet the requirements will be fined $100 each day until the requirement is fulfilled.

Employers who Chose to not Provide Government Health Coverage (Title IV, Sec. 412):
An excise tax of up to 8 percent of the wages paid to employees will be imposed upon an employer for not offering qualified health coverage.

Tax on Individuals who do not Accept Health Coverage (Title IV, Sec. 59B):
A person who does not have private health coverage (no one may sign up after the bill goes into effect) or is not on any form of government health care will be fined 2.5 percent of their modified adjusted gross income.

Health Insurance Coverage Returns (Title IV, Sec. 6050X):
Any individual providing coverage to any other person will file a return with certain information the Secretary will require. There will be a penalty for failing to file.

Taxpayer Income Information (Title IV, Sec. 431):
The Secretary may divulge the return information of any taxpayer to the officers and employees of the Health Choices Administration. The information used will be what the Secretary deems necessary. This information is to be used for determining affordability credit.

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August 24th, 2009 by B

Author: Keith Frith

Subsidies (Title II, Sec. 241):
Under this bill, the third year of government health care will allow individuals below the 400 percent poverty level and who are not eligible for Medicare, to received government subsidies to partake in the premium plan health insurance.

Employer Responsibility (Title III, Part 1, Sec. 311 & 312):
An employer is to offer a qualified health benefits individual plan and family plan. An employee is to be automatically enrolled in a health-benefits plan, but has the option to opt-out. The employer is to make a minimum contribution on the applicable premium up to 72.5 percent for the individual plan, and a minimum of 65 percent for family plans. The premiums range from 1.5 percent to ten percent. Eight percent of the average wages paid by the employer (this is added onto the premium being paid by the employer) will be deposited into the Health Insurance Exchange Trust Fund. The employer will provide the Health Choice Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury any information the Commissioner requires.

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August 22nd, 2009 by B

Author: Keith Frith

Taxes (Title II, Sec. 207):
A trust fund will be created for the health insurance exchange program. The amount of money given to this fund will be what Congress deems necessary. Part of the trust fund money will be taken from taxes on individuals who do not obtain health insurance deemed acceptable under this bill. Also, employers who do not provide acceptable coverage will be taxed.

State Insurance Exchange (Title II, Sec. 208):
A State may opt to apply for a State-based Health Insurance Exchange. The Commissioner may deny the application until it is determined the State meets certain requirements of the Commissioner.

Start-up Cost (Title II, Sec. 222):
Before collection of premiums, the US Treasury will provide $2 billion for creating the public health insurance option. This money is to be payed back over a 10 year period.

Rates for Physicians & other Professionals(Title II, Sec. 223):
The Secretary of Health and Human Services will set the payment rates of health care providers, physicians, and other health care professionals who participate in Medicare and the public insurance option. The rates will be similar to what Medicare pays.

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August 21st, 2009 by B

Author: Keith Frith

Concerning Retirees (Title I, Sec. 164):
A temporary $10 billion Retiree Reserve Trust Fund will be created to pay for retirees (55 or older and not on social security) through an employer health care plan. A claim exceeding $15,000 and less than $90,000 will be reimbursed up to 80 percent for the retiree. The trust fund will be used until the money is gone.

Concerning Children and Newborns (Title II, Sec. 205):
Any child born in the US may be enrolled in non-traditional Medicaid (normally has a higher copayment and fewer benefits). The child then may be enrolled under Medicaid after 60 days. If this bill passes, an eligible child for health assistance under the Social Security Act will automatically become part of the Health Insurance Exchange offered by the government.

Concerning Medicaid (Title II, Sec. 205):
Anyone who does not wish to take part in the exchange program the government is offering may instead use Medicaid. Those eligible for Medicaid will receive the proper benefits, and those not eligible for Medicaid will receive the non-traditional benefits.

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August 20th, 2009 by B

Author: Keith Frith

Concerning Monetary Contributions (Title I, Sec. 122):
An individual may have up to $5,000, and a family may have up to $10,000 in medical expenses before contributions toward medical insurance has to be paid. This amount will go up by $100 each year and will be based on the Consumer Price Index.

Concerning the Health Choices Commissioner (Title I, Sec. 142, sect. c):
To protect consumers, to promote quality and value, and to fulfill certain requirements, the Health Choices Commissioner will collect certain data and share this with the Secretary of Health and Human Services (the data being collected is not clearly stated).

Regarding Health Care Providers (Title I, Sec. 2746):
If a health insurance provider decides to drop the coverage of an individual, a notice will be provided, and a third party review may be given. The coverage will be provided until the third party concludes a review.

Help for Certain Providers (Title I, Sec. 1173A, sect. c & d):
Incentives will be given to health care providers if they participate in setting a standard for electronic transactions.

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August 19th, 2009 by B

Author: Lisa Eastman

The essential benefits package is health coverage based on the recommendations of the Health Benefits Advisory Committee. The Health Benefits Advisory Committee is a private-public advisory committee which will consist of the Surgeon General as the leader, nine members (not Federal employees) who are appointed by the President, nine members (not Federal employees) who are appointed by the Comptroller General (director of the Government Accountability Office), and up to eight more members (Federal employees) appointed by the President.

The essential benefits package will do the following: pay for the minimum health services, limit employee health care contributions, ensures provider networks follow the standards set forth by the Health Choices Commissioner, does not enforce annual or lifetime limit on covered health care services, and confirms the employer-sponsored health insurance is on par with Medicare and Medicaid services.

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August 18th, 2009 by B

Photographer: jynmeyer

This summary is under Title I, Sec. 101-116 of the bill H.R. 3200. Under this bill, a qualified health benefit provider must meet these requirements:

• Excluding pre-existing conditions will not be permitted.
• In the case of non-payment and discontinuation of coverage, the health insurance provider must send a notice stating the payments due, and a grace period for a customer to pay.
• The premium rate may not change except for age, geographical area, and family enrollment.
• Those with mental health issues and those prone to substance abuse must be given, at the very least, the minimum amount of coverage.
• For the insurance plans that use a provider network, certain requirements must be met according to what the Health Choices Commissioner (appointed by the President with consent from the Senate) deems necessary.
• The Commissioner will set a medical loss ratio (money spent directly on medical expenses) each year. Every year this ratio is unsuccessful, the qualified insurance providers must give a rebate to those enrolled under their plan.
• The Secretary of Health and Human Services will determine what equates an essential benefits package (the minimum amount of benefits) for use with various insurance options.

Although an individual may keep their current health insurance plan, providers may not give coverage to new customers once this bill is sent in motion. A health insurance provider may not change any terms or conditions it has created, including benefits or contributions. The provider may not increase premiums for a risk group of customers, unless it raises the premium for everyone in the group to the same rate. An employment-based health plan has five years to meet the same requirements as a qualified health benefits plan. H.R. 3200 has been referred to the House of Representatives.

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