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Monday, March 29, 2010

Stupid Congress Critter AND President Tricks II

Okay, one of the things claimed about HCR was that kids with pre-existing conditions would get immediate protection. In part, this was true. There is a provision in the law banning pre-existing condition clauses for children for plan years starting six months after passage (September, now).

But this was oversold; the reality is that insurance companies don't have to write coverage for sick children and can charge to cover the cost of the coverage if they do.

So now the NY Times sails into action claiming that this was an oversight. But it WASN'T. And also the White House is talking about fixing this through regulation, which it cannot:
A White House spokesman said the administration planned to issue regulations setting forth its view that “the term ‘pre-existing’ applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.”
I have serious concerns about an administration which is talking this way, because....

Here's an earlier take which quotes critter staffers:
Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

However, if a child is accepted for coverage, or is already covered, the insurer cannot exclude payment for treating a particular illness, as sometimes happens now. For example, if a child has asthma, the insurance company cannot write a policy that excludes that condition from coverage. The new safeguard will be in place later this year.

Full protection for children would not come until 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation.
The section that establishes the early date for children:
(e) Section 1253 of this Act is amended insert before
15 the period the following: ‘‘, except that—
16 ‘‘(1) section 1251 shall take effect on the date of
17 enactment of this Act; and
18 ‘‘(2) the provisions of section 2704 of the Public
19 Health Service Act (as amended by section 1201), as
20 they apply to enrollees who are under 19 years of age,
21 shall become effective for plan years beginning on or
22 after the date that is 6 months after the date of enact
23
ment of this Act.’’.
Section 2704:
1 (1) in section 2704 (42 U.S.C. 300gg), as so re
2
designated by section 1201(2)—
3 (A) in subsection (c)—
4 (i) in paragraph (2), by striking
5 ‘‘group health plan’’ each place that such
6 term appears and inserting ‘‘group or indi7
vidual health plan’’; and
8 (ii) in paragraph (3)—
9 (I) by striking ‘‘group health in
10 surance’’ each place that such term ap
11 pears and inserting ‘‘group or indi
12 vidual health insurance’’; and
13 (II) in subparagraph (D), by
14 striking ‘‘small or large’’ and inserting
15 ‘‘individual or group’’;
16 (B) in subsection (d), by striking ‘‘group
17 health insurance’’ each place that such term ap18
pears and inserting ‘‘group or individual health
19 insurance’’; and
20 (C) in subsection (e)(1)(A), by striking
21 ‘‘group health insurance’’ and inserting ‘‘group
22 or individual health insurance’’;
23 (2) by striking the second heading for subpart 2
24 of part A (relating to other requirements);
Section 300gg relates to pre-existing health condition exclusions only. Section 300gg-11 of 42 USC contains the provisions about guaranteed enrollment. Both are modified by the reform bill, but only the changes to 300gg take effect for children after six months.

There is no way that regulations can fix this. There is nothing unclear about the law or the language, although maybe it is not beach reading. Presidents just can't start writing regulations to enforce the law they think should have been passed.


Comments:
I am beginning to believe the whole purpose of the bill was 1) tax increase 2) sewing seeds for future propaganda.

As we've seen the tax increases are real, they're extensive, and they are all, except for those voters would most notice, front-end loaded.

As for reforming healthcare costs, it didn't touch it. It has a number of mandates for health insurance, but insurance is not care. Soon enough people are going to see this and get mad. Dem's will respond with plenty of blaming towards Republican stonewalling and insurance companies gaming the letter and spirit of the law. Of course their solution will be to go back and enact more legislation and get the government more involved in the insurance market.

As for cost reform, govt has no idea and no interest.
 
Presidents just can't start writing regulations to enforce the law they think should have been passed.

I guess this isn't really adding to the discussion, but I have to say... diktat has worked for him so well with auto company bond holders and TBTF bank accounting, why should he think it will stop all of a sudden over a bill most voters were against anyway.
 
The Chief said it was because they couldn't do anything about any of the real problems, so they had to pretend to do something about a problem.

The only thing is - we really did need health care reform, and this isn't it.

On the other hand, when did anything ever work when it was done this way. In the 70s, US auto makers got so sloppy that lemon laws were passed by legislatures. Who passed the lemon law law?
 
Hussain can now do whatever he wants. He and the Joker (Pelosi) have just proven that. To think otherwise is to be in denial. Dem's might try and compare it to Bush and the War, but the country wanted it and Congress passed it. I believe even the One voted yes.

I think the timing of the Shrinks post is poignant. We're formulating plans for the future. Should Hussain be re-elected current thinking is to leave the country.

No point in waiting for the fire to burn down congress to allow someone to grab emergency powers.
 
CF - where? Where is there really to go to be safe in the long run? If the US goes, Canada will be safe for a while but not too long. Australia will fall to China. Europe is already a lost cause.

Yep, SW's post kind of kicked me in the stomach.

Sebellius has now joined the fray. The law clearly doesn't do what she says it does, and this is another move like Waxman's to intimidate.

I truly dislike most insurance companies, but I put rule of law way above my dislikes. I hope they take it to court. They should win hands down and completely.

I need not remind you of the last time civilized and open western countries started ignoring laws in service of "the common good", so I completely understand your POV. People with no sense of history don't understand how dangerous this is.

Until the last week or so I considered Obama a relatively decent person who was not up to the job. I now concede to those who always said he was dangerous. He truly is. He does not respect the law.

The law may be wrong, but to try to override the normal way of making laws (especially when you have the power to do so, given by free elections) is a truly sick and perverted political aberration. And that's what this administration is doing.

They could pass an amendment easily to fix this, but they'd rather have the agitprop value for the next election. Obama needs to be seen as the defender of the downtrodden.

So the constitutional lawyer doesn't give a flip for the constitution. So he believes in nothing.
 
MoM,there has been little or no respect for the Rule of Law in DC this century,even by SCOTUS.This does not excuse Obama who swore an oath to defend the constitution and to faithfully execute the Law.I originally thought he would be a normally corrupt big money dem,some of those have done much more good than harm.Those that call him Bush#3 seem to be on the money.A pox on him.
 
Well, the news is that the insurance companies will cover children.

Of course, they can charge what they want, but it should help some.

I should feel good about this, but in a way it just worries me more about the government threatening companies. Because legally, the administration didn't have a leg to stand on.
 
"Presidents just can't start writing regulations to enforce the law they think should have been passed."
=========================

Says who? THIS President will remind you that HE WON dammit, and he's gonna do whatever he's gonna do.

Besides, he's got a whole Congress-full of legislators to do his bidding, and I'll bet they're just itching to try that "deem-and-pass" thing...
 
Oh, by the way, M-o-M:

How's the Chief doing after the dental episode?

And, regarding the beloved dog you had put to sleep, do you suppose it's possible he had developed a "hidden infection" somewhere that caused all his regulatory systems to go haywire too?
 
So the constitutional lawyer doesn't give a flip for the constitution. So he believes in nothing.

Not quite. He believes in nothing that gets in his way - like the constitution.

As you may remember, I wanted to believe he was another political hack who would "triangulate" as needed.

No such luck.
 
Interesting commenters: Everyone seems to be against Obama and protecting sick children while they wave the US constitution and know they are "right".
 
A_Nonny_Mouse - yes, I believe so (about the dog). We were treating him, but it is very hard to calibrate. I think he had a stroke at the end from an infection of the brain. He had improved greatly on abx, but I had to walk up his dosage very slowly because otherwise he had seizures. The last month of his life he felt wonderful and looked very normal. That was part of what made it so shocking.

The Chief is doing great. I am beginning to believe infection was the main problem. Flu will drag you down and cause secondary bacterial infections, and I think he had both a viral and a bacterial.

In any case, I am so relieved about the Chief. His blood pressure and blood sugar are now normal, and don't fluctuate alarmingly any more. He has a lot of energy and can go around and do things normally. He's an active person, and he was just about in total despair by January.
 
Last Anon - I think you are missing the point.

No matter what an association says, the law still says that insurance companies don't have to cover children. There is a gain here - as of September pre-existing exclusions won't be valid for kids (19 and under).

As of 2014 when the risk-pooling goes into effect, everyone gets the same protections. But I can't figure out how we do it fiscally; I think this reform will have to be re-reformed.

If you don't have a protection in law, you don't have a protection. I would not be very happy with the status quo if I were the parent of a sick kid.

Many medical insurance companies are sleazy outfits. Anyone who knows anything about how they operate will believe that they would write coverage, collect premiums and deny benefits.

I think Congress should go back and pass an amendment (if that was their intent). It still won't get a lot of kids coverage (because their families won't be able to pay the premiums), but it will help some.

There really isn't much in the way of protection without large risk pools. Any small risk pool that is experience-rated can be hit with devastating rate increases. Individuals are the smallest risk pool, of course.

Considering how much I give out of my own pocket to help people in these types of fixes, I don't think I can fairly be accused of indifference or apathy. I don't even believe prayer is valid unless one also takes any action one can to deal with the circumstance. I believe doing all one can do (financially and in other ways) is a requirement for a prayer to be valid.
 
M O M

Very nice response to Last Anon. Good to hear the tone and words like this in the present environment of confrontation, blame, and anger. That helped... it really helped. "I believe doing all one can do (financially and in other ways) is a requirement for a prayer to be valid." I agree. For goodness sake, we have to take responsibility... have to reach out rather than judge.

Ed G.
 
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