For all those apologists who say we should absolutely pass a health care bill, even without a public option, because it still “has so many great consumer protections,” I have a rude awakening for you. The AP is reporting that Harry Reid quietly gutted one of the most important consumer protections in the bill, the ban on annual limits:
The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.
As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not “unreasonable.” The bill does not define what level of limits would be allowable, delegating that task to administration officials.
Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned “No lifetime or annual limits.”
The Senate HELP committee bill had the following section.
SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.
`(a) In General- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish lifetime or annual limits on the dollar value of benefits for any participant or beneficiary.
`(b) Preventing Fraud and Abuse- This section shall not apply until the date on which the Secretary certifies that enacting this section will not result in undue proliferation of fraud and abuse, especially with regard to durable medical equipment.
Reid took this section, left the name, but completely gutted the consumer protection:
SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.
`(a) In General- A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish–
`(1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
`(2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue Code of 1986) on the dollar value of benefits for any participant or beneficiary.
`(b) Per Beneficiary Limits- Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage that is not required to provide essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act from placing annual or lifetime per beneficiary limits on specific covered benefits to the extent that such limits are otherwise permitted under Federal or State law.
Even the Senate Finance Committee bill made banning annual limits a mandatory part of any “essential benefits package” (the minimum requirement for any plan sold on the new exchanges):
‘‘(4) does not impose any annual or lifetime limit on the coverage of such covered health care items and services.
For some reason, Harry Reid decided to remove this core consumer protection. This “unreasonable” qualifier he added is a loophole you can drive a school bus through. Is our goal only to help Americans who are “reasonably” sick and “reasonably” in need? The whole point of insurance reform is to help those most in need, and not let insurance companies take away their care. No one who is suffering from a serious medical condition should be driven into bankruptcy because he or she is in need of an “unreasonable” amount of help. Insurance companies will still be allowed to drop their sick customers and deny claims if the care their customers need is of an “unreasonable” amount.



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Death by spreadsheet, again.
Thanks Harry.
I’ve been pondering since last night — when I wrote a depressed comment on one of Janes’ entries — how we can express our anger and disgust with the Democrats.
I’ve come up with what I think is a possibility: a version of a “money bomb” — an “unsubscribe” bomb to be detonated against the DNC, DSCC, DCCC, OFA, WhiteHouse.gov and whoever else sends out those e-mails crowing over Dem achievements and begging for more $$$$.
I propose scheduling this action for January 20, 2010, to “celebrate” one year since Obama’s inauguration.
Shameless pimp: I’ve posted a diary on this @ the Seminal. I hope you’ll read & comment.
where’s your bloody Jacob Hacker now apologist bitchez ?
Jon, thanks for this post.
Up until today I’d expected I’d support whatever “health” policy shards survived the corporatist gauntlet. I’d been thinking that the end result would at least save lives.
Knowing that Americans will be forced into debt servitude (to benefit Obama and Reid’s FI sector masters) for “insurance” that can deliberately exclude catastrophic conditions, I’m likely to change my mind.
With so many American families one paycheck away from homelessness (it self a killer), one in eight adults now dependent on Food Stamps to avoid starvation, one in four children raised in poverty – and no clear path for the shards of “health reform” to guarantee effective health care for the uninsured – Obama and Reid’s master plan looks like a master scam.
Now that the operational definition of Reid and Obama’s plan appears to be Federally enforced transfer of wealth from Americans to megacorps, I’m hoping an honest progressive economist will do the math on the following:
what will kill more people: the current system that leaves so many without care, or the increased poverty certain to result from Reid/Obama’s plan to force us to prop up their FI sector masters?
Well said.
The annual or lifetime cap on total health care expenses is an insurance company wet dream. It simplifies their underwriting and increases profits. It is at somewhat odds with the Pharmsters and their mega-pricing for bio-financial-logics. It allows people to get on them and pay for them, just not long enough to save their lives or cure their ills.
“Death by spreadsheet” exactly.
Just like I’ve been saying for weeks now. This bill doesn’t do much to stop continued deaths by spreadsheet and medical bankruptcies.
I don’t see how any progressive can make a persuasive argument to support this bill now. It needs to be stopped, or we’re going to have not much in the way of new help, nothing in the way of cost controls, and an excuse not to fix it anymore near term because “we just reformed healthcare, let’s give that a chance to work first.”
I’m pleading with all who really care, as I do, to please, call, email, and even write your Senators and Congresscritters and ask them to vote AGAINST this effort at reform and start over in 2010 or nationalize the 2010 elections around real reform. I’ve emailed my Senators several times, called their office, and today am writing a letter for snail mail.
This bill is not “reform” it is an insurance company protection, bailout, and guaranteed profit bill. Plain and simple. The good in it (and yes, there is some good in it) DOES NOT outweight the bad. KILL IT. NOW.
I am the only one who is ready to say:
“I didn’t leave the Democratic Party. The Democratic Party left me.” ??
Plus, I forgot to mention, you haven’t heard the last of The Stupid Amendment either. I would love it if we here at FDL would pick a day next week where all of agree to call our Senator’s urging them to vote no and start over. If we could coordinate that into one day, it might have more than zero impact. I’m not kidding myself or anyone here that it would have major impact, but it just might have more than zero impact. It’s worth a try, isn’t it? A few minutes on the phone??
I apologize, but this has been my biggest issue my whole life, and I admittedly have a very personal, and thus selfish, reason for wanting reform due to a niece of mine. If I really believed this bill was at least a stepping stone to reform, I’d advocate for it. It’s not. It actually puts into stone protections for insurance companies, when we all know what we need is to ultimately get rid of insurance companies.
I hope you’ll join me in working to kill this bill.
Thanks to all,
Joe
OldFatGuy
America i hardly recognize ya………too sad doc
I’m really curious about what a FDL poll on wheather to:
Keep(fighting) or Kill(bill) would show?
I love that idea. Count me in.
Jon, Jane, whaddya think?
Reid? He is probably the worst Democratic Senate Majority Leader I can remember. There is no excuse for having such a spineless corporate suck-up as a “Leader” in the Democratic party.
In the same way the Teabaggers want to take over the republican party, I think it’s time that the Progressives took over the Democratic Party before it becomes the Blue Dog/”R”-Lite party, which it’s well on its way to now.
Reid makes me sick… with no annual limit.
The AP article does not “report” what you say it does. It states:
“We don’t know who put it in, or why it was put in,” said Stephen Finan, a policy expert with the cancer society’s advocacy affiliate.
I guess “it must have been Reid, because Jane said so” doesn’t cut it with the AP or the actual experts in the field.
This administration and this Congress has spun out of control.
No.
This is the bill that the Democratic politicians are eager to take credit for? That has got to be the worst example of short term political thinking I’ve heard in a long, long time. The average voter pays attention to their own health care, in a way they don’t pay attention to issues like the War in Afghanistan, which has a big effect on America as a whole, but only a indirect effect on most individual Americans who aren’t in the military or have a close family member in the military. If this bill makes things worse for the millions of young voters who made Obama’s election possible, they will notice. Honestly, if this bill were accurately named, I beginning to think it would be called something like the “Making Sure a Generation of Voters Never Votes for a Democrat Again by Destroying the Middle Class Act of 2009″.
If only there was some “health care” reform left.
It’s all about insurance and drugs mandates.
Hospitals and doctor bills account for over 50% of health care costs.
Everything else is in the margins.
Word.
Is there some prevailing alternate reality inside the beltway that make these fools think that a “campaign reality” will overcome the damage they have done to their own credibility? And that includes Mr. Nobel himself, who can’t seem to figure out that Leadership is quite different than Public Speaking. Alway my biggest fear about Preznit Nobel… he was all talk and no action.
Mods, how about a summary yank for those who don’t even note the metadata correctly?
As an independent and after a year I will be giving up on Obama, the Dems, chnage etc.
He and the WH crashers share a lot in common, both grifters of a sort.
Nice shined shoes, nice talk and all air.
The technocrat came to Washington and Washington wined and dined him and his hubris took over…..for a moment I thought I would see some real leadership–silly me.
regards
Reid sure is working to guarantee a GOP Senate in 2010.
The man would like to be a “Master of the Senate” like LBJ, but he seems more in the mold of Barney Fyfe. Dump him and bring in Sheriff Andy Taylor. We can trust him and he can get a decent bill passed. Don’t send a Deputy to do the Sheriff’s job!
This doesn’t even look like the labors of short term political thinking. It, instead looks like a stampede for the exits from public service, and a last minute embrace of opportunities in the private sector. These are politicians
! – a genus related to rodents of particular infamy gained during the dark days of the plague.
They already know shit that we either don’t know yet, or just refuse to admit. That’s right,….
What is metadata?
Reid is probably not even master of his own office. There’s probably an insurance industry lobbyist answering his phones, doing his email and scheduling his day. And I mean one lobbyist for each of those tasks. HIs staffers are out there lying about Reid’s record to keep their parking spaces intact. Good luck with that next year.
This is partially a cross post of mine from the preceding post by Jane
I am coming or perhaps have now come to the position that the Senate is incapable of passing any health insurance reform. This most recent tap dancing tells me they are really foundering.
On the positive side; part of the reason I believe is because of how well informed the public is being kept by FDL and other contemporaneously posting outlets.. Pray this long process has inoculated the public, at least partially from buying any of these recent disgraceful versions.
I agree that we perhaps should be beginning to think of mounting a campaign to kill the bill. In case, as it now appears likely, it is nothing more than criminalizing the sick poor, rationing care by decree and of course enriching the insurance and pharmaceutical shareholders.
You probably could have just stopped at “the Senate is incapable.” That says it all and Reid is leading the parade. Have e-mailed him several time asking that he step down if he can’t lead. Have also complained to my 2 Democratic Senators about him. crickets.
I find it unlikely that Reid doesn’t know this was changed. That doesn’t constitute proof, of course, but if someone changed that without his permission, that individual ought to be in some serious trouble about now. Assuming the thing isn’t changed back now, I think you can assume Reid supports it.
I wonder if Obama spends much time these days pondering why folks on Main Street are still so damn bitter? Maybe he and Reid should form a government task force to find the answer.
They shit on their base, their constituents, their campaign promises. And the voters let them get away with it. Or if they are angry enough in Nevada, they might elect the Republican candidate to…what…shake things up in Washington?
But let\’s put this in perspective. Reid trails his Republican challengers in Nevada. Voters in Nevada oppose healthcare reform by 54% to 44%. So even if the progressives were able to launch a succesful primary challenge against Reid, the nominee would still almost certainly lose to the Republican candidate.
So, for all practical purposes, anything Reid does to stiff progressives on healthcare reform will actually help him be reelected. Or am I misconstruing the race in Nevada?
Meanwhile, why aren\’t thousands of progressives ringing the White House and the Capitol Building demanding, well, only what the Democrats promised them a year ago
They always try to make it sound as if some dastardly person slipped into the office and inserted this awful (gasp) thing into the bill. A pox on all of them.
I don’t know about misconstruing the race, but isn’t it possible you’re misreading the polling?
If I were polled anytime over the last several weeks, I’d answer that I oppose this health care reform too. And judging from the commenters here at FDL, I’m sure there are more than a few progressives who oppose this now.
So how do you know that a good deal of that 54% that oppose it aren’t in fact progressives oppposing it because it not’s good enough?
Metadata is data about other data… term mostly used by programmers… ie you have files… think of payroll… employee file, wage file, deductions file… then you would have other file or files that describe what is in the participatory files… such as the names of the other files, field names, procedure names, views etc…. Hope that helps. Me, I’m just sitting here with my jaws agape at the perfidy being practiced by our fearless leaders.
Spot on. Could have saved a lot of words.
Thanks for that.
Guess I’m still at a loss though in interpreting that comment @ 20 though. I don’t have a clue what it means.
me too, tried to figure out what was meant, but beyond me.
It seems to be how the game is played these days. Maybe we should make our laws less complicated, so that these things can’t happen.
It’s working with the war in Afghanistan. Never saw so many people with D beside their name crowing over the wonderful Obama surge etc etc.
They probably won’t discuss anything on that subject with constituents, one way or another. I really wouldn’t expect them to. That’s not to say your letters don’t have an effect, it’s just that it strikes me as unlikely that they’d discuss leadership issues with anyone but their peers in the Senate.
We need 10 million registered Democrats to switch registration to independent to send a signal to Obama, Reid and the DNC to emphasize the next “mandate” could be in jeopardy.
We could use a National Progressive Lobby. Get every Progressive to kick in a lousy $10.00 a year to a central depository to lobby Congress.
Either that or it’s time to get some members of Congress to move on to other pastures.
Whose the bigger fool,the fool or those who follow the fool?
I like it also, but why wait till then?
Sooner the better . . .
We need to make our voices heard, MUCH LOUDER than so far . . . but so far is where we ar and we wouldn’t be HERE without Mz. Hamsher and folks like PW and yerself Riesz, and many other Pups.
Now let’s make it louder . . . . LOT’S louder . . . .
One source, quoted by AP. Many other sources, and clearly drawn lines . . . Reid/WH/Obama.
It didn’t get there by itself, it was writ, and put there, and authorized to be done so, by someone.
That list of someone’s ain’t all that long, I don’t think.
*G*
Good to see your wings again . . .
It means yank the fucking trolls the minute they open their mouths and don’t deal with the facts at hand that are either in the post or in a comment(s).
Meta data as OBVIOUS KNOWN CONDITIONS/FACTS!!!!!
I’m for yanking the fuckers myself, but sometimes they are SO much fun to play with. For about half a minute.
Something is rotten here, but what is it? I noticed these words previously, in rummaging through the Senate bill, and paused over them. Let me include them here:
“What could this be about?” I asked. “How could a tax provision create a loophole for Sicko-type shenanigans?” But I got lazy, or maybe it was that this was just page 16 of a 2000 page bill and I have only one life to give to my country. At any rate I moved on.
Now that it’s gotten some attention I looked at IRC section 223. Nerds can find a .pdf version here For the rest of you, section 223 is about health savings accounts.
Maybe it’s been amended, but the version I have does not use the phrase “unreasonable annual limits” or come anywhere near the concept. It sets various dollar limits, but that’s not the same thing. To add to it, there is no mention of “participants” in IRC section 223.
The Senate health care bill often refers to IRC 223, so it’s likely the section number is intended. My guess is that there’s an industry concept of “unreasonable annual limits” out there that the Senate bill alluded to without tracking words in the way legislation should. That’s how such glitches often arise. You and I of course have no way to know for sure.
If this were a private contract, a contract lawyer would call section 2711 a busted clause. But the party who hadn’t written it would be protected under the rule of contra proferendum: construe words against the drafting party.
To whose favor would the error redound in this public case? Do I have to spell it out? Its implementation — in a Sicko-type situation — would be up to whatever regulators were in charge. For guidance they’d go to some staffer who wrote the words at the behest of — guess who? — someone in the industry. So there’d be frantic calls and an attempt to create a cleaner record in anticipation of litigation. Meanwhile the victim would die.
What’s worse here, that there’s a backdoor loophole or that we can’t even tell what it is? Laws are being enacted in our name by servile incompetents. That’s scary, and surely more of this is waiting to come to light.
They probably do need to put some limit on the amount they can charge for biologics, but a lifetime or annual cap are not the way to do it.
Who decides who dies because the cost is to high per year? You can guess what a panel like that would be called in the media. What about other kinds of medical care, that could not be as easily lowered just below the annual maximum and still provide a profit?
Larue, this whole instant troll yanking shit is about as savory as keeping the Guantanamo prisoners out of courts, or say, running the risk of executing innocent death row inmates.
I’ve seen the t-bagger like mob mentality in action on these threads at FDL and it is about as pretty as the anti immigration militias patrolling the Arizona border.
First rule should be to fairly engage first before going for the lynching; just because, they are ‘ferners’.
The devil is always in the details, isn’t it? This one’s pretty much slipping under the radar too.