Horrible Legislation

Very interesting, thanks Winthrope!

Should one assume that perhaps this type of insurance would only cover catastropic illness?

What really sets off alarm bells for me is having the federal government dabbling in state medical decisions.

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I agree, the states rights aspect of this is suprising considering it's a Republican bill. This bill takes away the state's authority to regulate health insurance.

As for what would be covered, who knows? It would be completely up to the insurance companies. Doesn't make sense to me.

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I live in Oregon where we have spent the last seven years in the right-to-die-wringer so I'm a little paranoid about meddlesome Feds.

I really can't understand why insurance companies would balk at preventative care and tests that could lead to early diagnosis. It's pennies to dollars, really. We all end up paying for it anyway when uninsured people seek emergency treatment.

This proposed bill doesn't make a lick of sense. I suspect it is a backdoor to get the Fed's noses into the State's business for other reasons.

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As long as the national priority is war, killing, and imperialism, there will be a health care crises!

Anon

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I just read a good article in the Seattle Post Intelligencer that really puts the human element of the bill into perspective. This will have very dire consequences for a lot of Americans.

Seattle PI

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I couldn't get your Seattle PI link to work!

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Re: Horrible Legislation

Winthorpe wrote:

I just read about a bill that the Senate will soon vote on that would override state mandates that guarantee a basic level of health insurance coverage. Under the guise of providing affordable health insurance to small businesses, the bill would leave these employees with bare bones health coverage.

If passed, insurance companies would not have to provide coverage for diabetes-related care, mental health care, prenatal care, newborn child care and cancer screenings, among other things.

I would recommend that everyone contact their Senators and tell them to oppose this bill, S.1955. Here is the article I read about the bill.

LA Times

Have you actually read the bill or are you just relying on the LA Times story for your info?? Your post here is extremely misleading as to the effect of this bill.

If, for example, a small business is in CA then the business would have to provide all of the coverage the State of CA mandates.

If the business's prinicple state of operation is NV and it has employees in CA as well then the company can choose which state's requirements they will follow and those benefits would apply to all of their employees - THAT is the part that preempts exisiting state laws.

The bill would have no practical effect on small businesses that only have operations in a single state (which is the overwhelming majority of small businesses...).

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I've been doing a little reading around and here is what I don't get:

A lot of the supporters say that this legislation would allow small business into the pool like big business' are.

But big businnes' with muti-state locations already operate within each individual state's guidelines, don't they?

There also seems to be a lot of talk about how the law would allow discrimination based on age and gender -- I don't really get that either.

And, could a business incorporate in a state which offered few protections even if they operated business in other state(s)?

I have mixed feelings about this having lived through the Oregon Health Plan years where care was rationed.

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Re: Horrible Legislation

fishin' wrote:

The bill would have no practical effect on small businesses that only have operations in a single state (which is the overwhelming majority of small businesses...).

Well then, that kind of makes me wonder why they're bothering. But admittedly, I haven't read it. Off to do that now.

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That's a good question, FreeDuck. The more I read about this the less I understand it.

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Re: Horrible Legislation

fishin' wrote:

Have you actually read the bill or are you just relying on the LA Times story for your info?? Your post here is extremely misleading as to the effect of this bill.

If, for example, a small business is in CA then the business would have to provide all of the coverage the State of CA mandates.
If the business's prinicple state of operation is NV and it has employees in CA as well then the company can choose which state's requirements they will follow and those benefits would apply to all of their employees - THAT is the part that preempts exisiting state laws.

The bill would have no practical effect on small businesses that only have operations in a single state (which is the overwhelming majority of small businesses...).

Yes, I have read the bill, for those of you who want to the link to the Library of Congress website (thomas.loc.gov sorry the link isn't working for some reason), type in S.1955 to the search to get the text of the bill.

This bill would gut state mandates for everyone, not just small businesses. An insurance company wouldn't be able to choose which state's requirements to follow (the state with the fewest mandates), known as "cherry picking." What they would be able to do is this; as long as an insurer offered a health insurance plan that contained the benefits given to state employees in one of the five largest states in the country, they would also be permitted to bypass state mandates and offer a plan with minimal coverage.

So you end up with insurance companies offering either a plan that meets requirements but is extremely expensive or plans that are cheap but don't cover what you need.

Also, boomerang, try this link to the Seattle PI story I tried to post yesterday. Seattle PI

To answer your question about age and gender discrimination; the bill would preempt state laws that limit the ability of insurers to vary premiums based on health status, age, gender and geography.

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Re: Horrible Legislation

Winthorpe wrote:

This bill would gut state mandates for everyone, not just small businesses. An insurance company wouldn't be able to choose which state's requirements to follow (the state with the fewest mandates), known as "cherry picking." What they would be able to do is this; as long as an insurer offered a health insurance plan that contained the benefits given to state employees in one of the five largest states in the country, they would also be permitted to bypass state mandates and offer a plan with minimal coverage.

Where exactly do you see any of this in the legislation? First of all, your claim that it will "gut state mandates for everyone, not just small businesses" is absolutely wrong. Section 2912 of the bill specifically states that the law applies to those businesses that qualify as a small business using the existing NAIC standards. There is also NO reference anywhere in the bill about the plans containing anything from the 5 largest states.

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So you end up with insurance companies offering either a plan that meets requirements but is extremely expensive or plans that are cheap but don't cover what you need.

Or plans that cover what you need and don't cover what you don't need. You also forgot the possibility of people remaining uninsured. That seems to be the option your prefer.

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To answer your question about age and gender discrimination; the bill would preempt state laws that limit the ability of insurers to vary premiums based on health status, age, gender and geography.

The bill itself also prohibts insurers from discriminating on the basis of age, gender and establishes a national standard for health status of a 15% max. variation in premiums. Under this legislation if a policy is offered it has to be applied to all employees of participating small businesses equeally. The bill actually closes an existing hole in the NAIC regualtions that permits discrimination based on age and gender.

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boomerang wrote:

A lot of the supporters say that this legislation would allow small business into the pool like big business' are.

But big businnes' with muti-state locations already operate within each individual state's guidelines, don't they?

Yes, they do - at significant additional cost to the company.

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There also seems to be a lot of talk about how the law would allow discrimination based on age and gender -- I don't really get that either.

Me either. There isn't anything in the bill that allows for any age or gender based discrimination.

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And, could a business incorporate in a state which offered few protections even if they operated business in other state(s)?

The law doesn't care where the business is incorporated. It specifically states that the basis is created from the state where the business has it's primary operations (the bill referrs to this as the "domicile state")

I have mixed feelings about this having lived through the Oregon Health Plan years where care was rationed.[/quote]

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So Fishin',

You're saying this is a handy, dandy bill, and deserves passing??

Anon

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I don't know if it does or doesn't deserve to be passed - it doesn't directly impact me either way - but using the old standby "the sky is falling" technique doesn't lead to viable solutions.

We have a whole lot of people that don't have health insurance and many of them are employed in small businesses or are self-employed and pointing to the cost of insurance as a reason.

I'd rather see 45 million people with 70% coverage than 45 million without any at all. That appears to be what the bill is attempting to at least get to.

Is it the be-all and end-all of insurance? Probably not. It's a patch but a patch is better than doing nothing at all. I just don't see the crashing impact Winthorpe is claiming will occur. The claims that it applies to anything more than small businesses are patently false.

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fishin' wrote:

I don't know if it does or doesn't deserve to be passed - it doesn't directly impact me either way - but using the old standby "the sky is falling" technique doesn't lead to viable solutions.

We have a whole lot of people that don't have health insurance and many of them are employed in small businesses or are self-employed and pointing to the cost of insurance as a reason.

I'd rather see 45 million people with 70% coverage than 45 million without any at all. That appears to be what the bill is attempting to at least get to.

Is it the be-all and end-all of insurance? Probably not. It's a patch but a patch is better than doing nothing at all. I just don't see the crashing impact Winthorpe is claiming will occur. The claims that it applies to anything more than small businesses are patently false.

If you have insurance that doesn't cover anything, what good is it?? If I as a small business, could incorporate in a state where the laws are minimal to nothing, then I could basically avoid giving decent coverage to my employees. There isn't anything that stops me from doing that. In California, we have a lot of businesses incorporating in Nevada to avoid the State Taxes, and many have been most successful at doing that!! Meanwhile, they still use all the State services that the California Corps. (like me) are paying for. This law just makes for more of the same style abuse!!

I haven't read it, because I am set with insurance, and I pay 100% of it for my employees. It is great insurance. It's one of those things that I think I owe them as an employer ... that is one of my moral responsibilities. Unfortunately, a lot of small businessman don't feel that way!! They would rather slide by and pocket the money and leave their employees in jeopardy.

Anon

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Anon-Voter wrote:

If you have insurance that doesn't cover anything, what good is it??

Who said it doesn't cover anything? There is a huge difference between not covering anything and not covering everything. I'm a single guy. Do I need a policy that provides me with pre-natal and maternity care? Why should I buy a policy that provides me with a benefit that I can't possibly use? I'm also a military retiree so my catastrophic care is already taken care of but I could use a better policy for more routine preventive care. Under most exsisting state laws I can't buy a policy that doesn't cover the areas I'm already covered for. Why should I have to pay for something I already have?

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If I as a small business, could incorporate in a state where the laws are minimal to nothing, then I could basically avoid giving decent coverage to my employees. There isn't anything that stops me from doing that.

No there isn't - you're right. If your primary place of business is in CA however, you gain no benefit from incorporating in NV. In this case the CA laws would still apply.

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In California, we have a lot of businesses incorporating in Nevada to avoid the State Taxes, and many have been most successful at doing that!! Meanwhile, they still use all the State services that the California Corps. (like me) are paying for. This law just makes for more of the same style abuse!!

Other than small businesses that are right on the state borders where they could have an office in NV and have customers in CA I don't see much of an impact. The self-employed would have an awful hard time claiming that their primary business is in NV if they live and do all of their work in CA.

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I haven't read it, because I am set with insurance, and I pay 100% of it for my employees. It is great insurance. It's one of those things that I think I owe them as an employer ... that is one of my moral responsibilities. Unfortunately, a lot of small businessman don't feel that way!! They would rather slide by and pocket the money and leave their employees in jeopardy.

Yup! Many of them don't buy insurance for themselves either. Do we just let them continue to go uninsured?

The company I work for still qualifies as a small business (just barely...) and we have employees in 13 states. The bulk of them are in CA 940 or so) with 12 here in MA, 4 in DC, 2 in GA, 1 in NE, 3 in TX, 2 in OH, etc.. Try finding an insurance company that can provide health coverage to every employee in each state. It's a PITA. (Aetna was the ONLY insurance company that stepped up to the plate and said they could do it and their policies suck!) As a result we hired a "Benefits Administrator" to work in HR just to handle benefits because we have different insurance carriers in each state and that's another salary we pay out of overhead. How many small businesses can afford to do that? Under this proposed bill we could have one policy (that would end up being based on CA law!) that would apply to everyone in the company, get rid of the extra HR body and take her salary and pay it out to the rest of the employees in raises and bonuses. (Because of the HR position and an extra payroll position the people that work for me have lost an average of $1,000/quarter in bonuses...)

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I agree with your point, fishin', about providing a basic level of care to more people. That is exactly what the Oregon Health Plan tried to do -- for the people who fell within it's income guidelines.

But I think where the fear of discrimination comes in is in exactly what you said about "why should I pay for prenatal care".

If your company has a policy of not hiring women in their childbearing years then you shouldn't. Otherwise you should. That is, you should if you take part in a company sponsored health plan.

The same with chronic illness, like diabeties.

The same with older people.

So, unless I'm missing some big and essential point, you would pay for that stuff under this law because your company is not allowed to discriminate against people in these categories.

And, if that is the case, this law seems pointless.

Or, like I said, I'm missing something....

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Fishin'

Like I said, I'll have to read this later tonight when it's quiet. It seems like it would be easy to abuse, that's just my quick and dirty thought. In the same light as you don't need all those coverages, some do. Chances are good, I'm never getting pregnant, but I do have to be sure that the colon cancer doesn't get tuned up again. We all have our Achilles heels!!

Anon

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