The Rockin Johnny B

Wednesday, February 15, 2012

Insurance Stuff

Idaho likely to spurn federal cash for exchange
Lawmakers, wary of Washington, shift focus to state program to help with health care funding
   The Associated Press
   BOISE — Opposition from House conservatives has ended Gov. Butch Otter’s plans to use a $20.3 million federal grant for a state-run Idaho insurance exchange required by the federal health care overhaul.
   Instead, discussions between legislators, Otter and the insurance industry have shifted toward a state exchange created without federal money, but that’s still sufficient to reassure U.S. Department of Health and Human Services officials that Idaho isn’t blowing them off.  Tricky slope you are on Gov.  The fed isn't gonna let you snub their guidelines.  They'll step in and take over, they where'll you dingbat.
   They’re walking a thin line between keeping a federal exchange from being imposed on Idaho that could disadvantage the state’s insurers, while still letting “Obamacare”-loathing legislators tell constituents they didn’t bend to Washington, D.C.  Don't be fooled.  It's about the money.  The state insurers don't want the so-called Obamacare package because they'll lose millions because they will no longer be in control.  They'll no longer be able to drop you when you get sick.  They will no longer be able to raise your premiums any time they want to.  This is what pisses 'em off...the money!  They don't give a damn about their policy holders.
   “My major concern personally is accepting federal funding,” said Rep. Lynn Luker, R-Boise. “It would lock us in to what they want us to do.”  Yes!  That's what it's supposed to do, forchristsake.  What's wrong with you Luker.  The insurance industry is broken in favor of the insurance companies.  If you instigate a plan that favors the policy owners, they'll lose MONEY.  Get it?
   The 2010 Patient Protection and Affordable Care Act envisioned exchanges as a “one-stop shop” to buy affordable insurance. The federal government offered to pay and Otter’s administration won $20.3 million for the effort.  But let's be an idiot and turn it down!  Jesus!
   But with Idaho one of 27 states that sued over the 2010 health care overhaul on constitutional grounds, conservative lawmakers say they want nothing to do with the federal money.  Of course they want nothing to do with the money.  They'll piss off their PACs if they do.
   Consequently, Sen. Dean Cameron, R-Rupert, and an insurance agent, says a smaller, undetermined sum — scratched from somewhere in Idaho’s tight budget — will likely be sufficient to at least get started. He said the important thing for Idaho is to not cede an exchange to the federal government, whose version he believes will disadvantage Idaho insurers and offer products that are more-expensive for consumers.  Who's gonna pay for the money?  You are!  Forgodsake, don't you realize these assholes are not in our favor?  Don't take the fed's money, let's try to squeeze some more out of our Idahoans.  Yes, the fed will give us 20 million, but let's not take it.  I simply cannot believe the idiocy of these nuts.
   “It would make it easier to use the federal funds,” Cameron said. “But I haven’t spent much time thinking about that, because I have to deal with the realities of the day.” 
   House Minority Leader John Rusche, D-Lewiston, and a former health insurance industry executive, said letting the federal money slip through Idaho’s fingers simply to win House conservatives’ support is a costly political bargain.  Finally, a voice of reason.  This is why I'm a Democrat.  They have some common sense.
   “How many teachers is $20.3 million?” Rusche said. “We’re going to build this on our own, using our money, instead of putting it into education, with the hope that we’ll be allowed to vary from federal standards. How does that serve Idahoans?”  YES!  This guy's got it right.
   The U.S. Supreme Court is unlikely to deliver 
a final verdict on Idaho’s lawsuit over the overhaul until late June. Meanwhile, Republican presidential candidates are all vowing to repeal President Obama’s signature first-term accomplishment, if they’re elected.  These Reps know this is gonna pass.  It already has.  They wanna take it to the S.C. to postpone it cause it'll look good to their PAC buddies in the insurance industry.  Keep in mind folks, the insurance companies have literally no restraints put on them EVER.  They hate the idea that someone's gonna call 'em on their succubus natures.
   Amid this uncertainty, some including Idaho Rep. Vito Barbieri, RDalton Gardens, are urging their legislative colleagues to do absolutely nothing.
   “There is no distinction between a purported state exchange or federal exchange,” Barbieri said. “That’s why I’m suggesting we take an entirely private or market-based approach.”  If we do nothing, the fed will.

Here's what the bill is all about...

PPACA [Patient Protection and Affordable Care Act] ]includes numerous provisions to take effect over several yearsbeginning in 2010. Policies issued before the law was promulgated are grandfathered from most federal regulations.
  • Guaranteed issue and partial community rating will require insurers to offer the same premium to all applicants of the same age and geographical location without regard to most pre-existing conditions(excluding tobacco use).[17]
  • A shared responsibility requirement, commonly called an individual mandate,[18] requires that all persons not covered by an employer sponsored health planMedicaidMedicare, or other public insurance programs purchase and comply with an approved private insurance policy or pay a penalty, unless the applicable individual is a member of a recognized religious sect, exempted by the Internal Revenue Service, or waived in cases of financial hardship.[19]
  • Medicaid eligibility is expanded to include all individuals and families with incomes up to 133% of the poverty level along with a simplifiedCHIP enrollment process.[20][21]
  • Health insurance exchanges will commence operation in each state, offering a marketplace where individuals and small businesses can compare policies and premiums, and buy insurance (with a government subsidy if eligible).[22]
  • Low income persons and families above the Medicaid level and up to 400% of the federal poverty level will receive federal subsidies[23] on asliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4).[24]
  • Minimum standards for health insurance policies are to be established and annual and lifetime coverage caps will be banned.[25]
  • Firms employing 50 or more people but not offering health insurance will also pay a shared responsibility requirement if the government has had to subsidize an employee's health care.[26]
  • Very small businesses will be able to get subsidies if they purchase insurance through an exchange.[27]
  • Insurance companies are required to spend a certain percent of premiums on certain expenses.[28] In what has been called a "quiet takeover," four of the five largest insurers have begun buying hospitals and medical groups as subsidiaries, keeping this spending within the same parent company.[29]
  • Co-paymentsco-insurance, and deductibles are to be eliminated for select health care insurance benefits considered to be part of an "essential benefits package"[30] for Level A or Level B preventive care.[31]
  • Changes are enacted that allow a restructuring of Medicare reimbursement from "fee-for-service" to "bundled payments."[32][33]
  • Additional support is provided for medical research and the National Institutes of Health.[34]

[edit]Summary of funding

The Act's provisions are intended to be funded by a variety of taxes and offsets. Major sources of new revenue include a much-broadened Medicare tax on incomes over $200,000 and $250,000, for individual and joint filers respectively, an annual fee on insurance providers, and a 40% tax on "Cadillac" insurance policies. There are also taxes on pharmaceuticals, high-cost diagnostic equipment, and a 10% federal sales tax on indoor tanning services. Offsets are from intended cost savings such as improved fairness in the Medicare Advantage program relative to traditional Medicare.[35]
Total new tax revenue from the Act will amount to $409.2 billion over the next 10 years. $78 billion will be realized before the end of fiscal 2014.[36] Summary of revenue sources:
  • Broaden Medicare tax base for high-income taxpayers: $210.2 billion
  • Annual fee on health insurance providers: $60 billion
  • 40% excise tax on health coverage in excess of $10,200/$27,500: $32 billion
  • Impose annual fee on manufacturers and importers of branded drugs: $27 billion
  • Impose 2.3% excise tax on manufacturers and importers of certain medical devices: $20 billion
  • Require information reporting on payments to corporations: $17.1 billion
  • Raise 7.5% Adjusted Gross Income floor on medical expenses deduction to 10%: $15.2 billion
  • Limit contributions to flexible spending arrangements in cafeteria plans to $2,500: $13 billion
  • All other revenue sources: $14.9 billion
Doesn't the government always spend other people's money?  What a stupid cartoon.

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