Posted by: reddiva | September 23, 2009

AND IN THIS CORNER…


A REPUBLICAN RESPONSE TO H.R.3200 – H.R.3400

[Already I see a difference in this bill.  I am not saying that by the time I have finished reading it I will be ready to sign on to it – all I am saying is that the “short title” lets me know right away that this isn’t going to be Democrat business as usual.  The bill is written by Representative Tom Rice (R-GA6) and has 42 co-signers.  That’s a good sign too.  Oh yes.. The short title? ]

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a)    SHORT TITLE.—This Act may be cited as the ‘‘Empowering Patients First Act’’.

[As I begin to read the bill, I can see one thing that hasn’t changed – the language is ridiculously difficult to understand.  I wish they would just write a bill in everyday English and be done with it!]

TITLE I—TAX INCENTIVES FOR MAINTAINING HEALTH INSURANCE COVERAGE

SEC. 101. REFUNDABLE TAX CREDIT FOR HEALTH INSURANCE COSTS OF LOW-INCOME INDIVIDUALS.

[The next 5 ½ pages or so go into detail about the change proposed to the Internal Revenue Code of 1986.  In all honesty, I am not smart enough to figure out the exact total of the tax credit that will be received, but I can tell from the reading that it is essentially either the entire amount or a big chunk of the money that a taxpayer pays for insurance for himself and his family.  The nice thing is that this tax credit is to be effective for tax year 2010.]

‘‘SEC. 7529. ADVANCE PAYMENT OF CREDIT AS PREMIUM PAYMENT FOR QUALIFIED HEALTH INSURANCE.

‘‘(a) GENERAL RULE.—Not later than January 1, 2010, the Secretary shall establish a program for making payments to providers of qualified health insurance (as defined in section 36B(e)) on behalf of taxpayers eligible for the credit under section 36B. Except as otherwise provided by the Secretary, such payments shall be made on the basis of the adjusted gross income of the taxpayer for the preceding taxable year.

[I have just re-read that paragraph for the fourth time, and each time I read it, it sounds as though the tax credit is immediately paid to the insurance provider of our choice.  I hope that is the correct interpretation.  If so, what a difference between the Federal Government telling me what I can qualify to purchase.  If you read it differently, please let me know.]

(2) ASSESSABLE PENALTIES.—

(A) Subparagraph (B) of section 6724(d)(1) of such Code (relating to definitions) is amended by striking ‘‘or’’ at the end of clause (xxii), by striking ‘‘and’’ at the end of clause (xxiii) and inserting ‘‘or’’, and by inserting after clause (xxiii) the following new clause:

‘‘(xxiv) section 6050X (relating to returns relating to credit for health insurance costs of low-income individuals), and’’

(B) Paragraph (2) of section 6724(d) of such Code is amended by striking ‘‘or’’ at the end of subparagraph (EE), by striking the period at the end of subparagraph (FF) and in-serting ‘‘, or’’, and by adding after subparagraph (FF) the following new subparagraph:

‘‘(GG) section 6050X (relating to returns relating to credit for health insurance costs of low-income individuals).’’.

[I wanted to know about the penalties we would be facing with this information so I went to the Internal Revenue Code of 1986 to check it out.  This is what it says:

Sec. 6724. Waiver; definitions and special rules

(a) Reasonable cause waiver

No penalty shall be imposed under this part with respect to any failure if it is shown that such failure is due to reasonable cause and not to willful neglect.

(b) Payment of penalty

Any penalty imposed by this part shall be paid on notice and demand by the Secretary and in the same manner as tax.

The section these phrases are being added to is the section where the penalty is waived.  In other words – we will NOT be penalized (at least so far) for not having health insurance.  That’s more like it!]

SEC. 103. ELECTION OF TAX CREDIT INSTEAD OF ALTERNATIVE GOVERNMENT OR GROUP PLAN BENEFITS.

(a)    IN GENERAL.—Notwithstanding any other provision of law, an individual who is otherwise eligible for benefits under a health program (as defined in subsection (c)) may elect, in a form and manner specified by the Secretary of Health and Human Services in consultation with the Secretary of the Treasury, to receive a tax credit described in section 36B of the Internal Revenue Code of 1986 (which may be used for the purpose of health insurance coverage) in lieu of receiving any benefits under such program.

[This sounds as though I will be given a choice to either accept any Government plan I qualify for or to accept a tax credit and purchase my own insurance.  I like the sound of that.  Here’s the good part…]

(c) HEALTH PROGRAM DEFINED.—For purposes of this section, the term ‘‘health program” means any of the following:

(1) MEDICARE.—The medicare program under part A of title XVIII of the Social Security Act.

(2) MEDICAID.—The Medicaid program under title XIX of such Act (including such a program operating undera Statewide waiver under section 1115 of such Act).

(3) SCHIP.—The State children’s health insurance program under title XXI of such Act.

(4) TRICARE.—The TRICARE program under chapter 55 of title 10, United States Code.

(5) VETERANS 1 BENEFITS.—Coverage for benefits under chapter 17 of title 38, United States Code.

(6) FEHBP.—Coverage under chapter 89 of title 5, United States Code. [Federal Employees Health Benefits Program.]

(7) SUBSIDIZED GROUP HEALTH PLANS.—Coverage under a group health plan (within the meaning of section 5000(b)(1)) which is subsidized by the employer.

(d) OTHER SOCIAL SECURITY BENEFITS NOT WAIVED.—An election to waive the benefits described in subsection (c)(1) shall not result in the waiver of any other benefits under the Social Security Act.

SEC. 105. LIMITATION ON ABORTION FUNDING.

No funds authorized under this Act (or any amendment made by this Act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion, except in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself, or unless the pregnancy is the result of an act of forcible rape or incest.

SEC. 106. NON-DISCRIMINATION ON ABORTION AND RESPECT FOR RIGHTS OF CONSCIENCE.

(a) NON-DISCRIMINATION.—A Federal agency or program, and any State or local government that receives Federal financial assistance, may not subject any individual or institutional health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.

(b) DEFINITION.—In this section, the term ‘‘health care entity’’ includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.

[I would prefer that it said that abortion is not covered period, but at least the “it’s my body” excuse won’t work here.  One more point in this section’s favor is that if a doctor does not perform abortions for reasons of conscious, he will not be penalized.]

SEC. 107. EQUAL EMPLOYER CONTRIBUTION RULE TO PROMOTE CHOICE.

[This section is very long.  I suggest you take the time to read it for yourself.  I have provided the link for a PDF formatted copy of H.R.3400 for your convenience.  Basically, it deals with changes to the tax code regarding the excise tax an employer might be expected to pay for not offering the employee a choice of coverage.]

SEC. 108. LIMITATIONS ON STATE RESTRICTIONS ON EMPLOYER AUTO-ENROLLMENT.

[In a nutshell, this says that a State may not make a law prohibiting auto-enrollment and that a company should auto-enroll new employees.  It also provides an “opt out” clause for those employees who choose not to be covered by the insurance offered by the new employer.  Small employers (fewer than 50 employees) are covered in Section 109 – a credit is provided for auto-enrollment of new employees.

Naturally there are restrictions upon restrictions in this bill but so far the most restrictive sections are dealing with insurance providers who fail to comply with the reserves they already are required by law to provide, if they refuse coverage to certain individuals, or if they would stop providing insurance rather than do business openly and forthrightly.  Somehow, that makes sense to me.]

TITLE V—MEDICAL LIABILITY AND UNCOMPENSATED CARE REFORMS

SEC. 501. SHORT TITLE.

This title may be cited as the ‘‘Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009’’.

SEC. 502. FINDINGS AND PURPOSE.

(a) FINDINGS.—

(1) EFFECT ON HEALTH CARE ACCESS AND COSTS.—Congress finds that our current civil justice system is adversely affecting patient access to health care services, better patient care, and cost-efficient health care, in that the health care liability system is a costly and ineffective mechanism for resolving claims of health care liability and compensating injured patients, and is a deterrent to the sharing of information among health care professionals which impeded efforts to improve patient safety and quality of care.

(2) EFFECT ON INTERSTATE COMMERCE.— Congress finds that the health care and insurance industries are industries affecting interstate commerce and the health care liability litigation systems existing throughout the United States are activities that affect interstate commerce by contributing to the high costs of health care and premiums for health care liability insurance purchased by health care system providers.

(3) EFFECT ON FEDERAL SPENDING.—Congress finds that the health care liability litigation systems existing thruoghout the United States have a significant effect on the amount, distribution, and use of Federal funds because of —

(A)the large number of individuals who receive health care benefits under programs operated or financed by the Federal Government;

(B) the large number of individuals who benefit because of the exclusion from Federal taxes of the amounts spent to provide them with health insurance benefits;

And

(C) the large number of health care providers who provide items or services for which the Federal Government makes payments.

(b) PURPOSE.—It is the purpose of this title to implement reasonable, comprehensive, and effective health care liability reforms designed to—

(1) improve the availability of health care services in cases in which health care liability actions have been shown to be a factor in the decreased availability of services;

(2) reduce the incidence of ‘‘defensive medicine’’ and lower the cost of health care liability insurance, all of which contribute to the escalation of health care costs;

(3) ensure that persons with meritorious health care injury claims receive fair and adequate compensation, including reasonable noneconomic damages;

(4) improve the fairness and cost-effectiveness of our current health care liability system to resolve disputes over, and provide compensation for, health care liability by reducing uncertainty in the amount of compensation provided to injured individuals; and

(5) provide an increased sharing of information in the health care system which will reduce unintended injury and improve patient care.

[Translation:  TORT REFORM!  TITLE V begins on page 175.  It is quite thorough in its scope.  If you are a proponent of tort reform, as I am, I suggest you read this part for yourself.  It is well worth the time it will take you.  There are limits on the length of time an insurance company can keep an employee in the appeals process; changes to the “decisions” that involve the amount of an individual award; lower mal-practice insurance rates for physicians, etc.  This is a sample of the changes:

ADDITIONAL NONECONOMIC DAMAGES.—In any health care lawsuit, the amount of noneconomic damages, if available, may be as much as $250,000…

Our attorney friends will not like this part.  The court has the authority to reduce the amount of the consignment to an attorney!  I like this bill.  Take that, ambulance chaser!]

SEC. 513. SENSE OF CONGRESS.

It is the sense of Congress that a health insurer should be liable for damages for harm caused when it makes a decision as to what care is medically necessary and appropriate.

[You go, Representative Price!

There is a whole section trying to reapportion some of the “stimulus funds” we have all heard so much about.  It starts on page 246.  I wonder how far they will get with this whole bill?]

TITLE XII—OFFSETS

Subtitle A—Enforcing Discretionary Spending Limits

Subtitle B—Repeal of Unused Stimulus Funds

[The very last item in this bill, page 268, is worth waiting for.]

SEC. 1235. REINSTATE THE MEDICARE TRIGGER.

Section 3 of House Resolution 5 of the One Hundred Eleventh Congress is amended by striking subsection (e) (relating to Medicare cost containment).

[H.R.5 Section 3 subsection (e):

“(e) Medicare Cost Containment- Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 shall not apply during the One Hundred Eleventh Congress.”

What does that mean?  It gets rid of the House’s obligation to debate reforms.  By striking it, the debate goes on.

Is H.R.3400 perfect?  No, it isn’t, but it is so much closer than even one page of H.R.3200 that it is worth taking to the bank.  From all the health care bills I have looked at, this one is by far the most “American citizen consumer friendly.”

In case you are wondering – not ONE reference to a “death panel” in this bill anywhere.]

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  1. […] I’m going to point you to an article that I posted on this same site on September 23, 2009.  It was the Republican Health Care Plan […]


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