How to be a Dictatorship 101.

If the bill passes, they will have buried themselves in the coffin the made for themselves.

The signing of the bill will be the nails in their governing coffin.

We do not want this bill!

"For example, a family of four making $44,000 would pay $2,763 in premiums —about 6 percent of its income— for a policy worth $9,435.

But a similar family making $66,000 would have to pay $6,257 in premiums, close to 10 percent of its income. That may be less than a mortgage, but it's more than a car payment."

Why the disparity? It's the same policy, is it not?

Weath redistrobution at its finest with increased taxes on the upper middle class to pay for the tax credits.

yes I know I had a spelling error

Nobody but nobody should have to pay a fine for not having health insurance, for whatever reason they do not have health insurance. Nobody but nobody should have to pay out more in insurance premium costs than they already do - and it seems, as usual, single people earning $55,000 + get hid hard. Nobody but nobody should be penalized for being able to afford a "cadillac" insurance plan. I am 51 years old, worked hard all my life to be able to buy an insurance policy that doesn't require authorizations from primary MD to go see anbody else, and I should not have to be taxed extra for finally reaching that goal in my life, nor should anybody else. The worst of it, none of this really would take effect until, at minimum 2013/2014!

Accountable Care Organizations-This is not as good as it seems. These organizations will hold onto patients even if they don't have the ability or staff to take care of the patient. It has happened to me and I have seen it happen to patients.

Insurance Companies-Since their lobbyists wrote this bill they have left plenty of loopholes in it here is an example: They will be required to spend 85% on patient care. All they will do is cut back on the preapproval staff. Almost everything that is done to an insured patient requires pre-authorization. This process is very costly to providers in time and labor. For the insurance company less staff=more profit. Less or delayed care = more profit. This will drive provider costs up and delay patient care.

Employers: Obama's plan wouldn't require employers to provide insurance to their workers, but it would hit them with a stiff fine if even one of their workers gets a federally subsidized coverage. Companies with 50 or fewer workers would be exempt, and those with 25 workers or fewer could get federal assistance.

But the fines could turn into a big headache for many employers, particularly since they may not be able to tell if their workers are getting benefits from the government. For example, a company with 100 employees that fails to provide coverage could face a fine of $140,000 under the plan Obama unveiled Feb. 22. Getting the bill from the IRS would become a dreaded moment for business owners.

Another reason for Employers to remain at under 50 employees and/or reduce the workforce even further.

The tax break that employer's would receive for hiring the unemployed would seem minuscule and insignificant compared to the bill they could receive from the IRS. What's to stop the employer from discharging the employee who is getting the federal subsidy?

Pass it and tweet it later. I am a military veteran of several theaters; proud to be an American, and I say to all of you politicians who Keep trying to blow smoke, up our you know whats; can kiss your rear- ends goodbye come the next major election season. I've made my list, and checking it often to remind me of who in office, is looking out for the best interest of America, or their own political (for the sake of not being vulgar) careers. I have a decent income and good if not very decent medical coverage, but unlike many of our so-called speaking for Americans, politicians, I would like to see my fellow Americans be medically protected throughout their lives. I, like many others, who stood in harms way; have put our lives on the line, to ensure the right to have a government that is more responsive to us than political ambitions. (Know this) I will personally campaign against you.

There will be a day of reckoning.

Fine for not buying into thier plan sounds like comunist crap.

If you arrive at the ER without health insurance do you get fined and throw out the door? 

And exactly what reform bill are you referring to? The bill that won't be published until tomorrow? You must be clairvoyant, or biased???

"Once the exchanges open, most Americans would be required to carry health insurance or pay a fine."

When a driver stops carrying car insurance, the DMV suspends their registration and levies a fine. So what gets suspended if someone doesn't carry health insurance? I happen to be a supporter of change, however if this is going to be "mandatory" instead of "available to everyone", I really have my doubts about it.

Hello America,

The Fezzy Bear Edited Edition, March 15, 2010, don't worry I knew all of you would be to lazy to read it, never fear Fezzy bear is here.

111

2

TH CONGRESSD SESSION H. R. ll
To provide for reconciliation pursuant to section 202 of the concurrent

resolution on the budget for fiscal year 2010.

IN THE HOUSE OF REPRESENTATIVES

M

1.))))

ARCH --, 2010(3) INSURANCE REFORMS.—This subdivision—
15

forms;

(A) enacts strong insurance market re
17

change, with a public health insurance option

(B) creates a new Health Insurance Ex
19

alongside private plans;
20

(C) includes sliding scale affordability
21

credits; and
22

(D) initiates shared responsibility among
23

workers, employers, and the government;
24

so that all Americans have coverage of essential
25

2.)))) (iii) Such other limited benefits as the

health benefits.
23

Commissioner may specify.
24

In no case shall an employment-based health
25

18

plan in which the coverage consists only of one
•

J. 55–345
1

or more of the coverage or benefits described in
2

clauses (i) through (iii) be treated as acceptable
3

3.)))))(1) I

coverage under this subdivisionN GENERAL.—Individual health insurance
13

coverage that is not grandfathered health insurance
14

coverage under subsection (a) may only be offered
15

ticipating health benefits plan.

on or after the first day of Y1 as an Exchange-par
17

(2) SEPARATE, EXCEPTED COVERAGE PER18
MITTED

.—Excepted benefits (as defined in section
19

2791(c) of the Public Health Service Act) are not
20

included within the definition of health insurance
21

coverage. Nothing in paragraph (1) shall prevent the
22

offering, other than through the Health Insurance
23

fered and priced separately from health insurance

4.)))))A qualified health benefits plan may not impose any

Exchange, of excepted benefits so long as it is of
7

pre-existing condition exclusion (as defined in section
8

2701(b)(1)(A) of the Public Health Service Act) or other9
wise impose any limit or condition on the coverage under

10

the plan with respect to an individual or dependent based
11

on any health status-related factors (as defined in section
12

2791(d)(9) of the Public Health Service Act) in relation
13

5.))))

20

to the individual or dependent.25 in the same manner as such sections apply to employers
•

J. 55–345
1

and health insurance coverage offered in the small group
2

market, except that such section 27 12(b)(1) shall apply
3

only if, before nonrenewal or discontinuation of coverage,
4

the issuer has provided the enrollee with notice of non5
payment of premiums and there is a grace period during

6

which the enrollees has an opportunity to correct such
7

6.)))))

nonpayment. Rescissions of such coverage shall be prohib8(a) IN GENERAL.—The premium rate charged for an
12

insured qualified health benefits plan may not vary except
13

as follows:
14

(1) LIMITED AGE VARIATION PERMITTED.—By
15

age (within such age categories as the Commissioner
16

shall specify) so long as the ratio of the highest such
17

ceed the ratio of 2 to 1.

premium to the lowest such premium does not ex
19

(2) BY AREA.—By premium rating area (as
20

permitted by State insurance regulators or, in the
21

case of Exchange-participating health benefits plans,
22

as specified by the Commissioner in consultation
23

with such regulators).
24

21

(3) BY FAMILY ENROLLMENT.—By family enrollment (such as variations within categories and
•

J. 55–345
1

compositions of families) so long as the ratio of the
2

premium for family enrollment (or enrollments) to
3

the premium for individual enrollment is uniform, as
4

specified under State law and consistent with rules
5

of the Commissioner.
6

(b) STUDY AND REPORTS.—
7

tion with the Secretary of Health and Human Serv

ices and the Secretary of Labor, shall conduct a

(1) STUDY.—The Commissioner, in coordina
10

study of the large group insured and self-insured
11

amine the following:

employer health care markets. Such study shall ex
13

teristics, including size, that purchase insured

(A) The types of employers by key charac
15

products versus those that self-insure.
16

tween typical insured and self-insured health

(B) The similarities and differences be
18

plans.
19

serve levels of employers that self-insure by em

ployer size.

(C) The financial solvency and capital re
22

(D) The risk of self-insured employers not
23

coming financially

7.))))))(E) The extent to which rating rules are

being able to pay obligations or otherwise be
2

likely to cause adverse selection in the large
3

group market or to encourage small and mid
4

size employers to self-insure
5

(2) REPORTS.—Not later than 18 months after
6

sioner shall submit to Congress and the applicable

the date of the enactment of this Act, the Commis
8

agencies a report on the study conducted under
9

ommendations the Commissioner deems appropriate

paragraph (1). Such report shall include any rec
11

to ensure that the law does not provide incentives
12

for small and mid-size employers to self-insure or
13

8.)))))(a) I

create adverse selection in the risk pools of largeN GENERAL.—A qualified health benefits plan
5

sioner. For any plan year in which the qualified health

shall meet a medical loss ratio as defined by the Commis
7

benefits plan does not meet such medical loss ratio, QHBP
8

offering entity shall provide in a manner specified by the
9

Commissioner for rebates to enrollees of payment suffi10
cient to meet such loss ratio.

9.)))))))(c) N

O RESTRICTIONS ON COVERAGE UNRELATED
6

efits plan may not impose any restriction (other than cost

sharing) unrelated to clinical appropriateness on the cov

TO CLINICAL APPROPRIATENESS.—A qualified health ben9
erage of the health care items and services

10.)))))(1) provides payment for the items and services

17

erally accepted standards of medical or other appro

priate clinical or professional practice;

described in subsection (b) in accordance with gen
20

(2) limits cost-sharing for such covered health
21

efit standards, consistent with subsection (c);

care items and services in accordance with such ben
23

(3) does not impose any annual or lifetime limit
24

on the coverage of covered health care items and
25

11.))))))))(b) M

services;INIMUM SERVICES TO BE COVERED.—The
8

lowing:

items and services described in this subsection are the fol
10

(1) Hospitalization.
11

(2) Outpatient hospital and outpatient clinic
12

services, including emergency department services.
13

(3) Professional services of physicians and other
14

health professionals.
15

dent to the services of a physician’s or a health pro

fessional’s delivery of care in institutional settings,

(4) Such services, equipment, and supplies inci
18

12.))))))))Force on Clinical Preventive Services and those vac

physician offices, patients’ homes2
cines recommended for use by the Director of the

3

Centers for Disease Control and Prevention.
4

(9) Maternity care.
5

(10) Well baby and well child care and oral
6

health, vision, and hearing services, equipment, and
7

supplies at least for children under 21 years of age.
8

(c) REQUIREMENTS RELATING TO COST-SHARING
9

AND MINIMUM ACTUARIAL VALUE.—
10

(1) NO COST-SHARING FOR PREVENTIVE SERV11
ICES

.—There shall be no cost-sharing under the es12
sential benefits package for preventive items

13.))))))(B) A

PPLICABLE LEVEL.—The applicable
22

level specified in this subparagraph for Y1 is
23

$5,000 for an individual and $10,000 for a
24

family. Such levels shall be increased (rounded
25

14.))))))(C) U

to the nearest $100) for each subsequent yearSE OF COPAYMENTS.—In establishing
5

cost-sharing levels for basic, enhanced, and pre6
mium plans under this subsection, the Sec

7
retary shall, to the maximum extent possible,

8

15.)))))) M

sory Committee shall be composed of the following

use only copayments and not coinsuranceEMBERSHIP.—The Health Benefits Advi
12

members, in addition to the Surgeon General:
13

(A) 9 members who are not Federal em14
ployees or officers and who are appointed by

15

the President.
16

ployees or officers and who are appointed by

(B) 9 members who are not Federal em
18

16.))))))))))(2) M

PLOYEES

sory Committee shall not be considered employees of

the Comptroller General of the United StatesEMBERS NOT TREATED AS FEDERAL EM.—Members of the Health Benefits Advi
6

ice on the Committee.

17.)))) (1) I

tablish an external review process (including proce

dures for expedited reviews of urgent claims) that

38

the Federal government solely by reason of any servN GENERAL.—The Commissioner shall es
•

J. 55–345
1

provides for an impartial, independent, and de novo
2

18.))))(1) I

review of denied claims under this subdivision.N GENERAL.—A qualified health benefits
17

plan shall comply with standards established by the
18

Commissioner for the accurate and timely disclosure
19

of plan documents, plan terms and conditions,
20

nancial disclosure, data on enrollment, data on

claims payment policies and practices, periodic fi
22

disenrollment, data on the number of claims denials,
23

data on rating practices, information on cost-sharing
24

and payments with respect to any out-of-network
25

19.)))))) (2) P

coverageLAIN LANGUAGE.—In this subsection, the
5

term ‘‘plain language’’ means language that the in6
tended audience, including individuals with limited

7

English proficiency, can readily understand and use
8

nized, and follows other best practices of plain lan

guage writing.

because that language is clean, concise, well-orga
11

velop and issue guidance on best practices of plain

(3) GUIDANCE.—The Commissioner shall de
13

20.))))))

language writing.SEC. 134. APPLICATION TO QUALIFIED HEALTH BENEFITS
2

PLANS NOT OFFERED THROUGH THE
3

HEALTH INSURANCE EXCHANGE.
4

The requirements of the previous provisions of this
5

subtitle shall apply to qualified health benefits plans that
6

change only to the extent specified by the Commissioner.

21.)))))))F) VA.—Coverage under the veteran’s

are not being offered through the Health Insurance Ex
8

health care program under chapter 17 of title
9

erage for the individual involved is determined

38, United States Code, but only if the cov
11

by the Commissioner in coordination with the
12

Secretary of Treasury to be not less than a level
13

specified by the Commissioner and Secretary of
14

retary of Treasury, based on the individual’s

Veteran’s Affairs, in coordination with the Sec
16

22.))))))))(G) O

priority for servicesTHER COVERAGE.—Such other health
19

fits risk pool, as the Commissioner, in coordina

tion with the Secretary of the Treasury, recog

nizes for purposes of this paragraph.

benefits coverage, such as a State health bene
23

The Commissioner shall make determinations under
24

this paragraph in coordination with the Secretary of
25

23.)))))(3) T

the Treasury.REATMENT OF CERTAIN NON-TRADI2
TIONAL MEDICAID ELIGIBLE INDIVIDUALS

vidual who is a non-traditional Medicaid eligible in

dividual (as defined in section 205(e) (4)(C)) in a

.—An indi
5

State may be an Exchange-eligible individual if the
6

individual was enrolled in a qualified health benefits
7

plan, grandfathered health insurance coverage, or
8

fore the individual became a non-traditional Med

icaid eligible individual.

24.)))))(1) S

graph (4), smallest employers described in this para

graph are employers with 10 or fewer employees.

current group health plan during the 6 months beMALLEST EMPLOYER.—Subject to para
4

graph (4), smaller employers described in this para

graph are employers that are not smallest employers

(2) SMALLER EMPLOYERS.—Subject to para
7

ployees.

described in paragraph (1) and have 20 or fewer em
9

(3) LARGER EMPLOYERS.—
10

(A) IN GENERAL.—Beginning with Y3, the
11

scribed in paragraph (1) or (2) to be Exchange

eligible employers.

Commissioner may permit employers not de
25.))))))))

ployer is permitted to be an Exchange-eligible em

ployer under this subsection and enrolls employees

(4) CONTINUING ELIGIBILITY.—Once an em
23

ployer shall continue to be treated as an Exchange

eligible employer for each subsequent plan year re

through the Health Insurance Exchange, the em
•

J. 55–345
1

gardless of the number of employees involved unless
2

and until the employer meets the requirement of sec3
tion 311(a) through paragraph (1) of such section

26.))))))(A) S

SIBILITY

ATISFACTION OF EMPLOYER RESPON.—For any year in which an employer
11

is an Exchange-eligible employer, such employer
12

may meet the requirements of section 312 with
13

ing such employees the option of enrolling with

respect to employees of such employer by offer
15

Exchange-participating health benefits plans
16

27.))))))))(6) A

through the Health Insurance ExchangeFFILIATED GROUPS.—Any employer which
2

is part of a group of employers who are treated as
3

a single employer under subsection (b), (c), (m), or
4

(o) of section 414 of the Internal Revenue Code of
5

1986 shall be treated, for purposes of this subtitle,
6

28.)))))))) (ii) E

as a single employer.XCEPTION FOR IMMINENT AND
13

SERIOUS RISK TO HEALTH.—Clause (i)
14

mines that a delay in termination, result

ing from compliance with the procedures

shall not apply if the Commissioner deter
17

nation, would pose an imminent and seri

ous risk to the health of individuals en

rolled under the qualified health benefits

specified in such clause prior to termi
21

29.))))))))(b) P

sioner shall pay from time to time from the Trust Fund

plan of the QHBP offering entity.AYMENTS FROM TRUST FUND.—The Commis
18

essary to make payments to operate the Health Insurance

such amounts as the Commissioner determines are nec
20

Exchange, including payments under subtitle C (relating
21

30.)))))) (A) T

to affordability credits). AXES ON INDIVIDUALS NOT OBTAIN2
ING ACCEPTABLE COVERAGE

ceived in the Treasury under section 59B of the

.—The amounts re
4

quirement of health insurance coverage for indi

viduals).

31.)))))

Subtitle A—Medicaid and Health Reform

Internal Revenue Code of 1986 (relating to reTITLE VII—MEDICAID AND CHIP
230

•

J. 55–345
Sec. 1701. Eligibility for individuals with income below 133

Federal poverty level.

Sec. 1702. Requirements and special rules for certain Medicaid eligible individuals.

Sec. 1703. CHIP and Medicaid maintenance of effort.

Sec. 1704. Reduction in Medicaid DSH.

Sec. 1705. Expanded outstationing.

Subtitle B—Prevention

Sec. 1711. Required coverage of preventive services.

Sec. 1712. Tobacco cessation.

Sec. 1713. Optional coverage of nurse home visitation services.

Sec. 1714. State eligibility option for family planning services.

32.)))))))))))))))))))))Subtitle D—Coverage

Sec. 1731. Optional medicaid coverage of low-income HIV-infected individuals.

Sec. 1732. Extending transitional Medicaid Assistance (TMA).

Sec. 1733. Requirement of 12-month continuous coverage under certain CHIP

programs.

Subtitle E—Financing

Sec. 1741. Payments to pharmacists.

Sec. 1742. Prescription drug rebates.

Sec. 1743. Extension of prescription drug discounts to enrollees of medicaid

managed care organizations.

Sec. 1744. Payments for graduate medical education.

33.))))))))))))

1⁄3 percent of the(ii) RFP CONTRACT DESCRIBED.—
21

The RFP contract described in this section
22

retary and a sponsor of a prescription drug

is a contract entered into between the Sec
24

plan pursuant to the Centers for Medicare
25

408

& Medicaid Services’ request for proposals
•

J. 55–345
1

issued on February 17, 2009, relating to
2

Medicare part D retroactive coverage for
3

34.)))))))))))))))

certain low income beneficiaries, or a simi1 amounts authorized to be appropriated for such purpose,
2

there are authorized to be appropriated, out of any monies
3

in the Public Health Investment Fund, the following:
4

‘‘(1) $51,000,000 for fiscal year 2010.
5

‘‘(2) $54,000,000 for fiscal year 2011.
6

‘‘(3) $57,000,000 for fiscal year 2012.
7

‘‘(4) $59,000,000 for fiscal year 2013.
8

‘‘(5) $62,000,000 for fiscal year 2014.
9

‘‘(6) $65,000,000 for fiscal year 2015.
10

‘‘(7) $68,000,000 for fiscal year 2016.
11

‘‘(8) $72,000,000 for fiscal year 2017.
12

‘‘(9) $75,000,000 for fiscal year 2018.
13

I Hope the Seniors are reassured? sincerely Fezzy Bear

‘‘(10) $79,000,000 for fiscal year 2019.’’.

I Know , I Know, if only Nancy would have let us read it, to begin with, sincerely Fezzzy Bear

There goes 13 of my employees so I can get below 50 and that's provided I don't close all together. I've spent the last 25 years building my company from 3 employees and have always treated them like family instead of workers. It's just one more nail in the coffin of small business and I'm too tired to go through anymore paperwork, fines, or regulations.

It's a RIGHT. And you know who gives you your rights- the Government!

• Affordable Health Care is a right.
• Clean water is a right.
• Clean air is a right.
• Good nutritious food is a right.
• A comfortable place to live is a right.
• A good job is a right.
• A good education is a right.

It is the duty of those having more than others to provide.

We must all be equal. No one may have more or less.

The government provides.

Please work hard so I can get my fair share.

Thank You..

I'm 63 years old. I worked for Qwest phone company for over 30 years. Part of my retirement was health benefits...My monthly payment was $41. My wife has stage 3 ovarian cancer and has been on chemo for the last 10 years to keep her alive. Qwest sold my division to The Carlile Group (G.W. Bush) for 8 Billion dollars. The Carlile group sold it to R.H. Donnelly who I never worked for and they drove it in the ground and filed chapter 11. After coming out of chapter 11 and with the help of the union (CWA & IBEW) They dropped all benefits to the retirees over the next 2 years. I now pay $800 a month and next year $1600 then it's over. How do you help me without some sort of reform or do I just let my wife die? jk

Seems like the only thing real is taxes. No benefits other than some sweetheart deals for the unions. Seniors in perfect health will benefit if they find any. The rest need to get their affairs in order.

It's our money first off, not theirs, and then a fine for not purchasing health care, what a boon.

Secret to health care is employment---the Dems have done nothing for employment and the Stimulus only made GOVERNMENT jobs which leach off of the system.

I am meeting a lot of once dems who will never vote dem again (many black) because of the thick Washington wax in that mans head lodged between those huge ears. This is a sham

START OVER!

WOW,

2700 page bill boiled down to one page? Freakiing amazing! This is nothing to do with health care and all about repaying the SEIU for electing Obama, this bill is mainly lies and exagerations and makes Enron's accounting look like the poster child of financial rectitude. Welcome to the USSA comrades. Oh! they attached the Education reform bill to the monstrosity just to add to the Left Wing takeover! The UK National Health service is the third largest employer in the world, aagter the Chinese Army and the Indian Railways, for less than 80 million people! just imagine the DMV staff running your mrdical care, HAHAHJAHAHA!

OBAMA has said seniors sex life ends at age 70--these are Obama's words also seniors will be denied health care after age 70 because it will cost too much to keep them alive---Obama is very careful to show only people of younger age not seniors being able to get this so called GOVERNMENT CONTROLLED HEALTH CARE this is SOCIALISM doesn't matter how you say it the only thing seniors will get is prescriptions.

AuntE, stats can say different things depending on how you look at them. 8% could mean that he isnt hiring lobbyists in his cabinet. Guys who simply still work for the big companies to be on the inside making sure their companies and pensions are safe. You know like Paulson who came in and "saved" america with bailouts, oh wait, saved his company, goldman Saks with bailouts and didnt save the competition. But that is the way it works isnt it.

If the stimulus money paid every legal US citzen $10,000 ea Which it could have based on the billons to bail out the insurance companies. USA's economic development would have returned.

DONT give the money to Insurance Companies, we've made them too powerful as it is.

According to the bill - you have to BUY insurance or PAY a FINE.

If I can't afford to live in my house - how in the he.. am I going to pay for Health Insurance.

I also love how they want to model things after the Mayo Clinic, when one of the Mayo Clinic Satellite offices in Arizona announced recently that it will no longer accept Medicare because it can't afford to. And the Mayo has always made patients file the Medicare paperwork themselves (most Dr's offices do this for patients, but it increases administrative costs tremendously).

We need reform, but expanding a broken system (Medicare) is probably not a good idea.

If this thing passes, you are going to see a tremendous number of providers (doctors) jumping ship and retiring or finding jobs at pharmaceuticals and insurance companies. So, more people will be covered, but there will be fewer people to see them -- sounds like fun to me.

well everyone, I can't afford another house payment. The illegals have taken up most of the jobs in the construction industry around here. I'm struggling to find work and don't really want to break my back for 8 bucks an hour. My wages are getting undercut and have been for many years. I guess at least I'll have health insurance when I move into my van down by the river. So, I'm better off making less than 44,000 a year. Let's see, so if I make even less than that, and claim to be from Hungary and can't speak english and have no papers? I get food stamps, a place to live, health insurance. Hmmm. If i start having even more kids I get even more benifits.. Hmmm. So if I have eight kids and cant afford any of them than I will get even more benifits. Hmmm. I think I get how America WORKS now.