Blogging the Bill #1

Blogging the Bill

Section 1:

Pre-existing condition exclusion ban is first on the Table of Contents. Lookin' good so far!

Important to note: the glossary starts on page 8 and runs to 14. I feel like this might be worth earmarking, so to speak, for future reference.

Reading the glossary, it appears I also need to read the Public Health Service Act of 1946.

Now they're bringing in the Social Security Act. Good thing there's lots of room on my hard drive... and the Employee Retirement Income Security Act of 1974.

Is this a pharmacological study? We've started talking Y1, Y2, Y3... as in years after the bill takes effect, starting in 2013. Perhaps this will help industry insiders understand the legislation.

Finally Title 1-Protections and Standards for Qualified Health Benefits Plan!
Jesus... another glossary. Webster's should get in on this.

Section A: What exactly is a Health Benefit Provider?
1. Grandfathered Health Insurance Coverage (p 16)
Huzzah! Everyone stop freaking out... you can keep your coverage.

Well, if:
a. The company stops new enrollment after the Bill takes effect
b. They don't change any benefits or terms, either
c. And they don't change the percentage by which your premium increases every year without changing it for everyone equally.

(So far, I don't think I'd like to be running an insurance company with these conditions.)

These grandfathered programs would have a 5-year grace period to meet requirements and to get up to speed with the benefit requirements. (Coming in a later section the bill promises.) Collective sigh of relief from the industry?

Now we're getting to the exceptions section which is so convoluted I absolutely have to look up the Public Health Service Act. Thank you Cornell University Law School for your online version of the Act.

Basically, these things remain not included in the definition of "health insurance benefit" if these were already separate from the plan: accident only coverage, workers comp, auto insurance, on-site medical insurance coverage, limited vision and dental, long-term care insurance a.k.a. nursing home insurance.

Nothing too shocking there as these seem to be not included in all insurance plans I've heard of.

Next up, Subtitle B: Standards guaranteeing access to affordable health coverage and such sexy topics as pre-existing conditions and other enrollment requirements.