Blog Archives

Are Co-ops an Alternative to the Public Option?

8/18/2009

The President recently said he is willing to sign a bill that does not include a public option. He would support a bill with co-ops instead. That would be great, if his idea of co-ops was the same as what is described as a “real co-op” the article “Don’t Let Co-ops Become a Trojan Horse”.

            A real co-op is:
Run by its members, Funded by its members and other private sources, and Controlled by its members.
What would congress need to do for these “real co-ops”?   Congress needs to amend the tax laws to do two things: Allow mutual insurance companies to be
the foundation of non-profit insurance companies;
and give people the same tax breaks for getting
insurance from a co-op as from their employer.

The over 600 page senate bill creates the co-op the president is talking about. It hardly seems like it would take 600 pages to accomplish that which is described above. The truth is the senate bill creates a co-op that is government controlled and government funded.

     “Don’t Let Co-ops Become a Trojan Horse” by Conn Carroll. http://fixhealthcarepolicy.com/in-the-news/dont-let-co-ops-become-a-trojan-horse/

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Uphold the Constitution

8/18/2009

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A man at Congressman Alan Mollohan’s Town Hall, on August 14, asked about the 10th Amendment, which says, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to people.” What does this mean? The powers not given to the federal government by the Constitution are powers of the state or the people. Article 1 Section 8 of the Constitution of the United States of America lists the powers of congress.

The man continued to ask the congressman what in the constitution gives congress the power to create this health care plan. Congressman Mollohan did not have an answer. It is not surprising he did not have an answer. James Madison would not be able to point out a power in the Constitution that gives congress this power, as evident by his statement, “I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents.” It would be good for everyone in the United States to have adequate Health Care; however it is neither the federal government’s responsibility nor it within the powers of the federal government to ensure we all have health care. We as individuals can help each other and states can create programs to help people. In fact, West Virginia has opportunities in place for place for people to get health care, such as Access West Virginia.

The Constitution is the law of the Untied States of America, and we should respect it as such. It is not just the duty of our elected officials to uphold the Constitution, but the duty of every American. We can do this by educating ourselves and others about the constitution and only electing officials who will uphold the Constitution. If an official does not uphold the Constitution, they need to be replaced by someone who will.

That being said, I encourage you to read the constitution. How can we uphold the Constitution if we do not know what it says? In fact, maybe we should send a copy to our elected officials. You can download a copy of the Constitution with the amendments below.

A man at Congressman Alan Mollohan’s Town Hall, on August 14, asked about the 10th Amendment, which says, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to people.” What does this mean? The powers not given to the federal government by the Constitution are powers of the state or the people. Article 1 Section 8 of the Constitution of the United States of America lists the powers of congress.

The man continued to ask the congressman what in the constitution gives congress the power to create this health care plan. Congressman Mollohan did not have an answer. It is not surprising he did not have an answer. James Madison would not be able to point out a power in the Constitution that gives congress this power, as evident by his statement, “I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents.” It would be good for everyone in the United States to have adequate Health Care; however it is neither the federal government’s responsibility nor it within the powers of the federal government to ensure we all have health care. We as individuals can help each other and states can create programs to help people. In fact, West Virginia has opportunities in place for place for people to get health care, such as Access West Virginia.

The Constitution is the law of the Untied States of America, and we should respect it as such. It is not just the duty of our elected officials to uphold the Constitution, but the duty of every American. We can do this by educating ourselves and others about the constitution and only electing officials who will uphold the Constitution. If an official does not uphold the Constitution, they need to be replaced by someone who will.

That being said, I encourage you to read the constitution. How can we uphold the Constitution if we do not know what it says? In fact, maybe we should send a copy to our elected officials. You can download a copy of the Constitution with the amendments below.

Congressman Alan Mollohan

E-Mail: CongressmanMollohan@mail.house.gov
Faxing is the most effective way to communicate with a congressman.

WASHINGTONPhone: (202) 225-4172Fax: (202) 225-7564Congressman Alan B. Mollohan2302 Rayburn House BuildingWashington, DC 20515

CLARKSBURGPhone: (304) 623-4422Fax: (304) 623-0571Congressman Alan B. MollohanRoom 209, Post Office BuildingPO Box 1400Clarksburg, WV 26302-1400

MORGANTOWNPhone: (304) 292-3019Fax: (304) 292-3027Congressman Alan B. MollohanMarina Tower, Suite 50448 Donley StreetPO Box 720Morgantown, WV 26507-0720

PARKERSBURGPhone: (304) 428-0493Fax: (304) 428-5980Congressman Alan B. MollohanRoom 2040, Federal Building425 Juliana StreetParkersburg, WV 26101

WHEELINGPhone: (304) 232-5390Fax: (304) 232-5722Congressman Alan B. MollohanFederal BuildingChapline StreetWheeling, WV 26003

Constitution
File Size:	219 kb
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How will we pay?

8/18/2009

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One of the concerns raised at a recent AARP Health Care Seminar I attended was the cost of the health care reform legislation being discussed at this time. The AARP representative admitted paying for the program is something still being worked out. When our country is already over $11,000,000,000,000 in debt, why are we considering a program that we do not know how to fund? This is the time ratchet down our spending, not create new expensive programs.

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Fix the Tire

8/18/2009

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In question at Congressman Mollohan’s town hall in Wheeling on August 14, a man used an analogy of a car to describe what HR 3200 does to our health care system. The man said that when your car has a flat tire you don’t buy a new car; you change the tire. The man was simply saying that we have a good health care system. It has some problems, but we do not need a complete overhaul.

The congressman said that HR3200 is not a complete overhaul. This legislation would phase out any insurance plans that do join the Health Exchange. In the Health Exchange, plans will have to meet many requirements laid out in the legislation and regulations determined by the health choices commissioner, thus going under government control. This bill also creates a public option that will be available to anyone, but does not have to be profitable. Thus, the public option will charge less than the private plans in the Exchange. How will private plans survive? A doctor, who attended the town hall, pointed out that in his small business it would be more economical to drop health insurance for his employees and pay the 8% tax businesses making over $250,000/year will have to pay if they do not provide insurance. Eliminating private insurance, encouraging businesses to drop coverage, how is this not a complete over haul?

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Contact AARP About Health Care Reform

8/18/2009

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On July 13, I attended an AARP seminar on Health Reform. Although the AARP representatives claimed they are not endorsing any bill at this time, all the literature handed out at the meeting referred seemed to support HR3200, which will lead to government takeover of the health care system. Government takeovers of Health Care in other countries do not help the older sector of society. Also, many seniors I talk to are not necessarily concerned for themselves. They want to preserve liberty for future generations. The AARP representatives say they want to hear from their members. If you belong to AARP, please contact them and let them know what you think about Health Care reform. Tell them to say no to government run health care.

By Mail

AARP 601 E Street N.W. Washington, DC 20049

By Phone

Contact Center Hours7:00 a.m. to 11:00 p.m. ETMonday through Friday

Toll-Free Nationwide: 1-888-OUR-AARP(1-888-687-2277)

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Sign Ideas for Health Care Rally

8/18/2009

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I have been asked about ideas for signs. Here some ideas relating to the health care legislation. Remember this is about your voice being heard, so when making your sign consider what you want to say to your elected officials. Please, keep the signs respectful and do not put personal attacks on any signs. This is about legislation and policy.

Hands Off My Health Care

Just Say NO to the Public Option

Vote NO on HR3200

Defend the 10th Amendment

Don’t Bankrupt Our Children

Who’s going to pay?

Stop stealing from our children

Socialism = Economic Slavery

Giving Up Responsibility=Giving Up Freedom

Take a Stand for Freedom

NO to Government Controlled Health Care

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Questions for Congress

8/11/2009

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Do you pledge that you will not vote for any Health Care Reform Bill that: a) You have not read, personally, in its entirety; and, b) has not been available, in its entirety, to the American people on the Internet for at least 72 hours, so that they can read it too?

Do you believe Members of Congress should have to be covered by the same Government Run Health Care they are proposing in the new legislation?

The bills being considered make serious cuts to the Medicare program. Do you support taking money out of Medicare to put in another government program?

The income tax increases to pay for the health plan are only supposed to affect the "very wealthy". However, many small businesses file their taxes as individuals and would be hit by these taxes. What will you do to protect small business struggling in this recession from further taxation?

Cash for clunkers was planned to last four months, but ran out of money after two days. HR 3200 is a 1017 page piece of legislation. This complicated program has many variables. If Congress cannot accurately count the cost of cash for clunkers, how can we know they will accurately count the cost of the health care plan and should we take on such a large project when our country already has a mountain of debt?

Can you guarantee I will be able to keep my health insurance for as long as I want to keep it?

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Insurance Plans You Can Keep

8/10/2009

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You can see in my blog, “Can You Keep You Plan?”* that all insurance plans that do not become exchange participating will be phased out. Now we need to learn about exchange-participating health benefits plans. Let’s start with the definition from page 73 of HR 3200.

(c) EXCHANGE-PARTICIPATING HEALTH BENEFITS PLAN DEFINED.—In this division, the term ‘‘Exchange-participating health benefits plan’’ means a qualified health benefits plan that is offered through the Health Insurance Exchange.

Wow, now I understand. Here are some highlights of Title II-Health Insurance Exchange and Related Provision (starting on page 72 of HR3200). Remember all private health insurance that is not in the exchange will be phased out.

1. The Commissioner will determine the benefits Exchange-participating health benefits plans can offer.

(a) IN GENERAL.—The Commissioner shall specify the benefits to be made available under Exchange-participating health benefits plans during each plan year, consistent with subtitle C of title I and this section. (Page 84-HR3200)

2. The Commissioner will determine cost sharing (how much you pay out of pocket) under Exchange-participating health benefits plans.

(6) RANGE OF PERMISSIBLE VARIATION IN COST-SHARING.—The Commissioner shall establish a permissible range of variation of cost-sharing for each basic, enhanced, and premium plan, except with respect to any benefit for which there is no cost sharing permitted under the essential benefits package. (page 87-HR3200)

3. The commissioner will determine your network (what doctors you can see) inExchange-participating health benefits plans.

(a) IN GENERAL.—A qualified health benefits plan that uses a provider network for items and services shall meet such standards respecting provider networks as the Commissioner may establish to assure the adequacy of such networks in ensuring enrollee access to such items and services and transparency in the cost-sharing differentials between in-network coverage and out-of-network coverage. (page 25- HR3200)

This gives the commissioner authority to make regulations concerning the network for qualified health benefits plans. As the definition of Exchange-participating health benefits plans says, exchange-participating plans are qualified health benefits plans.

In this 1017 page bill, there are many requirements on the Exchange-participating health benefits plans. I was not able to discuss them all here. Also, the commissioner will be able to impose other regulations at his/her discretion.

We have been told we will get to keep our health insurance if we like it. However, any health insurance that does not become an exchange-participating health benefits plan will be phased out and the ones that become exchange-participating health benefits plan will be government controlled and regulated by the commissioner. These plans will have the same names and they will still be privately owned, but they will not be the same plans we are use to having. All the plans will become one standard plan offered by different companies. What kind of choice will that be?

We will not control our health care; our doctors will not control our health care; our insurance companies will not even control our health care. Who will be making the decisions about our health care? The commissioner will control our health care, so who is this commissioner? The commissioner is a political appointee by the president (page 41-HR3200).

*"Can You Keep Your Plan" http://teapartyncwv.weebly.com/2/post/2009/08/can-you-keep-your-plan.html

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Can You Keep Your Plan?

8/10/2009

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How does this bill really affect the plans Americans have now? Will we still have choices or will we end up on a government-controlled plan anyway?

Well, according to page 19 of HR 3200, health insurance that is not “grandfathered” will only be offered as an “Exchange-participating health benefits plan.” The following is an excerpt from page 19 of HR 3200:

In general-individual health insurance that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.

That does not tell us much if we do not know to what “grandfather” or “exchange-participating” refer.

What is a grandfathered plan?

In Sec. 102 “Protecting the choice to keep current coverage” of HR 3200 (starting on page 16), the bill puts three major limitations on grandfathered plans.

1.      The plan cannot accept any new enrollees.

In general.-Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1. (Excerpt from page 16 of HR 3200)

Obviously, a plan that does not except new enrollees will not last very long. Also, this locks us into whatever health plan we have unless we go to an “exchange participating plan.” If our work insurance is dropped or we change jobs, we will not be able to enroll in another plan, unless it is an exchange-participating benefits plan.

2.      The plan cannot change any terms and conditions.

“Limitation on changes in terms or Conditions-Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.” (Excerpt from page 16 of HR 3200).

If anything in our health plan changes it will become an exchange participating benefits plan or cease to exist.

3.      The plan cannot charge higher premiums to at risk individuals.

The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner. (Excerpt from page 17 of HR 3200)

Ordinarily, insurance companies, regardless of what kind of insurance they’re selling, make money by paying out less money than they take in. They do this by charging higher rates to people that they believe are at a higher risk of needing a payout down the road. Grandfathered plans would have to either charge everyone high rates, including the healthy people, to make up for the unhealthy people, which would allow the public plan to undersell them, or they would go out of business trying to charge everyone the same low rates. This would cause grandfathered plans, those do not become exchange-participating health benefits plans, to go out of business.

These limitations are designed to phase out all grandfathered plans by forcing them to become exchange participating health benefits plans or causing them to go out of business. What does it mean to be an Exchange-participating health benefits plan? Check my blog entry “Insurance Plans You Can Keep”* to find out.

*"Insurance Plans You Can Keep" http://teapartyncwv.weebly.com/2/post/2009/08/insurance-plans-you-can-keep.html

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Health Care Bill (HR. 3200)

8/3/2009

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My husband went through the Health Care bill (HR 3200) that has come out of the House and found many points that the American people need to know and our elected representatives need to answer questions about. In the month of August, I will use my blog to explore these points in more detail. The following list covers the first 200 pages of the 1017 page bill.

·         All health care must meet government standards of price, coverage and operations—p. 15

·         After health care goes into effect, private plans can only continue if they don’t enroll new people, don’t change coverage, copays, or coinsurance, and only limited changes in premiums—p. 16

·         All employment-based health care plans must meet all government requirements after five years—p. 17

·         If you have limited health insurance (like a catastrophic coverage plan), you’ll still need to buy a comprehensive plan—p. 18

·         All individual health insurance must be purchased at government run exchange—p. 19

·         Insurance plans have to accept everyone rat the same price, no matter how sick they are without charging them more—p. 19

·         Families will be charged as individuals—p. 21

·         Audit of all self-insured health care plans—p. 22

·         Mandatory mental health and substance abuse coverage—p. 23

·         Government decides what doctors you see—p. 24

·         If your health care plan is too profitable, we’ll make you give out refunds until its not—p. 24

·         Government sets benefits for all health care plans—p. 25

·         Must cover abortion and euthanasia—p. 26

·         Abortion coverage—p. 27-28

·         Government committee recommends what treatments should be covered—p. 30

·         Government committee sets benefits—p. 32

·         Government controls how you can advertise your health plan—p. 37

·         Government makes final decisions on what’s covered and what’s not covered in both public and private plans—p. 38

·         Commissioner can apply all exchange rates to non-exchange plans—p. 40

·         Government settles disputes between insurance companies—p. 40

·         Political appointee runs nation’s health care system—p. 41

·         Government randomly audits health care companies and makes them pay the fees for it—p.43

·         Blank check to the government to gather any personal information it wants—p. 43

·         Government can redefine what terms mean—p. 45

·         Bureaucracy to resolve complaints—p. 47

·         Coverage for illegal aliens—p. 50

·         Establishes national health ID card—p. 58

·         Government electronic access to all financial accounts—p. 59

·         Penalties if you attempt to keep the government from accessing financial accounts—p. 62

·         Subsidy for unions and ACORN—p. 65

·         Blank check to spend up to $10 billion for union & ACORN health care—p. 70

·         Health care programs “off the books”—p. 71

·         Secretary can ration care—p. 71

·         Government won’t let in unless they don’t like your current coverage—p. 73

·         Veterans may be required to buy health insurance to access VA—p. 77

·         Once you’re in the federal health care system, there is no way out—p. 80

·         If your state wants to give you better coverage than the federal government provides, the state has to pay the federal government for the privilege—p. 87

·         Commissioner can hand out sweetheart deals to his friends—p. 89

·         Ensures illegal aliens don’t need to speak English to get health care—p. 91

·         Can’t go out of network to get health care—the return of the HMO—p. 92

·         ACORN & Americorp paid to spread information about health care and sign people up—p. 95

·         Government establishes when you can sign up for health care—p. 96

·         Government will sign you up for health insurance automatically whether you like it or not—p. 97

·         All newborns will automatically be enrolled in Medicaid until they enter the government health care plan—p. 101

·         All Medicaid-eligible people automatically enrolled in Medicaid even if they don’t apply—p. 102

·         Children will get kicked out of CHIP but there may not be room to enroll them an exchange plan, meaning that children may become uninsured—p. 102

·         After five years, investigative office to snoop out fraud sunsets—p. 109

·         Taxes people who don’t have health insurance to pay for others—p. 110

·         State health care plans must comply with federal rules—p. 111

·         Public plan doesn’t need to be profitable—read subsidized—p. 117

·         Health care benefits enforceable in federal court—new entitlement—p. 118

·         $2 billion startup capital for public option—p. 120

·         Government sets prescription drug prices—p. 122

·         For first 3 years, doctors will get 5% more from public plan than private plans—p. 122

·         Prices cannot increase after first 3 years—p. 123

·         No judicial review or administrative review of government set prices—p. 124

·         Secretary can set up any kind of payment system he or she wants—p. 125

·         Different geographic regions can be given different care—p. 126

·         Government sets pay for doctors—p. 127

·         If we apply for health care tax credit but qualified for Medicaid, we are enrolled for Medicaid whether we like it or not—p. 131

·         In the first two years, the poor can only get into the lowest tiered plans—p. 131

·         If you have employer-based health care, you can’t get health care tax credits—p. 132

·         Tax credits to subsize people up to 400% of federal poverty level (for family of four, currently $87,640)—p. 133

·         Study to determine whether to tax things that are currently tax free—p. 135

·         Health care service accesses your tax returns from IRS—p. 139

·         If income or family compensation changes, need to inform the government under penalties—p. 140

·         Different geographies may receive different care (political payoffs)—p. 142

·         Employer must provide any information about employees that the government wants—p. 145

·         Employers must auto enroll employees in health care—p. 145

·         Employers pay 72.5% of the premium cost of single plans and 65% of the cost of family plans—p. 146

·         Part time employees must be covered by employers—p. 146

·         People are automatically enrolled in the lowest tier plan unless you affirmatively opt out—p. 148

·         Employers can pay 8% tax on payroll to get out of providing health care for their workers—p. 149

·         Employers can only self-insure if they meet all the government’s criteria—p. 153

·         Employers who self-insure but don’t comply with all rules can be fined $100 a day—p. 155

·         Fines can be levied even if you didn’t know that something was wrong if the government thought you should have known—p. 156

·         Penalties go into the general treasury, not the health care system—p. 158

·         Employers who don’t join approved government system or don’t do it right are taxed—p. 159

·         Government establishes terms and conditions of employer plans—p. 160

·         Random audits of employers—p. 161

·         2.5% tax on income for anyone who doesn’t buy health insurance—p. 167

·         Tax applies even if you’re only without insurance for part of the year—p. 169

·         Illegal aliens don’t have to pay the health care tax—p. 170

·         Government will examine your religion to determine whether you can opt out religiously—p. 170

·         The end of two-person coverage—only single and family plans—p. 174

·         These taxes aren’t taken into account when they calculate your tax credit—p. 174

·         Employers have to provide info to the government on who they provide health care for—p. 175

·         If your average payroll is $20,000 per person, you get a tax credit equal to 50% of your health care costs. It phases out as the average payroll goes up. It also phases out if you have more than 10 employees. Great incentive not to pay people over $20,000—p. 189

·         No credits for any employee who makes over $80,000 a year—p. 190

·         Anyone you pay at least $5,000, must receive health insurance from employer—p. 191

·         The end of two person coverage. Only single payer and family coverage—p. 192

·         Any tax deduction for health care is reduced by the amount of this new tax credit—p. 192

·         Officers and employees of government health care bureaucracy will have access to all personal and financial records—p. 194

·         Extra tax on people who the government believes make too much—p. 197

·         Taxes go even higher after next presidential election—p. 198

I know that the blue dog Democrats have been negotiating changes, but the bottom line is this is a bill that is bad for America. We do not need another big spending program that will increase our mountain of debt, burden responsible Americans, and lead to govern

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