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
(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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