What the Pelosi Health-Care Bill Really Says

[Area52]

http://online.wsj.com/article/SB1000...abs%3Dcomments

By BETSY MCCAUGHEY
The health bill that House Speaker Nancy Pelosi is bringing to a vote (H.R. 3962) is 1,990 pages. Here are some of the details you need to know.

What the government will require you to do:

• Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.

• Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.

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Associated Press

Protestors wave signs in front of the Capitol on Thursday.
.On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.

• Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.

• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.

• Sec. 412 (p. 272) says that employers must provide a "qualified plan" for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.

Eviscerating Medicare:

In addition to reducing future Medicare funding by an estimated $500 billion, the bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.

• Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home."

The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to "disseminate this approach rapidly on a national basis."

A December 2008 Congressional Budget Office report noted that "medical homes" were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority.

• Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.

• Secs. 1158-1160 (pp. 499-520) initiates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. This will reduce payments for care (and by implication the standard of care) for hospital patients in higher cost areas such as New York and Florida.

• Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors). Advantage plans have warned this will result in reductions in optional benefits such as vision and dental care.

• Sec. 1402 (p. 756) says that the results of comparative effectiveness research conducted by the government will be delivered to doctors electronically to guide their use of "medical items and services."

Questionable Priorities:

While the bill will slash Medicare funding, it will also direct billions of dollars to numerous inner-city social work and diversity programs with vague standards of accountability.

• Sec. 399V (p. 1422) provides for grants to community "entities" with no required qualifications except having "documented community activity and experience with community healthcare workers" to "educate, guide, and provide experiential learning opportunities" aimed at drug abuse, poor nutrition, smoking and obesity. "Each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individual served by the program."

These programs will "enhance the capacity of individuals to utilize health services and health related social services under Federal, State and local programs by assisting individuals in establishing eligibility . . . and in receiving services and other benefits" including transportation and translation services.

• Sec. 222 (p. 617) provides reimbursement for culturally and linguistically appropriate services. This program will train health-care workers to inform Medicare beneficiaries of their "right" to have an interpreter at all times and with no co-pays for language services.

• Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs. For example, grants for nursing schools should "give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population." And secondary-school grants should go to schools "graduating students from disadvantaged backgrounds including racial and ethnic minorities."

• Sec. 305 (p. 189) Provides for automatic Medicaid enrollment of newborns who do not otherwise have insurance.

For the text of the bill with page numbers, see www.defendyourhealthcare.us.

[fab]

Good to know someone is reading the bill!

[draggar]

I doubt it is direct quotes:

• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.

No way a bill would be that vague ("thousands of dollars").

But with that aside:

• Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.

Doctors get screwed.

• Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs. For example, grants for nursing schools should "give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population." And secondary-school grants should go to schools "graduating students from disadvantaged backgrounds including racial and ethnic minorities."

"We're doing all we can do to promote equality by treating everyone differently".

[fab]

No way a bill would be that vague ("thousands of dollars").

Hey Draggar, he gave a page reference, and I posted the link to the actual bill. Now go fetch!

[draggar]

Hey Draggar, he gave a page reference, and I posted the link to the actual bill. Now go fetch!

‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
2 HEALTH CARE COVERAGE.
3 ‘‘(a) TAX IMPOSED.—In the case of any individual
4 who does not meet the requirements of subsection (d) at
5 any time during the taxable year, there is hereby imposed
6 a tax equal to 2.5 percent of the excess of—
7 ‘‘(1) the taxpayer’s modified adjusted gross in8
come for the taxable year, over
9 ‘‘(2) the amount of gross income specified in
10 section 6012(a)(1) with respect to the taxpayer.
11 ‘‘(b) LIMITATIONS.—
12 ‘‘(1) TAX LIMITED TO AVERAGE PREMIUM.—
13 ‘‘(A) IN GENERAL.—The tax imposed
14 under subsection (a) with respect to any tax
15 payer for any taxable year shall not exceed the
16 applicable national average premium for such
17 taxable year.
18 ‘‘(B) APPLICABLE NATIONAL AVERAGE
19 PREMIUM.—
20 ‘‘(i) IN GENERAL.—For purposes of
21 subparagraph (A), the ‘applicable national
22 average premium’ means, with respect to
23 any taxable year, the average premium (as
24 determined by the Secretary, in coordina
25 tion with the Health Choices Commis
26 sioner) for self-only coverage under a basic

298

1 plan which is offered in a Health Insur
2 ance Exchange for the calendar year in
3 which such taxable year begins.
4 ‘‘(ii) FAILURE TO PROVIDE COVERAGE
5 FOR MORE THAN ONE INDIVIDUAL.—In the
6 case of any taxpayer who fails to meet the
7 requirements of subsection (d) with respect
8 to more than one individual during the tax
9 able year, clause (i) shall be applied by
10 substituting ‘family coverage’ for ‘self-only
11 coverage’.
12 ‘‘(2) PRORATION FOR PART YEAR FAILURES.—
13 The tax imposed under subsection (a) with respect
14 to any taxpayer for any taxable year shall not exceed
15 the amount which bears the same ratio to the
16 amount of tax so imposed (determined without re17
gard to this paragraph and after application of para18
graph (1)) as—
19 ‘‘(A) the aggregate periods during such
20 taxable year for which such individual failed to
21 meet the requirements of subsection (d), bears
22 to
23 ‘‘(B) the entire taxable year.
24 ‘‘(c) EXCEPTIONS.—

299

1 ‘‘(1) DEPENDENTS.—Subsection (a) shall not
2 apply to any individual for any taxable year if a de3
duction is allowable under section 151 with respect
4 to such individual to another taxpayer for any tax5
able year beginning in the same calendar year as
6 such taxable year.
7 ‘‘(2) NONRESIDENT ALIENS.—Subsection (a)
8 shall not apply to any individual who is a non9
resident alien.
10 ‘‘(3) INDIVIDUALS RESIDING OUTSIDE UNITED
11 STATES.—Any qualified individual (as defined in
12 section 911(d)) (and any qualifying child residing
13 with such individual) shall be treated for purposes of
14 this section as covered by acceptable coverage during
15 the period described in subparagraph (A) or (B) of
16 section 911(d)(1), whichever is applicable.
17 ‘‘(4) INDIVIDUALS RESIDING IN POSSESSIONS
18 OF THE UNITED STATES.—Any individual who is a
19 bona fide resident of any possession of the United
20 States (as determined under section 937(a)) for any
21 taxable year (and any qualifying child residing with
22 such individual) shall be treated for purposes of this
23 section as covered by acceptable coverage during
24 such taxable year.

There you go.

[fab]

Good work my man. Quite impressive how you got it so quickly. Now all I have to do is read it.

[draggar]

I have the bill saved on my computer.

[fab]

I have the bill saved on my computer.

Planning on running for office?

[draggar]

I would never get in - I'm too honest.

Edit: And I would hate it there - too much corruption.

[Gerry]

I doubt it is direct quotes:

No, of course it is not. This article is written by former New York Lt. Gov. Betsy McCaughey Ross, (R). I am not even sure you could claim artistic license in her interpretations.


As for the fines - Hilarious...as if illegal aliens file taxes to begin with...

As for the Physician Assistant thing, another huge joke…this is merely recognizing the profession of Physician Assistants as being capable and qualified IN ADDITION TO Nurse Practitioners and Clinical Nurse Specialists in treating and caring for post-hospital extended care. This is something already being done and has been done for decades but for the first time mentions the services of Physician Assistants


http://www.scribd.com/doc/21803801/H...-as-Introduced

Good to know someone is reading the bill!

Reading is one thing.

Re-writting it to portray it as something entirely different or the the pleasure of someone's audience is something else.

Anyone else really into partisan politics? She and Virginia Foxx should be running mates - perhaps Palin - as the "death squad grandma's".

http://online.wsj.com/article/SB2000...055918380.html

A more accurate title would have been What the Betsy McCaughey Health Care Bill Really Says.

[Donald Aquilano]

thanks Area 52 for the info.

[Gerry]

Yeah, thanks a52 for the misinformation and quoting all the misquotes.

[Mike Cruz]

Yeah, thanks a52 for the misinformation and quoting all the misquotes.

lol

[Area52]

Yeah, thanks a52 for the misinformation and quoting all the misquotes.

lol

Some of you folks are so predictable.
You should know about Misinformation. It got a clueless neighborhood watch organizer into the White House.
I'm sure only all-knowing and distinguished individuals as yourselves would know the truth about this trash of a bill.

[Gerry]

Then why not just post it as the Area52 and McCaughy bill?

Because what you posted is not the Pelosi bill or no other bill I am aware of.

This is what happens when you are not capable of reading things for yourself and hearing things for yourself to make an informed decision. You print and quote an article from someone that has an axe to grind and you take it as being factual.

You have to rely on someone to tell you how you should think. They do your thinking for you. What makes this even more infectious and more a scourge is then those people go and tell more and they tell more and so on.

I have not read the entire bill yet (I will). There are many things I agree with and not agree with. There are a few parts I do not understand and will need some clarification.

For the parts you quoted and posted, those are so laughable and so false, false, false, false, false. What surprises me even more is people can actually write an article on this and then people like you can post it and not once think of the simple notion that, gee...what if someone reads the actual bill and sees I made this nonsense up?

They bank their reputation and job on believing that no one will do that, ala Rush, Hannity, Beck and others...they hope like hell people (their audience) are just listening, nodding, and agreeing.

Not wonder there is such a divide in this country.

And no wonder they say reading is fundamental.

[Area52]

Then why not just post it as the Area52 and McCaughy bill?

Because what you posted is not the Pelosi bill or no other bill I am aware of.

This is what happens when you are not capable of reading things for yourself and hearing things for yourself to make an informed decision. You print and quote an article from someone that has an axe to grind and you take it as being factual.

You have to rely on someone to tell you how you should think. They do your thinking for you. What makes this even more infectious and more a scourge is then those people go and tell more and they tell more and so on.

I have not read the entire bill yet (I will). There are many things I agree with and not agree with. There are a few parts I do not understand and will need some clarification.

For the parts you quoted and posted, those are so laughable and so false, false, false, false, false. What surprises me even more is people can actually write an article on this and then people like you can post it and not once think of the simple notion that, gee...what if someone reads the actual bill and sees I made this nonsense up?

They bank their reputation and job on believing that no one will do that, ala Rush, Hannity, Beck and others...they hope like hell people (their audience) are just listening, nodding, and agreeing.

Not wonder there is such a divide in this country.

And no wonder they say reading is fundamental.

As With most of your posts that I have read I see a trash talking bully. And you do more than your share of belittling others.

I posted an opinion, dcom, from a reputable person on the Wall Street Journal website, considered to be reliable information source.

You have the audacity to insinuate that we should value your opinion above Ms. McCaughey and the WSJ.

On top of that, you haven't even read the bill in question, but you know it isn't the Pelosi bill.

You don't know what the facts are, yet you trash this thread with your pious accusations and bald faced lies.

And with all the words you posted, you haven't disproved anything.

You have proved to be belligerent without just cause.

Please respond to my posts or threads with some edicut or leave it be.

You're starting to get too personal, man. You've been asked nicely!!!

[fab]

All we are saying is give peace a chance!

I know someone said that!

[Mike Cruz]

Just read the actual bill... but if you want to rely on other people to make up your mind for you and listen to everything they say, at least fact check what your listening / reading before trying to pass it on to other people, might save you some time / embarrassment, imho

I have read like 60 pages of the bill, obviously no where close to being finished and doubt that I will ever finish due to the lack of free time, but I will just reference to it anytime a subject comes up whether it be here or on TV and I suggest others do the same.

Look how quick it was for draggar to pull up the exact bill... its really not hard...

Btw, not trying to be rude, so please don't act like I am.

[draggar]

Just read the actual bill... but if you want to rely on other people to make up your mind for you and listen to everything they say, at least fact check what your listening / reading before trying to pass it on to other people, might save you some time / embarrassment, imho

I have read like 60 pages of the bill, obviously no where close to being finished and doubt that I will ever finish due to the lack of free time, but I will just reference to it anytime a subject comes up whether it be here or on TV and I suggest others do the same.

Look how quick it was for draggar to pull up the exact bill... its really not hard...

Btw, not trying to be rude, so please don't act like I am.

The sad part is that it is almost 2,000 pages of legal mumbo-jumbo that would require a law degree to make sense of it. Add in the fact that a lot of times extra and completely unrelated provisions are added in plus it usually has a misleading title (the Anti-Phishing consumer proteciton act is proof of that) makes it even harder to understand where the bill is really going.

Of course, we all know that this will be used as ammunition during election time, too. "Oh, so-and-so didn't want you to get coverage by voting against this!" and "So-and-so voted to increase the deficit" etc..

[Mike Cruz]

The sad part is that it is almost 2,000 pages of legal mumbo-jumbo that would require a law degree to make sense of it. Add in the fact that a lot of times extra and completely unrelated provisions are added in plus it usually has a misleading title (the Anti-Phishing consumer proteciton act is proof of that) makes it even harder to understand where the bill is really going.

Of course, we all know that this will be used as ammunition during election time, too. "Oh, so-and-so didn't want you to get coverage by voting against this!" and "So-and-so voted to increase the deficit" etc..

Yeap... They make these bills incredibly, ridiculously, long. Considering these bills are put together supposebly to benefit the American people, they should make them long enough and clear enough for the average American to be able to sit down and read within a day or two.

I know they are obviously trying to throw some things in their to benefit certain individuals, but I just don't think it is as drastic as many people are trying to make it out to be.