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justbeachy
So close....
Member since 7/07 2900 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
So I took it upon myself to read the bill.
(I felt like I shouldn't even be making a comment on here unless I read it! Eek!)
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
I obviously don't have the facts, as I am sure most of us don't, but just by looking at this SMALL SMALL SMALL portion of the bill, I am seeing some red flags.....
Can someone with more intelligence than me (so, anyone) please tell me if I'm going off the deep end with my thought process?
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Posted 7/29/09 5:27 PM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
Cpt2007
A new love!
Member since 1/08 5946 total posts
Name:
Liz
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SupaBonBon
So I took it upon myself to read the bill.
(I felt like I shouldn't even be making a comment on here unless I read it! Eek!)
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
I obviously don't have the facts, as I am sure most of us don't, but just by looking at this SMALL SMALL SMALL portion of the bill, I am seeing some red flags.....
Can someone with more intelligence than me (so, anyone) please tell me if I'm going off the deep end with my thought process?
which title and section this is from? can answer more completely seeing where it's located and the surrounding sections. 
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| Posted 7/29/09 5:31 PM |
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justbeachy
So close....
Member since 7/07 2900 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Sec 102 - PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
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| Posted 7/29/09 5:35 PM |
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Mommy2Boys
My Boys!!!!
Member since 6/06 14437 total posts
Name:
C
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SupaBonBon
So I took it upon myself to read the bill.
(I felt like I shouldn't even be making a comment on here unless I read it! Eek!)
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
I obviously don't have the facts, as I am sure most of us don't, but just by looking at this SMALL SMALL SMALL portion of the bill, I am seeing some red flags.....
Can someone with more intelligence than me (so, anyone) please tell me if I'm going off the deep end with my thought process?
I have the same understanding as you about the plan which is why I am against it. The way the plan is being set it almost seems like they are trying to eradicate private insurance overtime and everyone will be on the gov't plan which will probably s*ck Plus, employers who provide private insurance of course will want to switch to the gov't plans b/c it will save them money
Message edited 7/29/2009 5:56:03 PM.
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| Posted 7/29/09 5:54 PM |
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KartveliT
...
Member since 1/08 8363 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by jellybean1420
Posted by SupaBonBon
So I took it upon myself to read the bill.
(I felt like I shouldn't even be making a comment on here unless I read it! Eek!)
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
I obviously don't have the facts, as I am sure most of us don't, but just by looking at this SMALL SMALL SMALL portion of the bill, I am seeing some red flags.....
Can someone with more intelligence than me (so, anyone) please tell me if I'm going off the deep end with my thought process?
I have the same understanding as you about the plan which is why I am against it. The way the plan is being set it almost seems like they are trying to eradicate private insurance overtime and everyone will be on the gov't plan which will probably s*ck Plus, employers who provide private insurance of course will want to switch to the gov't plans b/c it will save them money
yes this is what my DR said yesterday too , and this is what I heard on few programs I have watched on CNN and FOX NEWS ..... scary 
Message edited 7/29/2009 6:07:06 PM.
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| Posted 7/29/09 6:06 PM |
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Mommy2Boys
My Boys!!!!
Member since 6/06 14437 total posts
Name:
C
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by tatuka
Posted by jellybean1420
Posted by SupaBonBon
So I took it upon myself to read the bill.
(I felt like I shouldn't even be making a comment on here unless I read it! Eek!)
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
I obviously don't have the facts, as I am sure most of us don't, but just by looking at this SMALL SMALL SMALL portion of the bill, I am seeing some red flags.....
Can someone with more intelligence than me (so, anyone) please tell me if I'm going off the deep end with my thought process?
I have the same understanding as you about the plan which is why I am against it. The way the plan is being set it almost seems like they are trying to eradicate private insurance overtime and everyone will be on the gov't plan which will probably s*ck Plus, employers who provide private insurance of course will want to switch to the gov't plans b/c it will save them money
yes this is what my DR said yesterday too , and this is what I heard on few programs I have watched on CNN and FOX NEWS ..... scary
Here is an article from CNN:
4 Reasons Obama's Health Plan is No Bargain
The so-called public option is now included in both the Senate and House bills, and is strongly endorsed by Obama. Under the public option, the exchanges would offer a plan resembling Medicare for more than 100 million working Americans. Today, most of them are covered by their employers' plans. But the Democrats' proposals contain a "pay or play" provision that would allow companies, in effect, to drop their coverage and substitute a payroll tax.
Because their health care costs are growing so rapidly, it's likely that most companies would dump their plans. "That's what will happen," says John Goodman of the National Center for Policy Analysis, which champions free-market solutions to health care. "Employees could then go to the exchanges and get subsidized insurance."
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| Posted 7/29/09 6:17 PM |
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eroxgirl
My Loves
Member since 5/05 15697 total posts
Name:
Rebecca
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SupaBonBon
So I took it upon myself to read the bill.
(I felt like I shouldn't even be making a comment on here unless I read it! Eek!)
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
I obviously don't have the facts, as I am sure most of us don't, but just by looking at this SMALL SMALL SMALL portion of the bill, I am seeing some red flags.....
Can someone with more intelligence than me (so, anyone) please tell me if I'm going off the deep end with my thought process?
I HAVE NOT READ THE BILL (just to be clear, lol) but I have read what you cut and pasted here - and just on face value "meet[ing] the same requirements" does not mean downgrading to me - I would take that to mean they should be equal to or greater.
If your insurance surpasses whatever the government plan would be then it's abiding by the law (assuming this becomes law, of course).
For it to be any other way would IMO be completely assinine and would send me right over to the anti-health plan camp in a heartbeat because it would be in direct opposition to what Obama is saying this health care reform is supposed to do.
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| Posted 7/29/09 6:47 PM |
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SweetestOfPeas
J'taime Paris!
Member since 3/06 32345 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by Cpt2007
Cannot stress enough how important it is to call your House of Represenatives Member this week if you feel strongly. The Senate isn't going to be doing anything with this for a while, and the House is trying to vote on their bill soon.
You can find who your representative is here: US House of Representatives
I sent 3 more emails today
Schumer
Gillibrand
Steve Israel (my rep)
I REALLY HOPE they don't fall on deaf ears!
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| Posted 7/29/09 7:13 PM |
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SweetestOfPeas
J'taime Paris!
Member since 3/06 32345 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by HeathKernandez
Posted by Janice
Posted by SweetestOfPeas
Posted by anonttcer
I feel like this is being forced upon us too..,. how is this democracy? (that is what scares me most- the govt telling us what to do like this.)
Will we have any choice?
I have a job- my husband has a job- we get top notch health care and we are WILLING AND ABLE to pay for it.
Why should sub par healthcare be forced on us?????
THANK YOU!!!
all we hear about is the 46 million who are not insured
what about the 250 million that ARE??? MANY of us are VERY happy with what we have right now and DO NOT WANT A CHANGE!!!!!
who are you people?
46 million. are willing to pay. deserve the right to healthcare. are you seriously going to deny people, your fellow Americans the right?
 thank you. I think the problem here is the majority of us are insured privately... I'm sure we'd be tooting a different tune if we were part of the country WITHOUT insurance...
of COURSE you do not want a CHANGE... that wouldn't benefit YOU, would it? We're a country of selfish people. ME ME ME...
There are serious problems with our health care and it needs to be changed...
you're calling ME selfish? who's the one who wants others to pay for their medical coverage?
I am not against a reform of some kind. but if you go back and read the OP, it lists all the things that WE AS THE INSURED would have to give up, so that folks like you who are not, can have.
yea - I'm the selfish one 
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| Posted 7/29/09 7:25 PM |
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SweetestOfPeas
J'taime Paris!
Member since 3/06 32345 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by jellybean1420
Posted by HeathKernandez
of COURSE you do not want a CHANGE... that wouldn't benefit YOU, would it? We're a country of selfish people. ME ME ME...
When it comes to health and insurance, alot of people think ME ME ME...b/c we know that noone else is going to take care of our families or kids except for us.
Why should anyone have to give up their right to see whatever dr they choose or the right to get top notch medical care god forbid something happens to one of thier kids, spouse, parent?
exactly!
and for the record, that's why I got a job at a company with kickbutt benefits, so that I can take care of ME!
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| Posted 7/29/09 7:28 PM |
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HeathKernandez
Our Ron is an awesome Ron
Member since 4/07 9091 total posts
Name:
baby fish mouth
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SweetestOfPeas
yea - I'm the selfish one
right on chief...
I am not against a reform of some kind. but if you go back and read the OP, it lists all the things that WE AS THE INSURED would have to give up, so that folks like you who are not, can have.
i AM insured. so you obviously didn't read my comment either.
Message edited 7/29/2009 7:33:52 PM.
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| Posted 7/29/09 7:30 PM |
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SweetestOfPeas
J'taime Paris!
Member since 3/06 32345 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by HeathKernandez
Posted by SweetestOfPeas
yea - I'm the selfish one
your words, not mine.
by the way- i AM insured. so you obviously didn't read my comment either.
well maybe next time you decide to make assumptions, you should read the OP first.
I have serious issues with losing any part of my EXCELLENT healthcare b/c of lies told by the President! He can’t find a way to pay for his promises, so all the burden falls on us. This is ***** BS
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| Posted 7/29/09 7:34 PM |
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HeathKernandez
Our Ron is an awesome Ron
Member since 4/07 9091 total posts
Name:
baby fish mouth
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SweetestOfPeas
Posted by HeathKernandez
Posted by SweetestOfPeas
yea - I'm the selfish one
your words, not mine.
by the way- i AM insured. so you obviously didn't read my comment either.
well maybe next time you decide to make assumptions, you should read the OP first.
I have serious issues with losing any part of my EXCELLENT healthcare b/c of lies told by the President! He can’t find a way to pay for his promises, so all the burden falls on us. This is ***** BS
Message edited 7/29/2009 7:56:03 PM.
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| Posted 7/29/09 7:37 PM |
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itkocak
Member since 7/07 7639 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Message edited 11/29/2011 5:40:03 PM.
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| Posted 7/29/09 8:29 PM |
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DaniJude
You're My Home <3
Member since 11/06 14815 total posts
Name:
Danielle
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by imthekevinofcindyandkevin
that's okay we have different tastes in music too but I luvs ya' anyway!
That's it Kevin - we can't be friends unless you like Toby Keith!
Honestly, forget healthcare, HOW does anyone not like Toby Keith?! I *TRY* to listen to other things - believe me - but I just keep going back. I can't get two minutes into any other artist without wanting to go back to him. It is a sickness. 
Seriously, I hope you are right about this with the healthcare - God, I have never wanted to be wrong more in my LIFE.
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| Posted 7/29/09 9:43 PM |
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DaniJude
You're My Home <3
Member since 11/06 14815 total posts
Name:
Danielle
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SupaBonBon
Sec 102 - PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
Yes, this is what I was saying to begin with -- this is what upsets me. Yeah, sure, you can keep your private insurance now but they have like 8654321 million different ways that you will have it taken away and the gov't will make you go on the socialized plan. So, in just a few short years all the private plans will be "weeded out" and private insurance won't exist anymore.
I also love the part where they determine how many quality years you have left in your life. So, say you are 65 years old and need a heart transplant or have a heart condition - or any type of serious health issue - they determine how many years you have left to live and take that into consideration for how, when, or IF they will treat you. Nice, it's like we're playing God now.
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| Posted 7/29/09 9:49 PM |
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SweetTooth
I'm a tired mommy!
Member since 12/05 20105 total posts
Name:
Lauren
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SweetestOfPeas
Posted by jellybean1420
Posted by HeathKernandez
of COURSE you do not want a CHANGE... that wouldn't benefit YOU, would it? We're a country of selfish people. ME ME ME...
When it comes to health and insurance, alot of people think ME ME ME...b/c we know that noone else is going to take care of our families or kids except for us.
Why should anyone have to give up their right to see whatever dr they choose or the right to get top notch medical care god forbid something happens to one of thier kids, spouse, parent?
exactly!
and for the record, that's why I got a job at a company with kickbutt benefits, so that I can take care of ME!
g-d forbid you should ever lose that job and its kickbutt benefits.
Message edited 7/29/2009 10:07:07 PM.
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| Posted 7/29/09 10:01 PM |
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SweetTooth
I'm a tired mommy!
Member since 12/05 20105 total posts
Name:
Lauren
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by DaniRella
Posted by SupaBonBon
Sec 102 - PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
I also love the part where they determine how many quality years you have left in your life. So, say you are 65 years old and need a heart transplant or have a heart condition - or any type of serious health issue - they determine how many years you have left to live and take that into consideration for how, when, or IF they will treat you. Nice, it's like we're playing God now.
You think insurance companies aren't doing this currently?
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| Posted 7/29/09 10:03 PM |
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DaniJude
You're My Home <3
Member since 11/06 14815 total posts
Name:
Danielle
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SweetTooth
Posted by DaniRella
Posted by SupaBonBon
Sec 102 - PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
I also love the part where they determine how many quality years you have left in your life. So, say you are 65 years old and need a heart transplant or have a heart condition - or any type of serious health issue - they determine how many years you have left to live and take that into consideration for how, when, or IF they will treat you. Nice, it's like we're playing God now.
You think insurance companies aren't doing this currently?
Not with both my grandfathers, my grandmother, my great aunt, my mom's uncle John -- and those are the only ones I can think of who are family members. I could go through the list of friends. I guess my problem with it is that it would become that way for every single person. I guess there are always going to be a few in the minority who have a bad experience. I think that's terrible - it should be eradicated all-together - NOT made more prevalent. JMO.
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| Posted 7/29/09 10:10 PM |
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itkocak
Member since 7/07 7639 total posts
Name:
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Re: 5 Freedoms You'd Lose in Health Care Reform
Message edited 11/29/2011 5:41:37 PM.
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| Posted 7/29/09 10:32 PM |
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Cpt2007
A new love!
Member since 1/08 5946 total posts
Name:
Liz
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SupaBonBon
But here's where I have a serious question - in this section:
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
Perhaps I'm reading it wrong (very possible considering I read at a 3rd grade reading level), but this says to me that if I am on my current private health care plan 5 years after this bill's passage, my current healthcare provider has to provide me with the same benefits as the government passed plan.
This concerns me because (and this is a total assumption, but I doubt I'm off base here...) I know that the govt. benefits are going to be less than my current private plan.
So would I be downgraded!? And at that point, what is the incentive for my private health care provider to even exist?! How is it possible for them to even compete?
And what about doctors?! Wouldn't you think that most would just go completely private and not accept ANY insurance!?
Sorry for the delayed response. Just got home.
I read through that section and the related sections and as another poster noted, what this does is that it guarantees a baseline of coverage. So, if a plan is not one of the grandfathered plans (as outlined in the section immediately before this one), it must meet a minimum standard of benefits. If the plan exceeds the minimum standard of benefits, then there is no change to that existing plan. What this is doing is saying "here are the things that must be covered at a bare minimum" but it does not say that anyone's coverage must be lessened to meet that standard.
Here is what the "baseline" coverage is as outlined in the bill. Again, all of this is from HR 3200, the House bill. The Senate bill is going to be VERY different. Sorry if the formatting isn't quite right.
SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED.
(a) In General- In this division, the term `essential benefits package' means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial security, that--
(1) provides payment for the items and services described in subsection (b) in accordance with generally accepted standards of medical or other appropriate clinical or professional practice;
(2) limits cost-sharing for such covered health care items and services in accordance with such benefit standards, consistent with subsection (c);
(3) does not impose any annual or lifetime limit on the coverage of covered health care items and services;
(4) complies with section 115(a) (relating to network adequacy); and
(5) is equivalent, as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services, to the average prevailing employer-sponsored coverage.
(b) Minimum Services To Be Covered- The items and services described in this subsection are the following:
(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department services.
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician's or a health professional's delivery of care in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.
(c) Requirements Relating to Cost-sharing and Minimum Actuarial Value-
(1) NO COST-SHARING FOR PREVENTIVE SERVICES- There shall be no cost-sharing under the essential benefits package for preventive items and services (as specified under the benefit standards), including well baby and well child care.
(2) ANNUAL LIMITATION-
(A) ANNUAL LIMITATION- The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B).
(B) APPLICABLE LEVEL- The applicable level specified in this subparagraph for Y1 is $5,000 for an individual and $10,000 for a family. Such levels shall be increased (rounded to the nearest $100) for each subsequent year by the annual percentage increase in the Consumer Price Index (United States city average) applicable to such year.
(C) USE OF COPAYMENTS- In establishing cost-sharing levels for basic, enhanced, and premium plans under this subsection, the Secretary shall, to the maximum extent possible, use only copayments and not coinsurance.
(3) MINIMUM ACTUARIAL VALUE-
(A) IN GENERAL- The cost-sharing under the essential benefits package shall be designed to provide a level of coverage that is designed to provide benefits that are actuarially equivalent to approximately 70 percent of the full actuarial value of the benefits provided under the reference benefits package described in subparagraph (B).
(B) REFERENCE BENEFITS PACKAGE DESCRIBED- The reference benefits package described in this subparagraph is the essential benefits package if there were no cost-sharing imposed.
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| Posted 7/29/09 10:56 PM |
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DaniJude
You're My Home <3
Member since 11/06 14815 total posts
Name:
Danielle
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Re: 5 Freedoms You'd Lose in Health Care Reform
HA!!!!!!!
I guess you've never listened to Toby's music...
"Courtesy of the Red, White, and Blue: The Angry American"
"Love Me If You Can"
"American Soldier"
"The Taliban Song"
"American Ride"
Yeah, I don't know if Toby sees eye to eye w/ the Libs!
I love ya though!! 
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| Posted 7/29/09 11:22 PM |
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Cpt2007
A new love!
Member since 1/08 5946 total posts
Name:
Liz
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by DaniRella
HA!!!!!!!
I guess you've never listened to Toby's music...
"Courtesy of the Red, White, and Blue: The Angry American"
"Love Me If You Can"
"American Soldier"
"The Taliban Song"
"American Ride"
Yeah, I don't know if Toby sees eye to eye w/ the Libs!
I love ya though!!
actually, Toby is a self proclaimed and registered Democrat.
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| Posted 7/29/09 11:25 PM |
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by SweetestOfPeas
what about the 250 million that ARE??? MANY of us are VERY happy with what we have right now and DO NOT WANT A CHANGE!!!!!
Ah but don't you understand? This man is so concerned with the people he represented in "South Side Chicago" and not representing the 250 + MILLIONS of hard working Americans.
I may get flamed for this but all he's concerned with is giving illegals and welfare recipients a free ride.
We work, we pay BIG taxes. Now, all that hard work for our OWN benefits are going to go down the drain.
The man's an assss. I said it from DAY one. I knew he was NO good. Glad I didn't vote for him. Honestly, it really does no good b*tching about him because he's in. There is really nothing we can do about it.
One thing I must add is why do they want to F up our healthcare? They don't care. ("They" meaning the politicians.) They won't be affected by this! While we lose our great benefits, Obama and his kids and all the others jackasses that came up with this plan are raking in the best of benefits as possible. So tell me, do they really give a $hit about us?
Message edited 7/30/2009 12:19:20 AM.
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| Posted 7/30/09 12:18 AM |
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SweetTooth
I'm a tired mommy!
Member since 12/05 20105 total posts
Name:
Lauren
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Re: 5 Freedoms You'd Lose in Health Care Reform
Posted by MrsMcCannEst42409
Posted by SweetestOfPeas
what about the 250 million that ARE??? MANY of us are VERY happy with what we have right now and DO NOT WANT A CHANGE!!!!!
Ah but don't you understand? This man is so concerned with the people he represented in "South Side Chicago" and not representing the 250 + MILLIONS of hard working Americans.
This is such an ignorant and prejudiced statement, I don't even know how to respond.
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| Posted 7/30/09 7:32 AM |
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