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View Full Version : SP, Sini...Could I borrow some of your lawspeak mind?


Sei'taer
07-19-2009, 09:43 PM
I've been hearing about this on the news for the past couple of days. Some pundits say it means one thing and some say it means another. What does it mean? If you want to see the whole thing it's here on page 16 (http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf).




SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT
2 COVERAGE.
3 (a) GRANDFATHERED HEALTH INSURANCE COV4
ERAGE DEFINED.—Subject to the succeeding provisions of
5 this section, for purposes of establishing acceptable cov6
erage under this division, the term ‘‘grandfathered health
7 insurance coverage’’ means individual health insurance
8 coverage that is offered and in force and effect before the
9 first day of Y1 if the following conditions are met:
10 (1) LIMITATION ON NEW ENROLLMENT.—
11 (A) IN GENERAL.—Except as provided in
12 this paragraph, the individual health insurance
13 issuer offering such coverage does not enroll
14 any individual in such coverage if the first ef
15fective date of coverage is on or after the first
16 day of Y1.

From what I understand, it means as long as I don't ever change my job and get new insurance, or as long as my company doesn't change it's insurance after the beginning of the year the law is passed I can keep my insurance, but if I ever change jobs and get a new insurance company, then I can't get that coverage and have to go with the gov't plan? Is that right? It's the LIMITATION ON NEW ENROLLMENT that has me confused...and I figure it's written that way on purpose. I'm not really trying to start a debate, just looking for your opinion. (this is TL though)

Sinistrum
07-19-2009, 11:26 PM
I honestly don't know. That is the thing I hate about Congressional Acts is that their definitions are always so convoluted. In order to answer that I would need to know what the term "Qualified Health Benefits Plan," what exactly they qualify for, and whether the act mandates that all insurers be such.

StrangePackage
07-20-2009, 12:07 AM
The quoted portion is a technical definition of what constitutes "Grandfathered Health Insurance Coverage" for the purpose of the statute. It basically says that any coverage, which is active and effective prior to Y1 (the date at which the new law becomes effective), is considered to be Grandfathered Health Insurance Coverage, and such coverage cannot be altered as provided by law after Y1 to have different terms and conditions, including rates, and still be considered "Grandfathered Health Insurance Coverage."

Now, what is "Grandfathered Health Insurance Coverage" and what types of legal protections or benefits does it enjoy? I have no idea.

Nothing in that section that you directed me to (and I am not reading 1000+ pages of pending legislation without a damn good reason) indicates a requirement for government mandated health care plans.

So far as I can tell- so long as you keep your current healthcare and do not switch jobs, or have your company change the terms and conditions of your coverage unless otherwise provided by law, such coverage will enjoy "Grandfathered Health Insurance Coverage" status. New job, or changes to the plan, will lose that status.

tworiverswoman
07-20-2009, 12:20 AM
I'm no lawyer and I'm not sure if it's significant - but I noted the phrase "individual health insurance coverage," which, in Hawaii at least, means NON-JOB-PROVIDED health coverage. Because Hawaii requires the employer to cover any employee who works more than 20 hours a week, it is important here to know the difference. Here, "individual health insurance coverage" is specifically coverage which is PURCHASED DIRECTLY BY THE INDIVIDUAL (family may or may not be included depending on what is purchased).

Most of the people who drafted this law probably don't live in Hawaii, though, so I can't tell from this if they mean the same thing.

Sei'taer
07-20-2009, 08:22 AM
That was basically my problem with the whole deal...I don't know what it means.


I went to a wedding this weekend and my wifes cousin (who is deaf and somehow good-naturedly puts up with my incredibly bad signing) said there was an article in the NYpost that showed a chart of how much New Yorkers would have to pay for the national healthcare. I haven't been able to find the chart though, but he said it was crazy how much this is going to cost individuals in NY and CA since the cost of living is so high there. If I can find it I'll link it.

JSUCamel
07-20-2009, 08:29 AM
A NY friend of mine told me that the new taxes plus health care plan will wind up costing NYers 58% in taxes. Bad time to be in New York right now.

I got nothing to offer on the original post, though. I'm not happy with the current plan right now.

tanaww
07-20-2009, 08:32 AM
That was basically my problem with the whole deal...I don't know what it means.


I went to a wedding this weekend and my wifes cousin (who is deaf and somehow good-naturedly puts up with my incredibly bad signing) said there was an article in the NYpost that showed a chart of how much New Yorkers would have to pay for the national healthcare. I haven't been able to find the chart though, but he said it was crazy how much this is going to cost individuals in NY and CA since the cost of living is so high there. If I can find it I'll link it.

Two points:

1. There's no way our current Congress will not screw up drafting a National Health Insurance Plan. I have something similar, right? Tricare. The reimbursement rates are so low that if you're not near a military treatment facility or located in Po-dunk Wisconsin (or someplace similar where even a pissant sized base is a significant employer), then good luck. Tricare's reimbursement is slow and low so getting necessary care can be really fun. The dental is even worse. Dentists in Po-dunk won't take it, period. That's how great their claims processing is.

We need to involved medical care providers and patients in the design process instead of consultants (consult: a combination of "con" and "insult"), lawyers and large political contributors.

2. Your sign language was pretty clear in the message you sent me on Friday ;)