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View Diary: Health Care Reform Bill Mythbusting #1: "Junk Insurance" (133 comments)

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  •  There are some protections (6+ / 0-)
    Recommended by:
    Linnaeus, bwren, glynis, turnover, pico, allep10

    for circumstances like this in 1302(b)(4) - I didn't excerpt from that section because it's one of the more complicated areas... but subsecs (A), (B), (C), (D), try to nibble around this issue.

    Could they deny coverage for certain types of lab work?  Yes - but then, there are certain types of lab work that Medicare (just to throw out what I think we all accept as a fundamentally good program for beneficiaries) doesn't cover either.  

    What they can't do -- or, to be more precise -- is yank the rug out from under you.  Of course - sure - it's tough to know, when choosing coverage, what sort of lab work you might need (and thus, what you should look for in a plan).  You might have some idea based on family medical history or some such...

    Some of that is likely to be filled in in the Sec 1302(b)(4)(G) provisions and the regs to follow - this is one of the sections that requires the HHS Secretary to conduct 'periodic reviews' and revise/report as necessary.  

    Which in the end, unfortunately means that yes - there probably will be some circumstances where certain individuals will find certain coverage gaps... but the thrust here is preventing 1)critical mass... it's not a loophole they can drive a truck through, and 2)when it comes up, the HHS is empowered to react.

    It's a crack, I'll admit, but one that probably isn't fillable outside of an NHS style system - meaning, forget single payer - you probably need nationalized health care to fully patch it.

    I guess everyone's got their own blog now.

    by zonk on Thu Dec 17, 2009 at 07:57:10 PM PST

    [ Parent ]

    •  Thanks for the thorough reply. (4+ / 0-)
      Recommended by:
      Linnaeus, bwren, glynis, turnover

      So this seems like one of the pressure points where people who are opposed to the bill and people who support it might find their arguments irreconcilable: both sides have to make guesses about how much of an impact that crack might have on actual coverage.  The loopholes look considerably smaller now that you've laid out the specific text of the legislation, but those opposed to the bill aren't completely wrong in suggesting that insurance companies - which are businesses, first and foremost - will likely use this as a leverage point to keep from bleeding away too much money on all the new people they'll have to cover.  

      Thanks again!

      Saint, n. A dead sinner revised and edited. - Ambrose Bierce

      by pico on Thu Dec 17, 2009 at 08:01:07 PM PST

      [ Parent ]

      •  Right (5+ / 0-)
        Recommended by:
        itskevin, glynis, turnover, pico, allep10

        and you're quite welcome.

        If put portions of the bill into 'perfect', 'good', 'better than status quo', 'status quo', and 'worse than status quo' -- I wouldn't argue this issue isn't much better than status quo.  I guess if I were to assign point values to each of those buckets (meaning status quo is a "2" and "better" is a "3"... this is probably somewhere in the 2.2 to 2.3 range).

        Like I said, I don't think it's for lack of trying, I think it's a fundamental problem with a health care system that aims to "insure" rather than just "treat".

        I'm not a big proponent of an NHS style system (not a huge opponent either, mind you) -- but this is one area where an NHS system certainly outshines the Japanese/Dutch/Swiss/this bill/ type system that still fundamentally has "insurance" elements.

        I guess everyone's got their own blog now.

        by zonk on Thu Dec 17, 2009 at 08:22:45 PM PST

        [ Parent ]

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