On Sep 1, 2009, at 3:04 PM, Patrick Coskren wrote:

> On Sep 1, 2009, at 2:59 PM, Charles Bennett wrote:
>
>> But it begs the question.
>>
>> How many *eligible* congressmen use medicare for their primary
>> insurance, forgoing the "cadillac" house and senate plans.
>>
>> I haven't been able to find the info but I'm willing to bet it's
>> near zero.
>
> So what?  Nobody's claiming the public option (aka Medicare for
> whoever wants it) would be better than the best private plans.  That's
> why it's an *option*.  It's for people who can't afford or can't get
> access to adequate coverage under the private plans.  The point is
> that it's pretty good, as measured by Medicare satisfaction rates,
> which are generally high.
>
> If you like your current plan, as Congressfolk usually do, keep it.
> No worries.
>

It's not quite like that.  You can keep your plan *IF* and only *IF*  
you have it on day 1 of the new law and there are no changes in "terms  
and conditions"

After that, you have no choice. you plan must *conform* to the  
government standards

In any case ALL policies must conform within 5 years.

So you can keep your plan sort of..

As long as you don't change jobs, and the plan stays charges the same  
rates etc..

Here is the meat of the matter.   The devil *IS* in the details.

 From page 16 of H.R. 3200 for those of you keeping score.

3 (a) GRANDFATHERED HEALTH INSURANCE COV

4 ERAGE DEFINED.—Subject to the succeeding provisions of

5 this section, for purposes of establishing acceptable cov

6 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:



On the first day of Y1 of the plan, everyone that wants to can keep  
their plan..

but.. No NEW enrollees..

Nww folks MUST join a conforming plan.   So THEY don't have the option  
of anything Obama doesn't approve of, and no one in the future with an  
employer plan does.

(excepting congress of course)

The kicker is that if you plan raises it rates for ANY risk group then  
it LOSES it grandfathered status.

If you change jobs, and switch to a new plan, you are out of you old  
plan and MUST now select a "conforming" plan at your new employer.

If you fall into a high risk category and they raise YOUR rates, you  
are out

so what right?  Well guess what.

(From Page 828 of H.R. 3200)



11 ‘‘SEC. 4375. HEALTH INSURANCE.

12 ‘‘(a) IMPOSITION OF FEE.—There is hereby imposed

13 on each specified health insurance policy for each policy

14 year a fee equal to the fair share per capita amount deter

15 mined under section 9511(c)(1) multiplied by the average

16 number of lives covered under the policy.

17 ‘‘(b) LIABILITY FOR FEE.—The fee imposed by sub

18 section (a) shall be paid by the issuer of the policy.



OIC..  the insurance company has to pay it..  So it has pressure to  
raise rates but if they change anything, you lose you grandfathered  
status.

W.C. Fields once said " I keep a bottle in my desk in case I see a  
snake, which I also keep in my desk"



What do they get for this fee?  They get a government plan they are  
supposed to compete with.

Wouldn't you like to have a business where your competitors have to  
pay you?  How long do you think they would last if YOU get to set the  
fee?



 From the PRO bill website.

<http://covertheuninsured.org/legislative_bill/hr-3200-dingell>

"Treatment of existing insurance coverage (“grandfathered coverage”)

Individual coverage. Individuals previously already enrolled in  
insurance bought through the individual (non-group) market prior to  
enactment could keep that coverage. Dependents could be added to it.  
Such coverage would not have to meet the new insurance and benefit  
requirements of the bill so long as the insurer did not change the  
terms or conditions of the policy or vary the percentage increase in  
the premium for its enrollees without changing the premium for all  
enrollees in the same group at the same rate.

Employment-Based Health Plans. Individuals enrolled in employment- 
based plans could keep their existing coverage and that coverage would  
not have to comply with the insurance or benefit requirements of the  
bill for a 5-year grace period (beginning 2013). Upon expiration of  
the grace period, the employment based plan would have to meet the  
bill’s applicable requirements, including those relating to the  
benefit package offered to employees. The plan would be considered  
acceptable coverage during the 5-year grace period for purposes of  
meeting the employer and individual mandates."

So under the most charitable reading of the bill the government "lets"  
me keep my current package for a 5 year grace period after 2013.

ASSUMING that there are NO changes made to it.

right..  anyone here ever have a health plan stay EXACTLY the same for  
a couple of years in a row?  No fee increases, no changes in "Terms  
and Conditions"  no changes in co-pay?   Me either.

Pretty much everyone sees some sort of rate hike every year or some  
sort of "changes in terms or conditions"

This is why average people are asking their critters if they have  
actually *read* the bill and why pissed off people are showing up at  
town halls.

Its not even "mostly" astroturf, it's people that read this and think  
"oh, hell no.."

"upon expiration of the grace period, the employment based plan would  
have to meet the bill’s applicable requirements" means that  "if you  
like what you have you can keep it" is no better than 1/2 true and not  
true at all after grace period.

1/2 truths = lot's of people showing up to "talk" to their congressmen.

=c=

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