Amendments to National Health Care Legislation

April 7, 2010

By Padmini Arhant

The health care legislation was signed into law in late March 2010. Subsequently, there is lot of disappointment to the effects of law and the insurance industry obligations that appear to contain many loopholes resembling the status quo.

Hence, upon reviewing the major components of the bill per the statements from the President’s letter, along with the data made available by Congress and the Congressional Budget Office,

It’s clear that amendments are necessary to protect ‘average Americans’ interests from the health industry behemoths.

Statements from the President’s letter:

“Now we need to begin the process of implementing these historic changes.

To ensure a successful, stable transition, many of these changes will phase into full effect over the next several years.”

1. “But for millions of Americans, many of the benefits of reform will begin this year – some will even take effect this week.”

Recommendation: Although, it’s claimed that the uninsured with pre-existing conditions would be covered beginning this week, the data should be provided for public knowledge.

The insurance companies willing to offer coverage to the uninsured population with pre-existing conditions including the information on the eligibility, the premium costs and the federal funding source is essential to confirm the benefit.

2. “Uninsured Americans with pre-existing conditions can join a special high-risk pool to get the coverage they need, starting in just 90 days.”

Recommendation: “High-risk” pool coverage starts effective immediately and not in three months’ time.

Insurance industry must note that this is a health issue and not a decision about any recreational activity or a vacation.

For some it could be a life threatening illness requiring urgent medical intervention.

Moreover, in the absence of specifics from the insurance industry – on coverage costs, limits and treatment level, the patients could be inhibited from seeking the comprehensive coverage they might need for their health problem.

3. “And Americans with insurance will be protected from seeing their insurance revoked when they get sick, or facing restrictive annual limits on the care they receive.”

Recommendation: This legislative law applies to the ‘currently insured,’ who are pre-screened and selected as the ‘low risk’ subscribers.

However, the law must be extended to the uninsured regardless of medical history.

4. “We passed this reform for 5th-grader Marcelas Owens, whose mother died because she didn’t get the health care she needed after she got sick, lost her job and her health insurance. Marcelas’ message to Congress was simple: “Finish health care reform. No other kid should lose their mom because they don’t have health care.”

We passed this reform for Natoma Canfield, who wrote to tell me that she could no longer afford her health insurance policy. Since losing her health insurance coverage in January, Natoma has been diagnosed with Leukemia and is fighting for her life.

Recommendation: In order to protect victims of such tragic situations, the Medicaid and Medicare (if age qualified) expansion is vital as suggested below.

5. We passed this reform for Ryan Smith, a small business owner with five employees. Ryan was doing his part to provide health insurance to his employees, but cannot keep up with rising health care costs.

Small businesses will receive significant tax cuts, this year, to help them afford health coverage for all their employees.

Recommendation: The public option is the reliable option for Small business and self-employed individuals struggling to compete in the dire economy.

Because, it’s being facilitated through tax cuts (federal funding) to enable their private coverage,

The public option is the ideal choice that would produce savings for this demography and the government.

6. “Early retirees will receive help to reduce premium costs.”

Recommendation: Again, the burden is shifted from the insurance industry to the taxpayers via federal help.

Instead, the Medicare threshold should be lowered from 65 to 55 in the amendment that would adequately address the issue.

7. Young people will be allowed coverage under their parents’ plan until the age of 26.

Recommendation: It should be at no additional costs to the subscribers.

8. Children will be protected against discrimination on the basis of medical history.

Recommendation: It’s verified to be true for the ‘insured’ but not the uninsured.

It was also revealed that the law is interpreted by the insurance industry as a discretionary action. Otherwise, a non-committal response and even coverage denial to this piece of legislation.

Therefore, imposing penalties for failure to comply will make the law effective.

9. We’re also making investments to train primary care doctors, nurses, and public health professionals.

Recommendation: It’s a step in the positive direction.

To make the investment worthwhile, it’s imperative to utilize the health care services for Medicare, Medicaid, CHIP, VA patients as well as the ‘Public Option’ subscribers rather than the private industry solely benefiting from it.

10. “State-level consumer assistance programs to help patients understand and defend their new rights” –

Recommendation: This could create variation in practice allowing the insurance and the health care industry to circumvent the respective state laws as seen in the environmental matter on carbon emissions, leading the environmental agency to adopt a standard law across the country.

That’s why, the independent and non-profit ‘National Consumer Health Rights Agency,’ would be ideal to deliver the service.

“In Marcela, Ryan, Natoma, my mom and so many other Americans, we are reminded of what this fight was about. It wasn’t about politics. It was about doing the right thing, and taking care of the hardworking people that make our country great.”

It would be beneficial to the suffering population upon incorporating the above recommendations and the amendments listed below.
By Padmini Arhant

Amendments to the National Health Care Legislation

Since the health care legislation is already passed, the applicable changes should be rapid without any legislative rigmarole.

1. Effects of law commencing in 90 days, 6 months and within a year must begin tomorrow and no later than April 12, 2010 to accommodate all different health situations experienced by those who are ill at present.

2. The contentious settings in 2014 and 2019 for full effects should be brought forward to June 2010.

3. Simultaneously, the tax laws scheduled for 2013 and 2018 should be modified to be effective immediately.

Accepting the uninsured patients as new subscribers should not be a daunting task given the resources and the established system that are currently in place.

In addition, the federal funding for private insurance coverage should be diverted to ‘public option,’ program, CHIP, Medicaid and Medicare expansion notwithstanding the VA patient care.

4. Introduction of public option to induce real competition is the hallmark of the amendment.

5. Lowering the Medicare eligibility threshold from 65 to 55 as agreed by most legislators in Congress during the health care debate.

6. Medicaid expansion to the unemployed and senior citizens falling short on prescription drug expenses despite the $250 rebate upon them reaching the coverage gap.

NB: The votes are available in the House and the Senate to pass these rules via ‘the reconciliation process,’ if the bipartisanship remains impossible.

7. Revive the deal with the health care service and Big Pharma on the estimated $500 billion dollar savings that was initially committed by the industries.

8. Jan 1, 2011 – Enactment calls for ‘marketplace’ insurers to invest premium dollars on medical services by 80 percent for individuals and small plans, whereas the large groups by 85 percent respectively.

Recommendation: Monitoring is essential to ensure such practice among the insurers.

The law would be redundant without oversight.

Independent and non-profit ‘National Consumer Health Rights Agency,’ is appropriate for it would prevent breach of the investment criteria.

9. Anti-trust laws passed by Congress should be extended for a longer period i.e. until 2020.

10. Mandatory insurance should be based on affordability and individuals without sufficient financial means automatically qualify for federal medical program via public option at a lower competitive cost and not higher than the private sector as determined earlier to boost the private insurance sales, during the health care legislative process.

Alternatively, the Medicaid program should be accessible for these individuals and families experiencing sudden change in status due to loss of family income generating an insurance lapse in premium payments.

These changes will provide for all Americans.

The health care reform would be meaningful with the all of the above recommendations and amendments.

Those who contribute to these enactments need not be concerned about their re-election for they will be guaranteed a victory in November, 2010.

The legislators from both sides of the aisle could make this happen by showing their willingness to prioritize their constituent’s physical health over the special interests’ financial gains.

Ultimately, the power lies in the citizen’s vote regardless of corporate campaign financing.

‘Change’ is made possible by the people in a democracy and not the profit seekers.

If there is will, there is a way.

Thank you.

Padmini Arhant

P.S: Comprehensive analysis on National Health Care Legislation was previously published on March 29, 2010 under “Health,” Category on this website.


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