Tag Archives: Essential Health Benefits Package

Ten Reasons ObamaCare is a Government Takeover of Health Care

From the Galen Institute’s Resource Guide for Candidates:

Ten Reasons ObamaCare is
A Government Takeover of Health Care
The 2,700-page Patient Protection and Affordable Care Act created the architecture for the government-controlled health care system that the administration is busily constructing through thousands of pages of regulation. Yet some argue that ObamaCare isn’t a government takeover of health care. Here are ten reasons why it is:
  1. MANDATES For the first time ever, the federal government will force citizens to use their own money to purchase a private product. The fact that the Supreme Court says the penalty for not complying is a tax does not diminish this breathtaking assertion of federal authority. Americans now are compelled to purchase an expensive health insurance product every month for their entire lives. What’s the next purchase the government will compel?
  2. GOVERNMENT DECIDES The federal government will also determine what health care benefits are “essential” — not us, not our doctors, but government bureaucrats.
  3. REGULATIONS Doctors and hospitals will face an avalanche of new reporting rules to make sure they are providing medical services that fit the government’s definition of “quality care.”
  4. 159 NEW BUREAUCRACIES The legislation creates at least 159 new boards, commissions, and programs that will rule over virtually every corner of the health care sector.
  5. STATES The states are being treated like contractors to the federal government, not sovereign entities empowered by the Constitution. They are ordered to set up new exchange bureaucracies lest the federal government sweep in and do it for them.
  6. EMPLOYER MANDATE Any employer with more than 50 employees must provide government-decreed health insurance to its workers — or face financial penalties.
  7. LOSING CURRENT COVERAGE Nearly 80 million people will not have the option of keeping the coverage they get through their jobs, according to results of a survey from McKinsey & Company. Many of them will be forced into the government-run health insurance exchanges.
  8. HIGHER SPENDING ObamaCare dramatically expands the number of people whose health coverage will be paid for entirely or in part by taxpayers, giving the government more power to decide which medical services millions more people will receive — or not.
  9. PRIVACY In order to parcel out taxpayer subsidies for insurance, the government and employers are going to need to know a lot more about us. An estimated 16,500 more IRS agents will be needed to check on our income and any changes to family status and our compliance with this massive new law.
  10. PUBLIC PLANS The law creates the infrastructure for public plans by requiring a federal agency to sponsor at least two national health plans. If private plans are crushed by ObamaCare’s regulations or simply turned into government contractors, these government plans could dominate the market, leading to the government-run health care system that the majority of Americans deplore.

We hope you find this Pro Patient Minute useful. Please feel free to circulate this to friends, family, and associates who need to know the truth about ObamaCare. The whole series is available on our website as Galen Guides. I encourage you to use these resources, distribute them to your networks, and share your ideas with us about how to reach as many people as possible with this message. Our freedom hangs in the balance!

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ObamaCare’s ‘Essential Health Benefits’: Few States Implement, HHS ‘Is in Clear Violation of the Law’

Michael Cannon writes:

ObamaCare directs the Secretary of Health and Human Services to define the “essential health benefits” that all consumers in the individual and small-group health insurance markets must purchase. HHS Secretary Kathleen Sebelius kicked that decision to the states, giving them a deadline of this past Friday, September 30. Kaiser Health News reports that all of 16 states submitted an Essential Health Benefits (EHB) benchmark to HHS by the deadline.

But did Sebelius have the authority to kick this decision to states?

No. Cannon quotes  Pennsylvania Insurance Commissioner Michael Consedine:

HHS guidance appears to render the states’ ability to innovate and to make an independent choice illusory

Louisiana’s Secretary of Health and Hospitals Bruce Greenstein and Insurance Commissioner James Donelson school Sebelius:

The State of Louisiana will not permit the federal government to dictate to our residents a default benchmark plan, as the federal government, in its disregard of the requirements of the Administrative Procedure Act regarding essential health benefits and other provisions of the PPACA, has no authority to do so under federal or Louisiana law until regulations are published in the Federal Register, following established notice and comment procedure.

The process developed for defining the essential health benefit benchmark has been a completely new method of establishing law without proper rulemaking. Implementation of new policies without open and public comment and publication in the Federal Register is in clear violation of the law.

Read the whole post: ObamaCare’s ‘Essential Health Benefits’: Few States Implement, HHS ‘Is in Clear Violation of the Law’ | Cato @ Liberty.

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Feds won’t add any insurance coverage mandates in exchanges – for now

The Denver Business Journal reports:

Insurance providers will not have to offer any new health benefits beyond what the state of Colorado already mandates that they include in their small-benefits plans in order to sell policies in health benefits exchanges, the U.S. Department of Health and Human Services HHS announced Friday. …

For an insurer to participate in these potentially lucrative exchanges, however, they are required to offer an essential benefits package that covers 10 types of services, ranging from preventive care to hospitalization to mental health care.

Business leaders feared that if the essential benefits requirement — undefined until Friday — included coverage of too many new services, it would make the plans offered through exchanges too expensive for the small businesses and individuals who don’t buy insurance now because of its costs.

Read more here: Feds allow states flexibility on ‘essential’ health benefitsDenver Post coverage here.

I’m not sure I understand this.   If a state does not already require any of the ten mandated benefits specified in ObamaCare (HR 3590, sec. 1302), then the obeying the mandate would add to existing ones.

The article continues:

Dede de Percin, executive director of the Colorado Consumer Health Initiative, expressed disappointment in the preliminary ruling …

Specifically, de Percin said this could lead to a “race to the bottom” among states in which they will require few upgrades in coverage as part of a federal law that was meant to ensure better health-care coverage for all Americans.

I think de Percin is referring to the ability for residents of one state to buy insurance that is legal in another state. That is, if any exchanges work this way. But she’s wrong. See this post for why: Buying insurance across state lines not a “race to the bottom”

Further, Scott Gottlieb argues that mandated benefits create a race to the bottom in his article: Health Insurance Exchanges: A Race To the Bottom:

[T]o afford the mandated benefits, health plans will have to shave other costs. They’ll do this the same way the Medicaid managed care plans deal with similar government rules – by offering very narrow networks of providers that patients can see. Or by cutting what health plans pay for services, even if it leaves beneficiaries with fewer providers willing to offer them access to medical care.

Remember that mandated benefits are backdoor socialized medicine.

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Authorities to decide what health plans in “exchanges” cover, not a freed market

In an article titled “Balance key to health exchanges,” Ed Sealover of the Denver Business Journal writes:

Federal officials are wrestling with a conundrum that could have major implications for small businesses throughout Colorado: Whether to require insurance plans offered through health benefits exchanges to focus on covering extensive services or on being affordable.

Numerous patient groups told officials with the U.S. Department of Health and Human Services   (HHS) what should be considered essential benefits in the exchanges — which will begin operating in 2014 under federal health care reform — during a closed-door meeting on Nov. 18 in Denver.

Autism advocates, for example, want full coverage for treatment of their disorder. Ophthalmologists want children’s visits to …

The rest of the article is accessible to subscribers only.  But just from the above, we see how organized minorities lobby for benefits for themselves at the expense of everyone else. For more details, see the post by Paul Hsieh, MD. on the essential benefits package.

Instead of having federal officials decide what the plans should cover, how about letting (gasp!) insurers and customers decide? The above political process for controlling health plans is akin to having the FCC decide what features cell phone plans should cover: how many minutes, texting limits, web access, etc.

In that case, surely there would be groups pushing to ban, say, plans that lack unlimited text messaging. This would increase the price of all plans, even for those who never text.

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The “Essential Health Benefits Package”: disease constituencies clamor to make it huge

Paul Hsieh, MD describes how interest groups are clamoring to have government require all legal health plans include certain mandated benefits, hence driving up the costs of the most basic health plans and requiring you to buy a plan with benefits you may neither want or need. Read the post: Get Ready For the Feeding Frenzy.

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