Fuzzy’s Notes: HR 3200, Pages 95-194

So what do we have so far? Pages 1-95 of HR 3200 do the following:

Set up a new government agency to oversee all heathcare in this country, both “private” and government-run. Appoint a lifelong Commissioner who has apparently unlimited powers to impose regulations and dictate insurance policies to private insurance companies, effectively crippling their ability to provide a decent policy to you. This Commissioner’s job will be, in part, to ensure that the government-run healthcare has adequate membership (to pay the TRILLIONS this will cost), that means everyone needs to be on it (twice), and his or her job is to see that this happens.

Establish a five-year “grandfather” period for people who are insured at the time of enactment (January 1, 2011). A “grandfather” period means that you will not be able to keep your own healthcare insurance after the five years are up and will be forced into a government-run or government-approved (the same thing) policy. “Grandfather” clauses always expire, and they always lead to the mainstreaming of whatever. When they raised the federal drinking age from 18 to 21, anyone who was 18 at that time (or about to turn 18) would be allowed to continue (or start) drinking legally. Everyone else was bound by the 21 age for legality. See? So, you get to keep your insurance for FIVE YEARS. That’s it, then you get pushed into the government’s plan. Period. It’s right there. Read it and weep. And call your president the purveyor of untruths (or partial truths) that he is.

Everyone will have to have insurance that meets the government’s standards, and only those private insurance companies who offer that insurance can offer policies. In other words, there is no competition, there is only the government-run health care “option” (“option” here means you can opt in or you can opt to be fined, jailed, or otherwise penalized as the government, in the form of the Commissioner, deems appropriate.).

You will be able to be sick to the tune of $5,000 per year as an individual and $10,000 per year for your family. This does not roll over, and with all the extras you’ll be obliged to pay, including co-insurance, you’ll burn through that before you’ve even had your annual check-ups. Count on it.

You’ll still pay, not only in the form of the promised tax increases to cover this, but also in a “tiered” manner that is income-based. You will also need to pay, in addition to the taxes and tiered policy prices, co-pays, deductibles, and most likely (the door is left open for this, and when has the government ever seen a door to getting more taxpayer money that it didn’t crash through?), co-insurance. I cannot even begin to estimate what your out-of-pocket expenses will be for these many layers of payment, but you can bet that it will an enormous percentage of your income. And you’ll get government healthcare, too! Woot!

The Cash for Clunkers car sales companies are currently waiting three to four weeks for their money back from the government, and it’s only three to four weeks because that is all the time that’s elapsed. They won’t see that money for months, maybe years. Money that was “guaranteed” in 10 days; the fun thing about the government is that they can promise anything and then not give it to you, and you have no recourse. These dealers had to file enormous amounts of detailed paperwork, any error kicked it back, and then they still didn’t get their money. They are still waiting. Efficient, huh? Dependable, right?

Sorry, got side-tracked there. Silly of me to compare one government-run tiny little program with a national healthcare program. Obviously, the small scale of the Cash for Clunkers program is causing the delays. They’ll be much better dealing with millions of individuals’ healthcare than they are with hundreds (perhaps thousands?) of car dealers. That’s logical.

The fun thing about it all is that you have no recourse. What do you do when the government tells you “no,” where can you possibly turn? You will never speak to a person in the government about your healthcare, and if you do, they’ll recite chapter and verse and tell you that this policy or that regulation or the other restriction means you’re screwed.

The Committee overseeing all of this will consist of one medical person and up to 26 other people, including someone who is “expert” in racial disparities. Goody! So if you’re not a minority, you move down the totem pole. Welcome to government-mandated “diversity” and “multi-culturalism.”

So that’s what the first 95 pages of the HR 3200 promise. Aren’t you giddy with glee? I bet the next hundred pages are even more fun!

1. “Outreach” is going to cost a bundle. It’s about educating people, particularly minorities, people with disabilities, people with mental illness, etc. on the wonders of government-run healthcare (pg 95-96). Clinics will be set up all over for this purpose (pg 96). Ca-CHING! Notice how they’re not going to bother trying to explain it to intelligent, hard-working Americans who will actually be paying for it. Even the president can’t explain it with any clarity, right? And what he does say is either a downright lie (this is not a step toward a single-payer system) or intentionally deceptive (you can keep the insurance you have . . . he leaves off the “for five years” part that might be of interest to many people.).

2. Your income will be monitored, and if you experience a “significant change of income,” your plan will likewise change (pg 97). That’s great, huh? Sure, this is in the section on outreach and presumably means poor people, but you know what? That’s not clearly stated, nor is it stated that this need be a negative change in income. So your insurance will go up if you get a raise or a bonus that moves your tax bracket for that year. Goody! Luckily, you won’t need to notify the government of your increased income, because they’ll already be watching your bank accounts and tax returns like a hawk. The Commissioner will also establish a means by which you are required by law to alert the government of such changes (I guess if their beady little eyes aren’t on your accounts at the moment you get your raise or bonus) (pg 141).

3. Automatic enrollment (pg 98). WTH? But the Commissioner will “take into account” your current health care providers when he or she “randomly” enrolls you in your shiny new government health care plan. Maybe they’ll even notify you of this automatic enrollment. That part’s not clear.

4. You think the tax laws are daunting? Know anyone trying to figure out Medicare? These are impossible for the average citizen to understand because they are so complicated and written in crazy government-speak. Your healthcare will be the same. Sound appealing?

5. In addition to the new “Choice” government agency, we’ll also be subsidizing 800 hotlines and a website to help people understand the un-understandable (pg 99-100). Goody. At least thousands of people will be added to the government payroll just to manage this.

6. Children born to parents who are not eligible for Medicaid or for some unclear reason can’t get the government-run option, will be considered Medicaid eligible (pg 100-01). This is confusing to me because an earlier provision seemed to lead to the elimination of Medicaid, and this will simply put more strain on the Medicaid system that is already ill-run, doesn’t function, and provides shoddy care. Weird. Perhaps this is another “transitional” measure. Whatever, the government knows best.

7. You know what, this section is actually making sense (sans the total crap about pushing ALL of us into the government-run healthcare system). Pages 100-02ish provide for all children who are born to people of low or no income be automatically enrolled in Medicaid. Why can’t we do this now? Wouldn’t that get more people covered who need to be without screwing things up for the 80+% of Americans who are happy with their healthcare plans? I’d support this if it weren’t part of a socialized healthcare bill, but alas! it is.

8. Continuing in this section, Medicaid is expanded and seems to be less difficult to get into than it is now (pg 101-04). This is a good thing, but where’s the money going to come from for this? Medicaid can’t pay now for the tiny number (relative to the whole population) of people enrolled, adding to the enrollment can only break an already broken budget. So where is the money coming from? Head-scratching moment here.

9. Ah-ha! From the states. And here, again, our dear, stupid, Dement-ocratic Congress simply refuses to look at the Constitution. One day, someone needs to point out the Tenth Amendment to these people. They can’t take away states rights in a bill like this, they would have to amend the friggin’ Constitution. Another lawsuit waiting to happen.

10. Blah, blah, blah. A lot of blather in here about Medicaid, but because much of it is unconstitutional and/or only a temporary, transitional measure, I’ll skip it.

11. Holy crap! Lucky us! We get yet another government office to pay for. On page 107, the “Office of the Special Inspector General of the Health Insurance Exchange” is established. Another presidential appointee, but this time Congress has to approve, too. The Commissioner, however, does not have to be Congress-approved; that’s a straight appointment. For life. And that guy (or gal) will have MASSIVE power. This Special Inspector General will report blah blah and supervise blah blah AND “have other duties” (pg 108). “Other” unspecified duties? This is truly frightening.

12. Radar alert. This Special Inspector Office “will terminate after five years” (pg 109). There’s that magic “five year” mark again, so that helps shed light on this Office’s “other duties.” Of course the bill doesn’t say why, but I think it’s pretty clear in conjunction with the “grandfather clause” that by then, Congress expects a full-blown government-run, single-payer healthcare system to be established. By then, they’ll have pushed out or regulated out (the Commissioner has unlimited power in “correcting” anything that makes your own private insurance look better to you than the government’s) all private insurance and established a vast network that can never be shut down. England has looked into undoing its socialized medicine program, but the cost would be astronomical. They’re stuck with it. And we will be, too.

13. Sec. 207 sets up a “Health Exchange Trust Fund” (pg 109). This will cover the “operating costs” of Health Insurance Exchange (the fancy euphemism for government-run, single-payer, socialized medicine). The money for this fund comes from TAXING ANYONE WHO DOES NOT HAVE “ACCEPTABLE” COVERAGE (pg 110). Stop, please, pause, and read that again. If you do not have “acceptable” (i.e. government-run) coverage, you will be TAXED for not having it. If you take the “option” of not going into the government-run plan, you will be taxed. Some option, huh? And keep in mind that this, too, is only temporary (five years); once that five years are up, you WILL NOT HAVE A CHOICE. On the bright side, because you’ll be forced into “acceptable” coverage provided by the government, you won’t be taxed. Yay!

14. This Trust Fund will also receive moneys from taxes on businesses who do not offer government-run healthcare (pg 110). Again, this is only temporary, after five years, the government will have “offed” all competition, so those taxes are merely incentives for businesses to get on board sooner, regardless of what their employees may want in terms of keeping the healthcare they get now. There will also be an “excise” tax for failure to meet the government’s standards (i.e. offer government-run healthcare only) (pg 110). Combine this with the “grandfather” clause about your keeping your insurance, and it’s unlikely that your employer will still have it to offer you for those five years. Think about it.

15. The next part writes a blank check to the Trust Fund (pg 110). All monies in the Treasury that aren’t otherwise allocated and that meet the expenses of the Trust Fund (whatever those are at any given time) will go directly into this Trust Fund. So they can spend and spend and spend, and obviously on totally useless things like surveys, umpteen useless committees, and God knows what else, and the money will magically appear out of thin air (er, the Treasury of the United States of America. It’s currently an empty vault with billions, or is it trillions, in I.O.U.’s to China in it. You know the one. We DO have an I.O.U. in it from Brazil to cover the money we borrowed from China to give to them for off-shore drilling. That’s money in the bank right there.).

16. Okay, this next part gets even more complicated and gruesome. State-based Exchanges can be set up UNDER the Federal Exchange with fed approval and supervision (pg 112-115). Wait for the good part: there can be NO MORE THAN ONE State-based exchange per state (pg 113), though many states may participate in a single exchange. Competition will be crazy between that ONE government (state this time, under federal guidance, supervision, and regulation) healthcare “option.” Okay, why do BO and this Congress have such a difficult time understanding that an option requires that there be two (preferably more) VIABLE choices? Deciding between a state or federal exchange is not an option. It’s the same damn thing considering the feds oversee and mandate the state exchanges as set up in this bill. If you have one “choice,” it is NOT a choice. It is not an option. D’oh! Another example of not an option is “we can cut off your head or rip your heart out with our bare hands,” which do you “opt” for? Remember, it’s your CHOICE!!

17. In order to provide you with a choice, the Commissioner mandates that only one provider (the government) can offer the so-called “public option” (pg 116). So you can’t get it through BlueCross or your own carrier, only through the government. They didn’t need to spell this out; it’s clear from the first 95 pages, but it’s nice that they included this restriction of free market competition, don’t you think? It makes their case for “ensuring competition” as only they can.

18. More “data collection” (pg 118). This time not just your finances but anything that will help them to avoid racial discrimination and “other disparities in health care.” No quotas explicitly stated here, but you can bet they will be added. It’s the government, after all, and they love affirmative action and quota-filling regardless of anyone’s need. If you’re white and well-off this does not bode well for you. That’s all I’m saying.

19. The Commissioner can set premium costs with the following TWO considerations (pg 119): that they meet the Commissioner’s own standards (whatever they are on any given day) and that they are “sufficient to fully finance” this enormous government take over and its continuation until this country simply collapses because it can’t sustain all the useless spending. Notice, too, that the premium rates will not be set with a consideration of adequate healthcare. That’s important.

20. The “start up cost” of this little endeavor is 2 trillion dollars (pg 120). Google “start up cost,” it’ll be fun. In addition to this 2 trillion is “such sums as necessary” to pay claims for 90 days (also pg 120). Add another 3 trillion to the 2 trillion, and you’re in the ballpark. My guess, it could be less. It could be more.

21. Practitioner fees will be dictated by the government as they are for those on Social Security. Same exact scale, actually (pg 121), with provisions for possibly scaling to current Medicare rates (pg 122). Keep in mind that many (most?) doctors don’t participate in Social Security or Medicare coverage because they can’t make ends meet if they do. It’s a typically low-ball government rate plan that is prohibitive in the real world that doctors live in and pay huge insurance fees for potential malpractice suits, etc. Well, that’s one way to make sure we don’t have decent healthcare; let’s pay doctors what the average firefighter makes. They’ll be rushing to build up six and seven figure medical school loans! And as there’s not yet mention of any tort reform, they can also expect to pay the currently exorbitant malpractice insurance, too. We’ll have more doctors than we know what to do with. It’ll be great.

22. Ah, the famous “well-child” visits (pg 122). This hasn’t really been set up in the bill yet, but I think this is what has the right wing up in arms. Government people coming to your home and telling you how to care for and raise your children. Sound like good times, George?

23. Holy crap. Not only will doctors “get” to charge SS and Medicare fees for service, but they will also be required to pay the government for the privilege of doing so (pg 127). At a rate set, of course, by the government and subject to change at the government’s discretion. I’m gobsmacked. IF private medical practices still exist once this national healthcare is in place, the price for such services will be exorbitant. They’ll HAVE to be with the government dictating prices in this manner for all healthcare for all people in the nation. Don’t expect private doctors to be an option once this is in full-swing unless you make millions a year.

24. Credits (pg 128-32). Similar to existing tax credits and based on income, family, etc. These can be used as follows (if you’re poor enough to qualify, and remember that the poverty level in this country is currently, for a family of four, a total income of $22,050. If you make more than that, you probably won’t qualify for healthcare credits.): in the first and second years (2011 and 2012), on the “basic” plan only (remember, no dental and no optical until you get to the “premium-plus” level, that’s basic and 100% paid for by the employer in most current employer-based plans.). Beginning in year 3 (2013), you can apply credits, if you qualify for credits in the first place, to enhanced or premium (but NOT premium-plus) plans. I guess by the third year, they anticipate having forced enough people into the government-run healthcare system to pay for that? Apparently, no credits are available for application to the premium-plus plans ever. It’s not here, anyway. Hmph! I guess truly poor people don’t need dental and optical coverage.

25. Scratch my logic in number 24. The bill actually defines the income level needed to receive these credits as “400 percent below the Federal poverty level for a family of the size involved” (pg 133). FOUR HUNDRED PERCENT below the fed poverty level. How is that even possible? 100% of $22,050 (the poverty line for a family of four) is $22,050, right? So if you make 100 percent less than the federal poverty line, you make zero dollars? How do you make negative money in this country (unless you’re the government, anyway)? Do you pay someone else to work for them? Weird. There must be some strange math that only the government understands, or maybe I don’t get what they mean by 400% below the federal poverty line. I know I must be missing something and wish I’d taken more maths classes in college. Anyone who knows what this actually means, please post a comment to explain it to me. Thanks.

26. Your premiums will be 1/12th of your GROSS annual income, whatever that income is (pg 136-37). It’s a flat tax, and I’m usually in favor of a flat tax, but that’s ridiculous given the limited care and the other “added” costs like deductibles, co-pays, co-insurance, etc., in addition to the limits of your access to healthcare (you can only spend 5k a year if you’re single and 10k per year for your entire family, remember?). If you make $50,000, you will pay premiums (not including other out of pocket and hidden taxes) of $4,200 dollars per year (I rounded up from $4,166 because the government will, just as it does on our income taxes). This is for the basic plan. I haven’t gotten to what the “enhanced,” “premium,” and “premium-plus” plans will cost you. There’s some more stuff about tables and how much more than the fed poverty line you make and how your premiums will go up the higher above that line you go. I’m not sure how that fits in with the 1/12th thing, though. It’s all government gobbeldy-gook. The bottom line is this is going to cost you and cost you BIG, especially if you currently have a good premium and good coverage that your employer pays part of. You’re the ones getting screwed by this bill. But hey! Bright side, you get to keep your great coverage for a WHOLE FIVE YEARS before you are forced into Obamacare. Well, assuming your employer can afford to and is willing to pay all the hefty fines and taxes for providing you with that option. That’s something to hold onto.

27. If you don’t make enough money to file a federal tax return (that’s about $8k, right?), then the Commissioner will “establish procedures for income verification” (pg 140). If you make so little that even the IR-freaking-S gives you a break, government-run healthcare will not. Lovely. Now we finally have an agency that makes the IRS look like they have a heart. And it’s our healthcare system! Stop and savor the irony.

28. Here’s a head-scratcher. So far, illegal immigrants have not been mentioned. HOWEVER, and I think pointedly, they are excluded from obtaining “affordability credits” (pg 143). Express exclusion from one part MEANS eligbility for the other parts. It works the same way that not mentioning abortion (a legal medical procedure) means that it will be supplied through government-run healthcare. Oh my God, these people in Congress are sneaky little weasles. I am SO against illegals getting healthcare here, even shoddy, crappy, government-run healthcare that I don’t want in the first place!

29. Shared responsibility (pg 143). This already sounds scary. Oh, it’s about how you, the citizen, and your employer should share responsibility with the government for your having “acceptable coverage.” Remember from pages 1-95, “acceptable coverage” boils down to government-run insurance, and everyone will be on it by the end of five years no matter what. The Commissioner’s job description is to make that happen. So it’s not new or scary; it’s simply iterating that we’re all going to be shoved into this regardless of whether we like it, understand it, or want it.

30. You’d think with you paying premiums, your employer paying into your health insurance as also required (pg 145), AND the government supposedly helping that it would be affordable. Funny how that’s not how it’s turning out. And keep in mind, too, that you will not be able to get what you get now after 5 years, or sooner with the fees your employer would have to pay to offer it to you (then the government can point to the employer and blame them for not offering your preferred, private plan. Sneaky.). You will only have the four options provided by the government (basic, enhanced, premium, and premium-plus), and if you don’t have those, you will be fined and violating federal law (i.e. federal law-breakers go to federal prison).

31. Pages 145-167 essentially make it impossible (or hugely costly in fines and fees to the government) for a business, small or large, NOT to comply with the law (that’s essentially how this is set up) that requires them to provide government-run healthcare to their employees and to pay for a portion (as described above). This is absolutely amazing. The government is forcing employers to offer this or risk being taxed and fined into bankruptcy. Aren’t there monopoly laws on the books? Or is it okay as long as the monopoly is run by the government and funded by the people? Grrrr.

32. You’ll be taxed 2.5% of your GROSS annual income for not having “acceptable” (i.e. government-run healthcare) coverage (pg 167-68). They’ll happily prorate this for you if you are covered for part of the year (169). Good of them.

33. As in Massachusetts, there is a “religious conscience exemption” (pg 170). This essentially means that you have to prove you are part of some cult or religion that does not accept modern medicine–this includes not having any medical treatments or purchasing ANY medicine (including over-the-counter meds like Midol and Nyquil) since you joined said religion or cult. I guess that’s okay, some people believe that God will cure them or that their illness is God’s will. This doesn’t mean those people won’t be paying for nationalized healthcare, they will. They just won’t have to pay premiums, co-pays, etc. and can “opt out” of any and all healthcare insurance, including government-run ones like the one we’ll have established in five years.

34. No wonder this things runs over a thousand pages, all of this (pg 171-75) is already stated in pages 1-95. Ugh. How annoying. It’s the stuff defining “acceptable coverage.” Again. And notice how ill-organized it is? I mean why not say what the tax will be for not having coverage when it’s first mentioned? Grrrr. Who taught these people how to write?

35. Look forward to tax day each year? April 15th the bestest day evah for you? Have we got an added bonus for you!! You get to file “Health Insurance Coverage Returns” each year, too (pg 175-77). Employers will fill out forms (like your W-2, 1099, etc.) and send these out to you, I guess in January when they send tax forms–that’s not detailed here. Then you get to file your healthcare return with the feds. Whoopeee! That’ll be such a party. And the failure to file your returns (health, not tax) will mean penalties similar to those for not filing your income tax returns (pg 177-78). Failure to have national health insurance and file your “Health Return” is in the same league with income tax evasion. Now that’s a government agency to fear!

36. Pages 179-88 relate the horrors that await businesses who do not file their health returns each year, who do not comply with the federal (soon to be LAW) that they offer national healthcare to their workers, etc. and etc. If you’re a business owner, read those pages carefully. Pages 188-94 cover small business credits, so that may be of interest to small business owners.

This brings us to page 194 and the exciting world of subsidies. We’ll see what wonders this holds next time. I’m thoroughly disgusted by most of what’s in pages 95-194, and I feel dirty just typing it up. I need a shower.


4 thoughts on “Fuzzy’s Notes: HR 3200, Pages 95-194

  1. Thanks for the ammo- I brought up these points and research today at the healthcare rally, and it really felt good to bring real information to the debate and cite sources and quote pieces of the bill. The Obamacare supporters usually had nothing to say in the face of reality.

  2. You're welcome, Teacher, and I'm super glad that you found it useful. The bill, the actual bill that may be pushed through, is vastly different from what the president and people on the left are saying. And I'm glad that you are standing up and facing these people who haven't read the bill and who don't know what they are supporting because they are being lied to from the top down. They think we are making all this up, but it's right there, in the bill itself. Go you!

  3. Thank you so much for your summaries. Although there are a couple areas I disagree with your understanding of the code, this is enormously helpful to me. I'm looking forward to your continued writings.

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