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Why No Congressman Wants to Talk About HR 3200

I have a headache. This is because I have been reading the full text of HR 3200, with the self-described "simple" title of "America's Affordable Health Choices Act of 2009".

Ow.

Remember how some genius created non-alcoholic beer, and in so doing managed to create a beverage with rotten taste, no nutrition, no buzz, and a higher-than-beer price tag, thereby creating something which no sane person would ever wish to purchase, much less imbibe? Well, this bill might be the legislative version of that concoction. It's frankly very nasty stuff. Want proof? OK, here is the list of definitions of terms from Section 100 of the 1,017-page monster. Read it through and see how well your noggin likes it:

"GENERAL DEFINITIONS.--Except as otherwise provided, in this division:
(1) ACCEPTABLE COVERAGE.--The term ''acceptable coverage'' has the meaning given such term 5 in section 202(d)(2).
(2) BASIC PLAN.--The term ''basic plan'' has the meaning given such term in section 203(c).
(3) COMMISSIONER.--The term ''Commissioner'' means the Health Choices Commissioner established under section 141.
(4) COST-SHARING.--The term ''cost-sharing'' includes deductibles, coinsurance, copayments, and similar charges but does not include premiums or any network payment differential for covered services or spending for non-covered services.
(5) DEPENDENT.--The term ''dependent'' has the meaning given such term by the Commissioner and includes a spouse.
(6) EMPLOYMENT-BASED HEALTH PLAN.--The term ''employment-based health plan''--
(A) means a group health plan (as defined in section 733(a)(1) of the Employee Retirement Income Security Act of 1974); and
(B) includes such a plan that is the following:
(i) FEDERAL, STATE, AND TRIBAL GOVERNMENTAL PLANS.--A governmental plan (as defined in section 3(32) of the Employee Retirement Income Security Act of 1974), including a health benefits plan offered under chapter 89 of title 5, United States Code.
(ii) CHURCH PLANS.--A church plan (as defined in section 3(33) of the Employee Retirement Income Security Act of 1974).
(7) ENHANCED PLAN.--The term ''enhanced plan'' has the meaning given such term in section 203(c).
(8) ESSENTIAL BENEFITS PACKAGE.--The term ''essential benefits package'' is defined in section 122(a).
(9) FAMILY.--The term ''family'' means an individual and includes the individual's dependents.
(10) FEDERAL POVERTY LEVEL; FPL.--The terms ''Federal poverty level'' and ''FPL'' have the meaning given the term ''poverty line'' in section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision required by such section.
(11) HEALTH BENEFITS PLAN.--The terms ''health benefits plan'' means health insurance coverage and an employment-based health plan and includes the public health insurance option.
(12) HEALTH INSURANCE COVERAGE; HEALTH INSURANCE ISSUER.--The terms ''health insurance coverage'' and ''health insurance issuer'' have the meanings given such terms in section 2791 of the Public Health Service Act.
(13) HEALTH INSURANCE EXCHANGE.--The term ''Health Insurance Exchange'' means the Health Insurance Exchange established under section 201.
(14) MEDICAID.--The term ''Medicaid'' means a State plan under title XIX of the Social Security Act (whether or not the plan is operating under a 6 waiver under section 1115 of such Act).
(15) MEDICARE.--The term ''Medicare'' means the health insurance programs under title XVIII of the Social Security Act.
(16) PLAN SPONSOR.--The term ''plan sponsor'' has the meaning given such term in section 3(16)(B) of the Employee Retirement Income Security Act of 1974.
(17) PLAN YEAR.--The term ''plan year'' means--
(A) with respect to an employment-based health plan, a plan year as specified under such plan; or
(B) with respect to a health benefits plan other than an employment-based health plan, a 12-month period as specified by the Commissioner.
(18) PREMIUM PLAN; PREMIUM-PLUS PLAN.-- The terms ''premium plan'' and ''premium-plus plan'' have the meanings given such terms in section 203(c).
(19) QHBP OFFERING ENTITY.--The terms ''QHBP offering entity'' means, with respect to a health benefits plan that is--
(A) a group health plan (as defined, subject to subsection (d), in section 733(a)(1) of the Employee Retirement Income Security Act of 1974), the plan sponsor in relation to such group health plan, except that, in the case of a plan maintained jointly by 1 or more employers and 1 or more employee organizations and with respect to which an employer is the primary source of financing, such term means such employer;
(B) health insurance coverage, the health insurance issuer offering the coverage;
(C) the public health insurance option, the Secretary of Health and Human Services;
(D) a non-Federal governmental plan (as defined in section 2791(d) of the Public Health Service Act), the State or political subdivision of a State (or agency or instrumentality of such State or subdivision) which establishes or maintains such plan; or
(E) a Federal governmental plan (as defined in section 2791(d) of the Public Health Service Act), the appropriate Federal official.
(20) QUALIFIED HEALTH BENEFITS PLAN.-- The term ''qualified health benefits plan'' means a health benefits plan that meets the requirements for such a plan under title I and includes the public health insurance option.
(21) PUBLIC HEALTH INSURANCE OPTION.-- The term ''public health insurance option'' means the public health insurance option as provided under subtitle B of title II.
(22) SERVICE AREA; PREMIUM RATING AREA.-- The terms ''service area'' and ''premium rating area'' mean with respect to health insurance coverage--
(A) offered other than through the Health Insurance Exchange, such an area as established by the QHBP offering entity of such coverage in accordance with applicable State law; and
(B) offered through the Health Insurance Exchange, such an area as established by such entity in accordance with applicable State law and applicable rules of the Commissioner for Exchange-participating health benefits plans.
(23) STATE.--The term ''State'' means the 50 States and the District of Columbia.
(24) STATE MEDICAID AGENCY.-- The term ''State Medicaid agency'' means, with respect to a Medicaid plan, the single State agency responsible for administering such plan under title XIX of the Social Security Act.
(25) Y1, Y2, ETC.--The terms ''Y1'' , ''Y2'', ''Y3'', ''Y4'', ''Y5'', and similar subsequently numbered terms, mean 2013 and subsequent years, respectively."

If that all makes sense to you and your head is not screaming for relief, see your doctor as soon as the government tells you you are allowed to do so.


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Comments (24)

The plain fact is that this... (Below threshold)

The plain fact is that this bill is 1017 pages long. However, if you read every OTHER piece of legislation that it references (in order to understand what they are talking about) it would probably run 10,017 pages.

Even if you read the regular bill, you have no hope of understanding its full implications unless you also read everything else referenced.

the only time you "define t... (Below threshold)

the only time you "define terms" in the manner above is when you don't anyone to actually UNDERSTAND the terms!

my favorite:
(6) EMPLOYMENT-BASED HEALTH PLAN.--The term ''employment-based health plan''--
(A) means a group health plan (as defined in section 733(a)(1) of the Employee Retirement Income Security Act of 1974); and
(B) includes such a plan that is the following:
(i) FEDERAL, STATE, AND TRIBAL GOVERNMENTAL PLANS.--A governmental plan (as defined in section 3(32) of the Employee Retirement Income Security Act of 1974), including a health benefits plan offered under chapter 89 of title 5, United States Code.
(ii) CHURCH PLANS.--A church plan (as defined in section 3(33) of the Employee Retirement Income Security Act of 1974).

4 DIFFERENT sections in 2 DIFFERENT documents are necessary in order to understand this ONE term!

What a crock of crap - they... (Below threshold)
Madalyn:

What a crock of crap - they don't want anyone to understand what it means, because that means we might not want to be a participant. I have heard lawyers who are trying to read it and say they don't understand it. What's going on here?

I think the whole purpose i... (Below threshold)
GarandFan:

I think the whole purpose is to so numb your brain that you're eyes will glaze over. After reading the first several pages, no matter how well intentioned, you'll give up and just say PASS IT! Amazing what you can bury in a piece of legislation that you don't want people to see.

Better idea: Let's not even 'write' the legislation, so that we all know what we're talking about. We'll just call it what we want, and vote on the nifty sounding name (or logo).

How many people read the gl... (Below threshold)
Desmothenes:

How many people read the glossary of a book though? The point of a glossary, or in this case a definition of terms, is as a reference for when you find a term in the main document that you want clarification on. Could you perhaps excerpt and actual part of the bill instead of a glossary?

Glossaries don't become leg... (Below threshold)
sam:

Glossaries don't become legalese that can then affect the law and its consequences.

Quote of the Day:"... (Below threshold)
Adrian Browne:

Quote of the Day:

"Humility is the ability to give up your pride and still retain your dignity."
~Vanna Bonta

Desmothenes, DJ l... (Below threshold)
P. Bunyan:

Desmothenes,

DJ linked to the full bill above, so go knock yourself out if you want to peruse. You may get spyware installed at govenment sites these days though, so be careful! (yes I'm joking- I hope)

For the past 15+ years I've been on the real world application end of federal and state legislation, to greater and lesser degrees, and believe me the definitions are very important. They are always right at the front of the bill because they are so important. Legislation is written using English words, but it's not written in conversational English. It's more a lawerese kinda thing, but if you take time you can get through it.

Several years ago there was a new regulation imposed on a program I was administrating. It was about 350 pages or so, IIRC. It took me many hours and Tylenols to get through it and turn it into a 2 or 3 page "what we need to do now" memo written in common English.

As P. Bunyan says, definiti... (Below threshold)
Upset Old Guy:

As P. Bunyan says, definitions are very important. References are made because many of the terms have standard definitions which appear elsewhere, are used in multiple bills/laws and their inclusion would make this bill many pages longer than it's current 1017.

If you are to make a dent at understanding any bill/law start here, understand the difference between the words "may" and "shall".

HAHAHAHAHAHARead t... (Below threshold)
jim m:

HAHAHAHAHAHA

Read the bill!!! HAHAHAHAHAHA

Whooo!

Sides aching...catching breath....

/congressional attitude

Let's see, how many pages (... (Below threshold)
GarandFan:

Let's see, how many pages (handwritten) was the US Constitution, which set up a new form of government? Now compare that to HR3200 which is supposed to be about "Health Care Reform", which is typewritten. Anyone else see the disconnect here? Things are only "complicated" when someone is trying to get something past someone else.

I've got A LOT left, but a ... (Below threshold)

I've got A LOT left, but a couple of good bits so far:

my favorite definition so far:

NON-TRADITIONAL MEDICAID ELIGIBLE INDIVIDUAL.
--The term ''non-traditional Medicaid eligible individual'' means a Medicaid eligible individual who is not a traditional Medicaid eligible individual.

and I don't really understand what the heck this is, so I don't know if I should laugh or be frightened:

CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS.
--The entity shall provide for culturally and linguistically appropriate communication and health services.

CULTURALLY AND LINGUISTICAL... (Below threshold)
jim m:

CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS

I take it that this will require hospitals and physician offices to provide interpreters for all 4500 living languages extant today.

I can see the multimillion dollar discrimination lawsuits already for not providing appropriate language services in Dagaare the national language of Ghana even though there are only 1M speakers of it world wide.

"Could you perhaps excerpt ... (Below threshold)
LaMedusa:

"Could you perhaps excerpt and actual part of the bill instead of a glossary?"

Which part of the 1018 pages would you like excerpted for you?

http://urbangrounds.com/2009/07/23/house-health-plan-hr-3200/

You can skim through this partial breakdown past the chart at the above link. You will see one word in particular repeated an awful lot, and that friendly word is GOVERNMENT. Add words like "decides", "allows", "ACORN", "mandates", well, you get the idea...

Oh, and congress won't talk... (Below threshold)
LaMedusa:

Oh, and congress won't talk about something they won't be immediately subjected to, and don't feel obligated to understand, themselves.

NON-TRADITIONAL MEDICAID EL... (Below threshold)
P. Bunyan:

NON-TRADITIONAL MEDICAID ELIGIBLE INDIVIDUAL=Illegal Allien

CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS=You must have a Spanish speaking doctor on duty at all times and you must have appropriate Muslim prayer accomodations.

"Better idea: Let's not eve... (Below threshold)
sodak:

"Better idea: Let's not even 'write' the legislation, so that we all know what we're talking about. We'll just call it what we want, and vote on the nifty sounding name (or logo)"
I don't see a problem with this. The US constitution, even though it is written can be read as a "living - breathing document". Therefore I agree legislation does not even have to be in writing. It(niffty sounding name ie Health Care Reform) can be interpreted to mean whatever our leaders deem it to mean.

Ouch!My head hurts.Can(coul... (Below threshold)
1903A3:

Ouch!My head hurts.Can(could)these people EVER write a bill that the common man or women would be able to read and understand?My guess is NO because they dont want you to know, so that they can go on their marry way of screwing us over.

Quit whining and ask where ... (Below threshold)
epador:

Quit whining and ask where the hell the Senate drafts are!

You also have to like the b... (Below threshold)

You also have to like the blatant bankrupting of private insurers. It requires insurers to return any money at the end of the year that they have collected in premiums and not paid out in benefits. In other words, the insurer cannot build up reserves in 'healthy' years to pay out more in 'sick' years. Can you imagine any insurer being able to do that? Picture hurricane insurance. Basically what they're doing is the equivalent of forcing the insurer to return the premiums every time there's no widespread hurricane damage, leaving them with nothing but a year of premiums when there is a Katrina or Hugo. Can you imagine an insurer not going bankrupt under that restriction or, more likely, even bothering to get into the business to begin with?

The thing to watch out for ... (Below threshold)
cirby:

The thing to watch out for is when they put definitions on words that DON'T match either common sense or previous definitions of the words as used in other laws and regulations. When you see a page like this, there's certainly another page somewhere that has one or two words or phrases that sneak a whole different meaning into the bill.

By referencing other laws and regulations (and not including the text from those other laws for reference), it's a safe bet that they're stacking the deck in several nasty ways. Until someone (or, more likely, several dozen someones) goes through, line by line, and annotates not only this bill, but the other laws referenced (and the ones THOSE laws reference), nobody can have any idea what it really does.

Look, for example, at that idiotic law they passed protecting young children from toxins - which accidentally (?) outlawed the sale of children's books from before a certain date, due to regulating the amount of lead in printing ink. Since the ink has to be certified lead-free, you can't resell a used children's book (or, inddeed, anythign a child might use) unless the book has been tested (and a horrible cost per book), or face a $100,000 fine PER BOOK. This law also made it illegal to sell a motorcycle or ATV that a child might use (yes, even toy ones, or ones designed specifically for kids)), since they "contain lead."

because there are a number ... (Below threshold)
truthsayer:

because there are a number of laws that reference health coverage, the bill has to reference some of those statutes or they would all have to be revised and consolidated, which makes no sense. when you look at the referenced statutes, you will find that there is nothing evil in them. better to read it and try to understand it than take the word of either the liberal or the conservative press.

Actually, cirby, printing i... (Below threshold)
truthsayer:

Actually, cirby, printing inks were specifically excluded from the law so books would not be affected. you need to read the laws before you start commenting on them. your post makes a good head shaker story but it's wrong.

The general public who are ... (Below threshold)

The general public who are oblivious to HR 3200 need to know what it entails. The actuality of it needs to get out so it can be heard. People need to be informed, and they need to know what is actually going on with this bill. Go to www.buythebill.com to get a free PDF download of the bill, or you can purchase a printed and binded hard copy of the bill.




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