AAHCA 2009 - 2nd Objection: You Can't Really Retain Your Old Coverage

You can peruse the America's Affordable Health Choices Act of 2009 at your own convenience. Other than the fact that this legislation is utterly without any constitutional authority, I have been looking it over and here is my second objection:

Folks point to Section 102 to show that it allows folks to maintain their current coverage, but this is a smokescreen, when you actually read the entire section. I will put my comments in braces {}, so you can see what I mean:

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT-

(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1. {No new enrollment into existing plans will be allowed by anyone who is not already covered by that plan.}

(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day. {New enrollment is allowed only for dependents.}

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1. {The insurer has to freeze the plan and cannot make any changes to the plan.}

(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner. {Insurers cannot single out a specific person without affecting all people in this risk group equally.}

(b) Grace Period for Current Employment-based Health Plans-

(1) GRACE PERIOD-

(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121. {Here we see there is a five-year-plan whereby the insurers must alter their plans so as to cover the items listed in the "essential benefits plan." I talked about this in the last post. What this means that no matter what your plan currently covers, if it does not cover what some bureaucrat believes is "essential," then your insurer will be forced to cover it.}

(B) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following: {Here, they are essentially grandfathering existing government-issued health plans.}

(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).

(ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.

(iii) Such other limited benefits as the Commissioner may specify.

In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division {Except to the extent that an already existing government plan is not up to snuff.}

(2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE- During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division. {Any existing plan is OK until after the end of the five-year-plan, when all plans will be forced to conform.}

(c) Limitation on Individual Health Insurance Coverage-

(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan. {If you are not covered by an employer plan, then you have an individual plan. In this case, any new individual plan has to be "approved" and contain the "essential benefits package" of things that most folks don't need but will be forced to pay for.}

(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage. {There is list of items in this other act that are not deemed to be part of the health insurance coverage and can be priced separately.}

The lesson is that you cannot really keep the coverage you have now, because insurers are going to be forced to include the "essential benefits package," even though you and I don't believe that we need these benefits, which will drive up the cost of these private plans. If the price of these private plans is forced high enough, then employers (and individuals) will cancel those policies and force people to purchase the same type of "essential benefits" from the "Public Option."

Medicare and Medicaid are already bankrupt or fast approaching bankruptcy. The above requirements will force everyone to become part of the same utterly bankrupt system.