Just when you think that filing your taxes couldn't get any more fun than it already is, the Health Care Reform Act is here!
You can read all of the wonderful details of this legislation by searching for "HR 3200" on the following website: http://thomas.loc.gov/
Basically, as part of health care reform, you will be required to prove that you participated in an approved health insurance program when you file your income tax, or you will get to pay Uncle Sam even more money. See for yourself:
"SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
`(a) Tax Imposed- In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of--
`(1) the taxpayer's modified adjusted gross income for the taxable year, over
`(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.
`(b) Limitations-
`(1) TAX LIMITED TO AVERAGE PREMIUM-
`(A) IN GENERAL- The tax imposed under subsection (a) with respect to any taxpayer for any taxable year shall not exceed the applicable national average premium for such taxable year.
`(B) APPLICABLE NATIONAL AVERAGE PREMIUM-
`(i) IN GENERAL- For purposes of subparagraph (A), the `applicable national average premium' means, with respect to any taxable year, the average premium (as determined by the Secretary, in coordination with the Health Choices Commissioner) for self-only coverage under a basic plan which is offered in a Health Insurance Exchange for the calendar year in which such taxable year begins.
`(ii) FAILURE TO PROVIDE COVERAGE FOR MORE THAN ONE INDIVIDUAL- In the case of any taxpayer who fails to meet the requirements of subsection (e) with respect to more than one individual during the taxable year, clause (i) shall be applied by substituting `family coverage' for `self-only coverage'.
`(2) PRORATION FOR PART YEAR FAILURES- The tax imposed under subsection (a) with respect to any taxpayer for any taxable year shall not exceed the amount which bears the same ratio to the amount of tax so imposed (determined without regard to this paragraph and after application of paragraph (1)) as--
`(A) the aggregate periods during such taxable year for which such individual failed to meet the requirements of subsection (d), bears to
`(B) the entire taxable year.
`(c) Exceptions-
`(1) DEPENDENTS- Subsection (a) shall not apply to any individual for any taxable year if a deduction is allowable under section 151 with respect to such individual to another taxpayer for any taxable year beginning in the same calendar year as such taxable year.
`(2) NONRESIDENT ALIENS- Subsection (a) shall not apply to any individual who is a nonresident alien.
`(3) INDIVIDUALS RESIDING OUTSIDE UNITED STATES- Any qualified individual (as defined in section 911(d)) (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during the period described in subparagraph (A) or (B) of section 911(d)(1), whichever is applicable.
`(4) INDIVIDUALS RESIDING IN POSSESSIONS OF THE UNITED STATES- Any individual who is a bona fide resident of any possession of the United States (as determined under section 937(a)) for any taxable year (and any qualifying child residing with such individual) shall be treated for purposes of this section as covered by acceptable coverage during such taxable year.
`(5) RELIGIOUS CONSCIENCE EXEMPTION-
`(A) IN GENERAL- Subsection (a) shall not apply to any individual (and any qualifying child residing with such individual) for any period if such individual has in effect an exemption which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.
`(B) EXEMPTION- An application for the exemption described in subparagraph (A) shall be filed with the Secretary at such time and in such form and manner as the Secretary may prescribe. Any such exemption granted by the Secretary shall be effective for such period as the Secretary determines appropriate.
`(d) Acceptable Coverage Requirement-
`(1) IN GENERAL- The requirements of this subsection are met with respect to any individual for any period if such individual (and each qualifying child of such individual) is covered by acceptable coverage at all times during such period.
`(2) ACCEPTABLE COVERAGE- For purposes of this section, the term `acceptable coverage' means any of the following:
`(A) QUALIFIED HEALTH BENEFITS PLAN COVERAGE- Coverage under a qualified health benefits plan (as defined in section 100(c) of the America's Affordable Health Choices Act of 2009).
`(B) GRANDFATHERED HEALTH INSURANCE COVERAGE; COVERAGE UNDER GRANDFATHERED EMPLOYMENT-BASED HEALTH PLAN- Coverage under a grandfathered health insurance coverage (as defined in subsection (a) of section 102 of the America's Affordable Health Choices Act of 2009) or under a current employment-based health plan (within the meaning of subsection (b) of such section).
`(C) MEDICARE- Coverage under part A of title XVIII of the Social Security Act.
`(D) MEDICAID- Coverage for medical assistance under title XIX of the Social Security Act.
`(E) MEMBERS OF THE ARMED FORCES AND DEPENDENTS (INCLUDING TRICARE)- Coverage under chapter 55 of title 10, United States Code, including similar coverage furnished under section 1781 of title 38 of such Code.
`(F) VA- Coverage under the veteran's health care program under chapter 17 of title 38, United States Code, but only if the coverage for the individual involved is determined by the Secretary in coordination with the Health Choices Commissioner to be not less than the level specified by the Secretary of the Treasury, in coordination with the Secretary of Veteran's Affairs and the Health Choices Commissioner, based on the individual's priority for services as provided under section 1705(a) of such title.
`(G) OTHER COVERAGE- Such other health benefits coverage as the Secretary, in coordination with the Health Choices Commissioner, recognizes for purposes of this subsection."
Monday, July 20, 2009
The Tale of the Lemon Aide Stands
This is the story of Sally, a young girl with a dream: to make a living by quenching the thirst of the hot, parched masses with her wonderful, home-made lemon aide. It took her awhile to get started, but she saved her money, bought the ingredients and equipment that she needed to make her lemon aide, and set up her stand.
Her lemon aide was delicious, and with the high temperatures caused by global warming there were certainly enough thirsty people out there, so it wasn't long before there was a constant flow of customers coming for her sweet concoction. At 50 cents a cup, she was doing okay!
One day, another young girl, Michelle, showed up at her stand. "I don't think that it's fair that you make people pay for your lemon aide," Michelle told Sally. "Not everyone has the money to buy it. I'm going to open a stand next to yours and give it to people for free."
"SEC. 100. PURPOSE; TABLE OF CONTENTS OF DIVISION; GENERAL DEFINITIONS.
(a) Purpose-
(1) IN GENERAL- The purpose of this division is to provide affordable, quality health care for all Americans and reduce the growth in health care spending.
(2) BUILDING ON CURRENT SYSTEM- This division achieves this purpose by building on what works in today's health care system, while repairing the aspects that are broken.
(3) INSURANCE REFORMS- This division--
(A) enacts strong insurance market reforms;
(B) creates a new Health Insurance Exchange, with a public health insurance option alongside private plans;
(C) includes sliding scale affordability credits; and
(D) initiates shared responsibility among workers, employers, and the government;
so that all Americans have coverage of essential health benefits."
------ from the text of HR 3200 as found on the website:
http://thomas.loc.gov/
(Bold letter feature later added by ME!)
"Well, it's a free country," Sally replied. "I'm not afraid of a little competition. You can open a stand."
"Okay, I will," Michelle told her. "There's just one problem: I don't have the money to start a stand. I will need you to pay for it."
Sally thought for a moment. "Well, I guess I can do that," Sally said. "It's certainly a noble idea, and business has been really good for me. Sure! Let's do it!"
Some ideas for paying for health care reform are: Tax part of employer contributions to health insurance; impose Medicare tax on state and local government employees; tax sugary and alcoholic drinks; change or eliminate Flexible Spending Arrangements; and modify Health Savings Accounts. The latest idea put forth by Democrats suggest a graduated surtax for couples earning $350,000+, to include a 5.4 percent surtax on people with income over $1 million.
So Sally raided her piggy bank and gave Michelle the money that Michelle needed to start her lemon aide stand. Michelle had a few customers come to her stand, but it seemed that the people at Sally's stand had better lemon aide (Sally was using the secret recipe that had been handed down to her from her great-grandmother, and she used only the finest ingredients, with a couple of secret ingredients for good measure.) Most of Michelle's customers simply whined and complained about the disparity, and other customers got in line at Sally's stand.
"I have another request," Michelle announced the next day. "Your lemon aide seems to have something that mine doesn't, and that's not fair! I want you to use MY recipe from now on."
Sally looked at Michelle's recipe. Grandma's secret ingredients weren't there. Sally took a sip of Michelle's lemon aide to get a taste. It was not nearly as sweet as Sally's, and it was a little watery. But in the fiery heat of a CO2 warmed globe, it still quenched her thirst, so Sally agreed to use Michelle's recipe. Since she was having to pay for ingredients at both stands, Sally actually was relieved a little when she realized that Michelle's recipe would save her some money.
"And it has to be EXACT!" Michelle demanded. "Don't be changing ANYTHING, do you hear me? Oh, and you can only service your old customers; if you get any new customers, you have to send them to me!"
"SEC. 101. REQUIREMENTS REFORMING HEALTH INSURANCE MARKETPLACE. (a) Purpose- The purpose of this title is to establish standards to ensure that new health insurance coverage and employment-based health plans that are offered meet standards guaranteeing access to affordable coverage, essential benefits, and other consumer protections.
(b) Requirements for Qualified Health Benefits Plans- On or after the first day of Y1, a health benefits plan shall not be a qualified health benefits plan under this division unless the plan meets the applicable requirements of the following subtitles for the type of plan and plan year involved:
(1) Subtitle B (relating to affordable coverage).
(2) Subtitle C (relating to essential benefits).
(3) Subtitle D (relating to consumer protection).
(c) Terminology- In this division:
(1) ENROLLMENT IN EMPLOYMENT-BASED HEALTH PLANS- An individual shall be treated as being `enrolled' in an employment-based health plan if the individual is a participant or beneficiary (as such terms are defined in section 3(7) and 3(8), respectively, of the Employee Retirement Income Security Act of 1974) in such plan.
(2) INDIVIDUAL AND GROUP HEALTH INSURANCE COVERAGE- The terms `individual health insurance coverage' and `group health insurance coverage' mean health insurance coverage offered in the individual market or large or small group market, respectively, as defined in section 2791 of the Public Health Service Act.
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.
(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.
(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.
(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."
"SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
(a) Establishment-
(1) IN GENERAL- There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
(2) CHAIR- The Surgeon General shall be a member and the chair of the Health Benefits Advisory Committee.
(3) MEMBERSHIP- The Health Benefits Advisory Committee shall be composed of the following members, in addition to the Surgeon General:
(A) 9 members who are not Federal employees or officers and who are appointed by the President.
(B) 9 members who are not Federal employees or officers and who are appointed by the Comptroller General of the United States in a manner similar to the manner in which the Comptroller General appoints members to the Medicare Payment Advisory Commission under section 1805(c) of the Social Security Act.
(C) Such even number of members (not to exceed 8) who are Federal employees and officers, as the President may appoint.
Such initial appointments shall be made not later than 60 days after the date of the enactment of this Act.
(4) TERMS- Each member of the Health Benefits Advisory Committee shall serve a 3-year term on the Committee, except that the terms of the initial members shall be adjusted in order to provide for a staggered term of appointment for all such members.
(5) PARTICIPATION- The membership of the Health Benefits Advisory Committee shall at least reflect providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies. and at least one practicing physician or other health professional and an expert on children's health and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee.
(b) Duties-
(1) RECOMMENDATIONS ON BENEFIT STANDARDS- The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services (in this subtitle referred to as the `Secretary') benefit standards (as defined in paragraph (4)), and periodic updates to such standards. In developing such recommendations, the Committee shall take into account innovation in health care and consider how such standards could reduce health disparities.
(2) DEADLINE- The Health Benefits Advisory Committee shall recommend initial benefit standards to the Secretary not later than 1 year after the date of the enactment of this Act.
(3) PUBLIC INPUT- The Health Benefits Advisory Committee shall allow for public input as a part of developing recommendations under this subsection.
(4) BENEFIT STANDARDS DEFINED- In this subtitle, the term `benefit standards' means standards respecting--
(A) the essential benefits package described in section 122, including categories of covered treatments, items and services within benefit classes, and cost-sharing; and
(B) the cost-sharing levels for enhanced plans and premium plans (as provided under section 203(c)) consistent with paragraph (5)."
"SEC. 142. DUTIES AND AUTHORITY OF COMMISSIONER.
(a) Duties- The Commissioner is responsible for carrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS- The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE- The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
(3) INDIVIDUAL AFFORDABILITY CREDITS- The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.
(4) ADDITIONAL FUNCTIONS- Such additional functions as may be specified in this division.
(b) Promoting Accountability-
(1) IN GENERAL- The Commissioner shall undertake activities in accordance with this subtitle to promote accountability of QHBP offering entities in meeting Federal health insurance requirements, regardless of whether such accountability is with respect to qualified health benefits plans offered through the Health Insurance Exchange or outside of such Exchange."
So Sally modified her recipe and made her lemon aide to match the lemon aide offered by Michelle. Some of her old customers stopped by. "A dollar!" Mr. Jones exclaimed. "Why did you raise the price?"
"Well, you see," Sally explained. "My costs have gone up. I'm not just paying for lemons and sugar for my lemon aide; I'm having to pay for Michelle's lemons and sugar, too."
Mr. Jones grumbled, pulled out a dollar, and took a sip of Sally's lemonade. "Hey! What's going on? This doesn't taste the same!"
"I had to change my recipe," Sally answered. "I had to make my lemon aide match Michelle's."
"Well, why should I pay more for the same stuff, when I can get it for free?" Mr. Johnson murmured. "I'm going over there."
As the weeks wore on, Sally watched sadly as all of her old customers went to Michelle's stand. Business at Michelle's stand was ten times what it had been at Sally's. The lines were long for the free lemon aide, and it took Michelle some time to service all of the customers. Some of her customers got discouraged and left, but most waited around for the free, but watery, lemon aide.
As the last customer left for the day, Michelle came to Sally. "I need some more money. Business has been great, and I'm out of lemons and sugar!"
Sally opened her piggy bank and three quarters tumbled out. "Is that all you got?" Michelle asked. "I need more than that! You're going to have to sell your bicycle!"
"I can't," Sally told Michelle. "I already sold it to get the money that you needed last week."
Even the Congressional Budget Office reports that the current proposals would cost $1 trillion and only reduce the number of the uninsured by $16 million.
"What am I supposed to do now?" Michelle asked.
"I don't know," Sally answered. "But I'm done; I'm taking my stuff and going home!"
Her lemon aide was delicious, and with the high temperatures caused by global warming there were certainly enough thirsty people out there, so it wasn't long before there was a constant flow of customers coming for her sweet concoction. At 50 cents a cup, she was doing okay!
One day, another young girl, Michelle, showed up at her stand. "I don't think that it's fair that you make people pay for your lemon aide," Michelle told Sally. "Not everyone has the money to buy it. I'm going to open a stand next to yours and give it to people for free."
"SEC. 100. PURPOSE; TABLE OF CONTENTS OF DIVISION; GENERAL DEFINITIONS.
(a) Purpose-
(1) IN GENERAL- The purpose of this division is to provide affordable, quality health care for all Americans and reduce the growth in health care spending.
(2) BUILDING ON CURRENT SYSTEM- This division achieves this purpose by building on what works in today's health care system, while repairing the aspects that are broken.
(3) INSURANCE REFORMS- This division--
(A) enacts strong insurance market reforms;
(B) creates a new Health Insurance Exchange, with a public health insurance option alongside private plans;
(C) includes sliding scale affordability credits; and
(D) initiates shared responsibility among workers, employers, and the government;
so that all Americans have coverage of essential health benefits."
------ from the text of HR 3200 as found on the website:
http://thomas.loc.gov/
(Bold letter feature later added by ME!)
"Well, it's a free country," Sally replied. "I'm not afraid of a little competition. You can open a stand."
"Okay, I will," Michelle told her. "There's just one problem: I don't have the money to start a stand. I will need you to pay for it."
Sally thought for a moment. "Well, I guess I can do that," Sally said. "It's certainly a noble idea, and business has been really good for me. Sure! Let's do it!"
Some ideas for paying for health care reform are: Tax part of employer contributions to health insurance; impose Medicare tax on state and local government employees; tax sugary and alcoholic drinks; change or eliminate Flexible Spending Arrangements; and modify Health Savings Accounts. The latest idea put forth by Democrats suggest a graduated surtax for couples earning $350,000+, to include a 5.4 percent surtax on people with income over $1 million.
So Sally raided her piggy bank and gave Michelle the money that Michelle needed to start her lemon aide stand. Michelle had a few customers come to her stand, but it seemed that the people at Sally's stand had better lemon aide (Sally was using the secret recipe that had been handed down to her from her great-grandmother, and she used only the finest ingredients, with a couple of secret ingredients for good measure.) Most of Michelle's customers simply whined and complained about the disparity, and other customers got in line at Sally's stand.
"I have another request," Michelle announced the next day. "Your lemon aide seems to have something that mine doesn't, and that's not fair! I want you to use MY recipe from now on."
Sally looked at Michelle's recipe. Grandma's secret ingredients weren't there. Sally took a sip of Michelle's lemon aide to get a taste. It was not nearly as sweet as Sally's, and it was a little watery. But in the fiery heat of a CO2 warmed globe, it still quenched her thirst, so Sally agreed to use Michelle's recipe. Since she was having to pay for ingredients at both stands, Sally actually was relieved a little when she realized that Michelle's recipe would save her some money.
"And it has to be EXACT!" Michelle demanded. "Don't be changing ANYTHING, do you hear me? Oh, and you can only service your old customers; if you get any new customers, you have to send them to me!"
"SEC. 101. REQUIREMENTS REFORMING HEALTH INSURANCE MARKETPLACE. (a) Purpose- The purpose of this title is to establish standards to ensure that new health insurance coverage and employment-based health plans that are offered meet standards guaranteeing access to affordable coverage, essential benefits, and other consumer protections.
(b) Requirements for Qualified Health Benefits Plans- On or after the first day of Y1, a health benefits plan shall not be a qualified health benefits plan under this division unless the plan meets the applicable requirements of the following subtitles for the type of plan and plan year involved:
(1) Subtitle B (relating to affordable coverage).
(2) Subtitle C (relating to essential benefits).
(3) Subtitle D (relating to consumer protection).
(c) Terminology- In this division:
(1) ENROLLMENT IN EMPLOYMENT-BASED HEALTH PLANS- An individual shall be treated as being `enrolled' in an employment-based health plan if the individual is a participant or beneficiary (as such terms are defined in section 3(7) and 3(8), respectively, of the Employee Retirement Income Security Act of 1974) in such plan.
(2) INDIVIDUAL AND GROUP HEALTH INSURANCE COVERAGE- The terms `individual health insurance coverage' and `group health insurance coverage' mean health insurance coverage offered in the individual market or large or small group market, respectively, as defined in section 2791 of the Public Health Service Act.
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.
(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.
(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.
(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."
"SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
(a) Establishment-
(1) IN GENERAL- There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
(2) CHAIR- The Surgeon General shall be a member and the chair of the Health Benefits Advisory Committee.
(3) MEMBERSHIP- The Health Benefits Advisory Committee shall be composed of the following members, in addition to the Surgeon General:
(A) 9 members who are not Federal employees or officers and who are appointed by the President.
(B) 9 members who are not Federal employees or officers and who are appointed by the Comptroller General of the United States in a manner similar to the manner in which the Comptroller General appoints members to the Medicare Payment Advisory Commission under section 1805(c) of the Social Security Act.
(C) Such even number of members (not to exceed 8) who are Federal employees and officers, as the President may appoint.
Such initial appointments shall be made not later than 60 days after the date of the enactment of this Act.
(4) TERMS- Each member of the Health Benefits Advisory Committee shall serve a 3-year term on the Committee, except that the terms of the initial members shall be adjusted in order to provide for a staggered term of appointment for all such members.
(5) PARTICIPATION- The membership of the Health Benefits Advisory Committee shall at least reflect providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies. and at least one practicing physician or other health professional and an expert on children's health and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee.
(b) Duties-
(1) RECOMMENDATIONS ON BENEFIT STANDARDS- The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services (in this subtitle referred to as the `Secretary') benefit standards (as defined in paragraph (4)), and periodic updates to such standards. In developing such recommendations, the Committee shall take into account innovation in health care and consider how such standards could reduce health disparities.
(2) DEADLINE- The Health Benefits Advisory Committee shall recommend initial benefit standards to the Secretary not later than 1 year after the date of the enactment of this Act.
(3) PUBLIC INPUT- The Health Benefits Advisory Committee shall allow for public input as a part of developing recommendations under this subsection.
(4) BENEFIT STANDARDS DEFINED- In this subtitle, the term `benefit standards' means standards respecting--
(A) the essential benefits package described in section 122, including categories of covered treatments, items and services within benefit classes, and cost-sharing; and
(B) the cost-sharing levels for enhanced plans and premium plans (as provided under section 203(c)) consistent with paragraph (5)."
"SEC. 142. DUTIES AND AUTHORITY OF COMMISSIONER.
(a) Duties- The Commissioner is responsible for carrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS- The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE- The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
(3) INDIVIDUAL AFFORDABILITY CREDITS- The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.
(4) ADDITIONAL FUNCTIONS- Such additional functions as may be specified in this division.
(b) Promoting Accountability-
(1) IN GENERAL- The Commissioner shall undertake activities in accordance with this subtitle to promote accountability of QHBP offering entities in meeting Federal health insurance requirements, regardless of whether such accountability is with respect to qualified health benefits plans offered through the Health Insurance Exchange or outside of such Exchange."
So Sally modified her recipe and made her lemon aide to match the lemon aide offered by Michelle. Some of her old customers stopped by. "A dollar!" Mr. Jones exclaimed. "Why did you raise the price?"
"Well, you see," Sally explained. "My costs have gone up. I'm not just paying for lemons and sugar for my lemon aide; I'm having to pay for Michelle's lemons and sugar, too."
Mr. Jones grumbled, pulled out a dollar, and took a sip of Sally's lemonade. "Hey! What's going on? This doesn't taste the same!"
"I had to change my recipe," Sally answered. "I had to make my lemon aide match Michelle's."
"Well, why should I pay more for the same stuff, when I can get it for free?" Mr. Johnson murmured. "I'm going over there."
As the weeks wore on, Sally watched sadly as all of her old customers went to Michelle's stand. Business at Michelle's stand was ten times what it had been at Sally's. The lines were long for the free lemon aide, and it took Michelle some time to service all of the customers. Some of her customers got discouraged and left, but most waited around for the free, but watery, lemon aide.
As the last customer left for the day, Michelle came to Sally. "I need some more money. Business has been great, and I'm out of lemons and sugar!"
Sally opened her piggy bank and three quarters tumbled out. "Is that all you got?" Michelle asked. "I need more than that! You're going to have to sell your bicycle!"
"I can't," Sally told Michelle. "I already sold it to get the money that you needed last week."
Even the Congressional Budget Office reports that the current proposals would cost $1 trillion and only reduce the number of the uninsured by $16 million.
"What am I supposed to do now?" Michelle asked.
"I don't know," Sally answered. "But I'm done; I'm taking my stuff and going home!"
Friday, July 10, 2009
Do As I Say...
Our wonderful President reluctantly has admitted that he has not been able to quit the smoking habit; we need to understand that it is a hard thing to overcome, and it is his personal business. I used to agree that it is his business -- that is until I heard that they are looking at imposing a smoking ban on the military.
I am not a fan of smoking; I have never smoked and I never intend to start. However, I find it amazing that the men and women who are tasked with fighting for/defending our country might be denied the CHOICE of whether or not to smoke, while our Commander-In-Chief is free to light up whenever he feels the need. During his campaign, Obama made it clear that he wanted his daughters to have the CHOICE to get an abortion in the event that either of them got pregnant. But I guess that CHOICE is only available for abortion, and only available for the elite. I suppose that Washington believes that the men and women who might be called upon to make the ultimate sacrifice don't have sense enough to CHOOSE what they want to do with their own bodies.
I am so happy that our First Lady has such a sense of fashion! I was tickled to death to see her in her $540 sneakers. So snappy! And imagine my glee when I saw her $5,950 clutch! It was inspiring! Of course, the White House denies that it cost that much; they stressed that it only cost $875. Yippee! That's only $850 more than I would be able to spend.
Of course, how much our First Lady spends on her accessories is not my business. Except for the fact that it is probably our tax dollars paying for all this stuff. And then there is that whole lecture that Obama has given us about our need to make sacrifices for health care for everyone, and our need to generally "share the wealth".
Timothy Geithner said, ""I think the adjustment to a period of excess is necessary. You never want to have a crisis to remind people of the importance of living within your means, not borrowing too much, or why regulation is important," said Geithner. "You never want to have a crisis this damaging to make that point. But we are going to emerge stronger from this. When we get through this, people are going to care less about what they make and more about what they do, what they achieve with what they make. And that will help make this country stronger." Wow!
Obama is a big believer in economic justice; yet he serves beef that costs $100 per serving at his White House parties. Is the Obama household going to be the model for rejecting "excess" that this country needs to follow? Wow!
Of course, OUR sacrifice has only begun. We have that whole global warming thing to combat. I see mass transit, small houses, and being very hot in the summer in our future. I have a friend who is a true-blue Democrat, and a big Al Gore fan. She thinks that making companies pay for carbon emissions and all of the economy crushing measures involved in "cap and trade" (HR 2454) are fine, since we have to save the planet.
Does she recycle? "I don't have time to mess with that, " she answered. I do; I am the queen of recycling on our street.
How about composting? "Oh, please! Isn't that a hassle?" she once asked me.
"No, not really," I answered. "I think it's kind of neat, all that turning 'trash' into soil-building treasure!"
How about planting trees (which actually remove CO2 from the air), or maybe doing a little gardening (I've learned a lot from my garden)? "Who has time for that?" my Al Gore-loving friend asked.
So, as an "evil", planet hating, CO2 monger, I spend my time actually trying to do things in my daily life to reduce my carbon footprint and help to save the polar bears.
I remember being shocked when I heard about Al Gore's $30,000-a-year electric bill and his private jet. Once again, I normally don't care what someone's utilities cost, or how they get from place to place. But, then again, most people aren't telling me that I need to change my lifestyle while they continue to live as they wish. I also don't own shares in the company that will be getting paid for carbon offsets; Al Gore does.
The theme that I see with this administration, and all of those who are connected with its players, policies, and goals, is: "Do as I say, not as I do."
Sorry. I can't hear what you are saying, for your actions are just too loud.
I am not a fan of smoking; I have never smoked and I never intend to start. However, I find it amazing that the men and women who are tasked with fighting for/defending our country might be denied the CHOICE of whether or not to smoke, while our Commander-In-Chief is free to light up whenever he feels the need. During his campaign, Obama made it clear that he wanted his daughters to have the CHOICE to get an abortion in the event that either of them got pregnant. But I guess that CHOICE is only available for abortion, and only available for the elite. I suppose that Washington believes that the men and women who might be called upon to make the ultimate sacrifice don't have sense enough to CHOOSE what they want to do with their own bodies.
I am so happy that our First Lady has such a sense of fashion! I was tickled to death to see her in her $540 sneakers. So snappy! And imagine my glee when I saw her $5,950 clutch! It was inspiring! Of course, the White House denies that it cost that much; they stressed that it only cost $875. Yippee! That's only $850 more than I would be able to spend.
Of course, how much our First Lady spends on her accessories is not my business. Except for the fact that it is probably our tax dollars paying for all this stuff. And then there is that whole lecture that Obama has given us about our need to make sacrifices for health care for everyone, and our need to generally "share the wealth".
Timothy Geithner said, ""I think the adjustment to a period of excess is necessary. You never want to have a crisis to remind people of the importance of living within your means, not borrowing too much, or why regulation is important," said Geithner. "You never want to have a crisis this damaging to make that point. But we are going to emerge stronger from this. When we get through this, people are going to care less about what they make and more about what they do, what they achieve with what they make. And that will help make this country stronger." Wow!
Obama is a big believer in economic justice; yet he serves beef that costs $100 per serving at his White House parties. Is the Obama household going to be the model for rejecting "excess" that this country needs to follow? Wow!
Of course, OUR sacrifice has only begun. We have that whole global warming thing to combat. I see mass transit, small houses, and being very hot in the summer in our future. I have a friend who is a true-blue Democrat, and a big Al Gore fan. She thinks that making companies pay for carbon emissions and all of the economy crushing measures involved in "cap and trade" (HR 2454) are fine, since we have to save the planet.
Does she recycle? "I don't have time to mess with that, " she answered. I do; I am the queen of recycling on our street.
How about composting? "Oh, please! Isn't that a hassle?" she once asked me.
"No, not really," I answered. "I think it's kind of neat, all that turning 'trash' into soil-building treasure!"
How about planting trees (which actually remove CO2 from the air), or maybe doing a little gardening (I've learned a lot from my garden)? "Who has time for that?" my Al Gore-loving friend asked.
So, as an "evil", planet hating, CO2 monger, I spend my time actually trying to do things in my daily life to reduce my carbon footprint and help to save the polar bears.
I remember being shocked when I heard about Al Gore's $30,000-a-year electric bill and his private jet. Once again, I normally don't care what someone's utilities cost, or how they get from place to place. But, then again, most people aren't telling me that I need to change my lifestyle while they continue to live as they wish. I also don't own shares in the company that will be getting paid for carbon offsets; Al Gore does.
The theme that I see with this administration, and all of those who are connected with its players, policies, and goals, is: "Do as I say, not as I do."
Sorry. I can't hear what you are saying, for your actions are just too loud.
Sunday, June 28, 2009
What Michael Jackson Taught Me
Since hearing about Michael Jackson's death this week, I've thought about him more than I would have expected. I liked most of his music, but I was not one of the screaming girls attending his concerts. However, I am old enough that I was around to see ALL of the Michael Jacksons: the cute little kid, the break-out soloist, the King of Pop, and the sad story that he later became.
The little kid was amazing; his talent was incredible and he and his brothers gave me many songs to which I could sing and dance while I was growing up. The break-out solo artist was great, too, and it had been fun to finally hear from him after so many years. But the King of Pop was at his pinnacle, and I've noticed something about that period of time. It came to me yesterday when I was watching a video marathon featuring his videos.
To me, there were two videos that he did that stood above the rest. "We Are the World" was more than just a video; it was a movement. I remember the starvation that was going on at the time. The efforts made by all involved with that video, but especially Michael, brought our country together in a way, and in an effort to help, that was incredible.
But my favorite Michael video of all time: "The Man in the Mirror". I can't watch this video without crying (ask my family!). At first I cry for all of the suffering that is shown in the beginning, and then I'm crying for the hope that is depicted in the end. Such a powerful couple of minutes! When I finally quit crying after watching that video, I just want to run out and kiss a baby, pat a dog, and donate money to some worthy help organization.
I don't think Michael understood the power that he had to inspire others toward change. If he had, maybe we would have seen more of those videos and efforts, and maybe the world could have been a better place by now.
Here's what I learned from Michael Jackson: We are at our best when we are thinking of ourselves least. As long as Michael seemed focused on worthy causes his career soared, he seemed to have direction, and he just seemed more together. It was when he became reclusive and focused on indulging his own fantasies that things began to slip. Of course, since I wasn't there, it could just be an illusion, but that's how it looked from here.
Now that he is gone, I grieve for the child who never had a childhood, I reject the man who turned inward, and I mourn the death of "The Man in the Mirror".
The little kid was amazing; his talent was incredible and he and his brothers gave me many songs to which I could sing and dance while I was growing up. The break-out solo artist was great, too, and it had been fun to finally hear from him after so many years. But the King of Pop was at his pinnacle, and I've noticed something about that period of time. It came to me yesterday when I was watching a video marathon featuring his videos.
To me, there were two videos that he did that stood above the rest. "We Are the World" was more than just a video; it was a movement. I remember the starvation that was going on at the time. The efforts made by all involved with that video, but especially Michael, brought our country together in a way, and in an effort to help, that was incredible.
But my favorite Michael video of all time: "The Man in the Mirror". I can't watch this video without crying (ask my family!). At first I cry for all of the suffering that is shown in the beginning, and then I'm crying for the hope that is depicted in the end. Such a powerful couple of minutes! When I finally quit crying after watching that video, I just want to run out and kiss a baby, pat a dog, and donate money to some worthy help organization.
I don't think Michael understood the power that he had to inspire others toward change. If he had, maybe we would have seen more of those videos and efforts, and maybe the world could have been a better place by now.
Here's what I learned from Michael Jackson: We are at our best when we are thinking of ourselves least. As long as Michael seemed focused on worthy causes his career soared, he seemed to have direction, and he just seemed more together. It was when he became reclusive and focused on indulging his own fantasies that things began to slip. Of course, since I wasn't there, it could just be an illusion, but that's how it looked from here.
Now that he is gone, I grieve for the child who never had a childhood, I reject the man who turned inward, and I mourn the death of "The Man in the Mirror".
Wednesday, November 5, 2008
Another President that Mexico Can Love
This may be my shortest entry yet, because it's just a fleeting thought. Details of Mr. Obama's economic plan are beginning to trickle out, and it seems that one of his ideas is to create a big government program to address our infrastructure. Hooray! New/repaired roadways, and I'm hoping new bridges, too! While that is a credible idea as far as our declining infrastructure is concerned, it is being touted as part of his ECONOMIC plan. The idea is that this program will not only fix some things that actually do need fixing, but it will create jobs! Lots of jobs! The American economy and the American worker will be rescued!
I just have one little question: Aren't road construction jobs (and manual labor jobs in general) in the category of jobs that we have been told that "most Americans won't do"? How is creating a bunch of jobs for which shady contractors will end up hiring a bunch of illegal aliens going to help the American worker?
I can't wait to see what else is coming!
I just have one little question: Aren't road construction jobs (and manual labor jobs in general) in the category of jobs that we have been told that "most Americans won't do"? How is creating a bunch of jobs for which shady contractors will end up hiring a bunch of illegal aliens going to help the American worker?
I can't wait to see what else is coming!
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