As critics have repeatedly point out, once Congress starts specifying minimum mandated coverage requirements for health insurance there will be no end to the lobbying to maximize the “minimum” that you will have to pay for in your health plan.
Well, it turns out Congress is already behaving exactly as predicted — and they haven’t even passed a bill yet!
The earlier House “Tri-Committee Bill” (H.R. 3200) lists in Section 122(b) the “Minimum Services to be Covered.” The new “Pelosi Bill” (H.R. 3962) includes the same language, only this time it appears as Section 222(b), and — ta-da! — it includes more required benefits!
Whereas the earlier bill had ten enumerated subsections — hospitalization, physician services, prescription drugs, etc. — the new bill adds an eleventh subsection requiring coverage for, “durable medical equipment, prosthetics, orthotics and related supplies.”
Also, subsection seven, which originally required coverage for “mental health and substance use disorder services,” has been expanded by adding the clause, “including behavior health treatments.”
As previously noted, these are just the “top-level” required benefits. It will be left to HHS to define in detail — in thousands of pages of regulation — the type, scope, frequency, and duration of the specific services that must be covered, along with the rules for which providers must be paid for providing which services, and the criteria under which specific patients qualify for different, specific services.
Of course, insurance companies and the HR departments of any employers still providing worker health benefits will be required to comply with all of these, constantly evolving and expanding, “minimum” benefit requirements.
Also, predictable is that anyone dissatisfied with some future ruling by the new health care czar or the HHS Secretary on some aspect of the detailed minimum benefit rules will go lobby Congress to get their own preference written into law.
It seems that in the new Pelosi-Reid health system, your most important contact won’t be your personal physician. It will be your personal lobbyist.
You do have a personal lobbyist, don’t you?
In the desperate attempt to portray their massive new spending bill as “budget neutral,” Congress and the Obama Administration are relying on more desperate measures to hide the true cost of the legislation. The Senate Finance Committee bill includes Section 1209, aka the “Fail-Safe Mechanism to Prevent Increase in Federal Budget Deficit.” But it is more than just a budget gimmick, it is an unprecedented change in the balance of power from Congress to the President that ought to unite liberals and conservatives in opposition to it. This is either a dangerous or cynical game.
Under Section 1209, if the President certifies that the changes under this legislation cause an increase in the federal deficit, “… the President shall instruct the Secretary of Health and Human Services and the Secretary of the Treasury to reduce such credits and subsidies …” that are provided under the legislation.
In other words, the level of federal assistance that is being promised may not actually be delivered. Reducing the subsidies would fall disproportionately on the lowest income levels. Having trapped millions of Americans into buying a product they cannot afford, Congress now gives the President the full unchecked authority to reduce those subsidies (which are worth up to $16,500 a year for a family of four).
This provision abdicates Congress’ responsibility to provide alternative means of lowering costs. This is just another massive relinquishment of power by Congress to the Obama Czar State. Consider if such power were given to the President in other government assistance programs? Imagine the protests from senior groups if such power were in the hands of the Commissioner of the Social Security Administration and the Administrator of the Centers for Medicare and Medicaid Services ? The unfunded liabilities of Social Security and Medicare would be resolved, of course, but it would come directly out of the hides of beneficiaries.
No doubt the Administration and congressional leaders will try to convince themselves and everyone else, this provision does not really mean what it says it means, it is there only to fool those good but pesky analysts at the Congressional Budget Office. But at what point will the Obama Administration and congressional negotiators ask themselves, are we so desperate on this one issue, we are willing to put everything else at risk?