The Conservative Party Principles

The Conservative Party Principles

Thursday, May 6, 2010

The Top Governemnt Lies About the Health Care Bill! Part 2.

" If you like your doctor, like your health plan you can keep it"

The lie above was re-iterated by Shifty aka. POTUS in 57 Speeches and more than 150 remarks:

Here is the lie from Shifty himself from several of those speeches:

Now unless you are living on another planet or oxygen deprived like the liberal elitists that rammed this legislation down America's collective throats, the bill is going to raise the costs and raise the premiums:

The news every day is now showing the backlash from Americans rejecting Liberal Fascism and the Socialist programs they are in love with. Every day more politicians are "retiring" before facing the firing squad of this November's election's!
(And in my opinion as well as with many other conservative Americans, they are showing their true cowardice in their inability to face the people they screwed with this bill.)

Here are the facts that WILL change Individual and Group plans:

Timeline for Changes:
Get a free copy of the timeline here:


Under the new law, individuals and employers/employees have the right to keep the coverage they had as of March 23, 2010 and are exempt from many reforms. These individual and group health plans are considered “grandfathered plans.” Collectively bargained plans that were ratified before the date of enactment are grandfathered until the date that the last collective bargaining agreement related to coverage ends. This also applies to changes made by your employer to group coverage. make one change and you lose "grandfather status."

The Department of Health and Human Services (HHS) will establish a process for federal review of fully insured premium rate increases.

By July 1, an Internet portal will be created for consumers and small businesses to shop for health Insurance.

Starting July 1, 2010, imposes a 10 percent tax on tanning services.

$5 billion has been appropriated to create a temporary high-risk insurance pool to help adults with pre-existing conditions get coverage if they have been uninsured for six months. The program will be effective through 2013.

A temporary reinsurance program will be established for employers providing coverage to early retirees over age 55 who are not eligible for Medicare. The federal government will provide $5 billion to fund the program.

Plans may not impose lifetime limits on the dollar value of essential benefits. Annual limits will be restricted (to be determined by HHS). Restricted annual limits do not apply to grandfathered individual plans.

No rescission's are permitted, except in cases of fraud or intentional misrepresentation.

Children may stay on their parents’ policies until age 26 if coverage isn’t available through their work, regardless of their marital status. Any employer contribution toward the premium is a tax-deductible business expense for the employer and not taxable income for the member.

Plans may no longer impose pre-existing condition exclusions for children under 19(does not apply to grandfathered individual plans).
Effective for new plans and plans renewed six months after the law’s enactment date (does not include “grandfathered plans”):

New policies must cover the full cost of preventive care as recommended by the U.S. Preventive Services Task Force, recommended immunizations, preventive care for infants, children and adolescents, and additional preventive care for women.

New minimum requirements for internal and external claims appeals processes.

Plans that require or provide for a primary care provider (PCP) designation must allow each member to designate any in-network PCP, or pediatrician for children, accepting new patients.

Plans may no longer require an authorization or referral to an Ob-Gyn. Prior authorization or increased cost-sharing for emergency services is also prohibited.

Nondiscrimination rules that apply to self-funded health plans are expanded to group fully insured health plans. Plans cannot base an employee’s eligibility or continued eligibility on hourly or annual salary.

Beginning in 2010, small businesses with fewer than 25 employees and average wages of less than $50,000 get a tax credit for their contributions to buying health insurance for employees.
The tax credit starts at up to 35 percent and increases to 50 percent in 2014 when the exchange is operational. A full tax credit may be available to small businesses with fewer than 10 employees and average wages of less than $25,000


Beginning in 2011, employers will be required to disclose the value of health care benefits on an employee’s annual W-2.

Employers will be required to notify employees: About the availability of the exchange, for new employees, at the time of hiring; for current employees, by March 1, 2013;
They may be eligible for a subsidy under the exchange if the employer’s contribution to the plan is less than 60 percent of total allowed costs of the benefits;
If the employee purchases coverage in the exchange, he or she will lose the employer’s coverage contribution.

Beginning in 2011, the pharmaceutical industry will pay annual industry fees. The fee will be phased in and will hold steady at $2.8 billion a year after 2019.

An insurer must publicly report on its MLR and spend at least 85 percent of large group premiums and 80 percent of individual and small group premiums on medical services, or provide rebate payments to enrollees.

Health savings accounts (HSAs) and flexible spending accounts (FSAs) may no longer be used to purchase over-the-counter drugs unless prescribed by a doctor. Increases tax for non qualified HSA withdrawals from 10 percent to 20 percent, and for Archer MSA withdrawals from 15 percent to 20 percent.

HHS is required to study the group health plan markets to compare employer characteristics and determine whether the new insurance market reforms are likely to cause adverse selection in the large group market or to encourage small and midsized employers to self-insure. HHS and the Department of Labor must also collect information on self-funded plans. These studies could lead to additional employer reporting requirements.

Within 12 months of the law’s enactment, HHS, in consultation with the National Association of Insurance Commissioners, will develop uniform standards and definitions for summaries of benefits and coverage explanations. Within 24 months of enactment, group health plans must provide enrollees and applicants with coverage documents that meet these standards.


A new fee is imposed on individual and group health plans to fund comparative effectiveness research ($1 per participant through 2013; $2 per participant through 2019).

The private sector may purchase standardized data extracts of Medicare Parts A, B and D claims data to combine with their own claims data to evaluate provider performance measures on quality, efficiency, and the effectiveness of care.


Beginning in 2013, manufacturers of medical devices will pay a 2.3 percent excise tax on sales of medical devices.

Beginning in 2013, the Medicare payroll tax rate will increase by 0.9 percent for individuals who make more than $200,000 and couples that make more than $250,000.

A new 3.8 percent tax will be added on income from interest, dividends, annuities, royalties and rents for those at the same income threshold.

Contributions to flexible spending accounts are limited to $2,500 a year.


Beginning in 2014, a non-deductible premium tax will be imposed on insurers ($8 billion
in 2014, $11.3 billion in 2015 and 2016, $13.9 billion in 2017 and $14.3 billion in 2018.
After that, it will increase in an amount proportional to overall premium growth).

Everyone must have coverage or pay a penalty, which will be enforced by the Internal Revenue Service. The penalties will be phased in over time: an individual without insurance must pay whichever amount is greater: $95 or 1 percent of income.

Employers don’t have to offer their employees health insurance coverage, but most of them with more than 50 employees will pay an assessment if they don’t, or if they offer coverage that isn’t affordable. Full-time and part-time employees are included when determining whether an employer has 50 employees (based on current full-time employee equivalency rules).

Employers with 50 or more employees that do not offer “minimum essential coverage” will pay $2,000 for each employee over the first 30 employees if one of their employees gets a tax subsidy to buy insurance under an exchange. Everyone must be in the plan or the employer pays a penalty!

Employers with 50 or more employees that do offer minimum essential coverage but have
at least one full-time employee receiving subsidized coverage under an exchange, will pay whichever is less: $3,000 for each employee receiving a premium credit, or $2,000 for each full-time employee.
Again if 1 person opts out the employer is penalizedfor every employee.

Employers must provide “free choice” vouchers to employees with incomes below 400 percent of the federal poverty level if the employee’s contribution to coverage is between 8 percent and 9.8 percent of income and the employee chooses to purchase coverage in the exchange. No penalties will be imposed on employers with respect to employees who receive these vouchers. Employers with more than 200 employees that offer coverage must automatically enroll new full-time employees in coverage. Employees may opt out.

Large employers will be subject to expanded 5500 reporting requirements to include information on the health insurance coverage of their employees.

Individual and group health plans can no longer impose pre-existing condition exclusions for any person of any age (does not apply to grandfathered individual plans).

Annual limits on essential health benefits are prohibited (does not apply to grandfathered individual plans).

Health insurers must accept every individual and employer who applies for coverage.

Rating restrictions go into effect for new fully insured small group plans.
Insurance companies cannot base premiums on health status, claims experience
or gender. Premiums can only vary by:
– Age (no more than 3:1)
– Geography
– Family size
– Tobacco use (no more than 1.5:1)

States are allowed to merge the individual and small group markets.

Coverage of routine patient care costs is mandated for participation in approved clinical trials (does not apply to grandfathered plans).

State health insurance exchanges are up and running for small businesses and individuals to buy insurance. States can allow large employers to participate beginning in 2017.

HHS will establish procedures, which may include rate schedules for broker commissions, for a state to allow brokers to: Enroll individuals in any qualified health plans in the individual or small group market as soon as the plan is offered through an exchange in the state; assist individuals in applying for premium tax credits and cost-sharing assistance for plans sold through an exchange.

Essential benefit plan is created, which mandates the level of benefits that must be included in plans offered in the exchange, as well as in the individual and small group markets outside the exchange. Deductibles are limited to $2,000 for individuals and $4,000 for families in the small group market (self-funded plans and grandfathered plans are exempt from this requirement).

There will now be a Cafeteria plan system offering 4 plans: Bronze, Silver, Gold and Platinum with coverage for the co-insurance amount ranging from a 80-20 to 100-0 and limits for Maximum Out Of Pocket or MOOP to individual 0f $5,000 and family $10,000.
Currently the fewest amount of health plans I can offer anyone from any of the 8 companies I broker is 12 and the most 1100. If you currently have a plan you like through your employer and you leave, your coverage ends and you are now subject to the new rules.

If you own your own coverage it must conform to the new plan guidelines or it WILL BE CHANGED as mandated by the bill.

HSA's & FSA's contribution's are to be frozen and they are now examining and redefining what a "qualified expense" will be. Current contribution limits for HSA's are individual $3,000 & family $6150 and FSA is $2500 per person.

Waiting periods cannot exceed 90 days.

Expands health plan wellness incentives up to 30 percent of total coverage costs(up to 50 percent with HHS approval).

A temporary reinsurance program will be established for the individual market and funded by individual and group health plan assessments ($25 billion in 2014-2016).
(If you are not in the insurance or financial industry, a re-insurer is a company or entity that insures a primary insurance companies exposure to loss by owning the rights to that portfolio should it financially default). This is where the Single Payer System becomes FACT! Nowhere in the bill have they idetified that this will be a privatized program, it will be the Government!
I will not raise taxes on anyone making less than $250,000 per year!
Every tax on any product or service is passed on to the consumer, economics 101!

In Summary:

If you have individual coverage in force before the bill was signed and you NEVER make any changes to that coverage then you may be allowed to maintain that policy if the review boards and your insurance company DEEM it credible (and you can afford the premium hikes coming). The insurance reviews that will be permanently created to "study" insurance plans effectiveness have the authority to force a carrier to adapt plan coverage to meet its guidelines. This means that existing policies now such as High Deductible Health Plans for catastrophic coverage or Limited Benefit Plans, must be changed to meet new requirements of the bill!

If you have group health coverage in place before the bill was signed and the plan administrators or your employer NEVER makes any coverage changes to the plan, then it too may stay in force. But those plans are also subject to the same governement oversight as individual plans and both will be combined into the "exchanges" when they are approved and this will force many group plans to go into them to find cost effective coverage.

This was the case in Massachusetts when they enacted this legislation in 2006 and within 1 year only 4 insurance companies were still writing policies in that state.

Lets look at Massachusetts for a snapshot of how this legislation is working there:

Mark S. Gaunya, president of the Massachusetts Association of Health Underwriters, explains how Massachusetts’s system is in danger of collapsing because it did little to control costs.
“Initially, MassCare was expected to cost $88 million a year — but today the Massachusetts health care budget exceeds $4 billion, and our fiscal budget for 2011 is underfunded by $294 million because of this law,” Gaunya says. “Simply put, Massachusetts can’t afford it.”
The system’s weak individual mandate is also forcing insurance companies to take the sickest and most expensive residents while healthy people go without insurance until they absolutely need it, driving up costs for all the other residents who buy health insurance.
To see why Massachusetts’s system is self-destructing and what lessons we should all be learning, click here: click here for Mass. HC timeline:

The same legislative loopholes exist in this bill with one indisputable result: higher premiums for those people who need coverage and can afford the skyrocketing premiums or Medicaid style health care for those who cannot.

This plan even received a negative rating from Medicare's Chief Actuary Richard S. Foster on 04/22/2010, he stated that premiums could see annual rate increases of 12-17% or higher due to the bill. Also in their assessment they acknowledged that the resulting compensation cuts in Medicare and Medicaid would result in a 15% drop in providers and hospitals and that number was conservative.
Also what most people are not privy to is that most insurance companies use the Medicare Fee For Service Schedule as the base line for negotiating reimbursement rates with doctors and hospitals. With the drastic cuts necessary, the health care system will become two tiered, those that can afford private care and the other 90% of us using public care. Yes that is what this bill creates a public care system or one step closer to their real goal: Socialized Medicine!

So will you be allowed to keep your doctor or plan if you want to, that depends on if your doctor is willing or able to accept a 30% cut in pay and if your plan meets federal guidelines for coverage, you NEVER change it, you can afford to pay 100% more for it in 4 years or your employer is willing to provide health insurance instead of saving the money and just paying the penalties which would save them 150%!

Sure Why Not?

In Freedom to all Americans,

Dr. Keith C. Westbrook Phd.

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