Posted on 03/08/2017 11:38:31 AM PST by nickcarraway
The plan to repeal and replace Obamacare unveiled by House Republican leaders on Monday orders insurance companies to charge people 30 percent more in premiums for a full year if they did not have insurance for 63 days or more in the previous year.
The sections of the Republican bill that create this mandate on insurance companies are titled: “Continuous Health Insurance Coverage Incentive,” and “Encouraging Continuous Health Insurance Coverage.”
The first subsection of the “Encouraging Continuous Health Insurance Coverage” section is entitled: “Penalty Applied.”
This subsection says insurance companies “shall” impose the penalty.
“[A] health insurance issuer offering health insurance coverage in the individual or small group market shall, in the case of an individual who is an applicable policyholder of such coverage…increase the monthly premium rate otherwise applicable to such individual for such coverage during each month of such period, by an amount determined under paragraph (2),” says the bill.
Paragraph 2 goes on to explain that the “increase” in premiums the government will require is 30 percent over the normal premium for the plan.
“The amount determined under this paragraph for an applicable policyholder…is the amount that is equal to 30 percent of the monthly premium rate otherwise applicable to such applicable policyholder for such coverage during such month,” the Republican bill says.
The proposed legislation goes on to say that the burden of proof will be with the individual American seeking to buy health insurance. If they cannot document that they did not have a 63-day lapse in insurance during the previous year, they must pay the 30-percent penalty.
The person who must pay the penalty, the bill says, is “an individual who…cannot demonstrate (through presentation of certifications described in section 2704(e) or in such manner as may be specified in regulations, such as a return, or a statement made under section 6055(d) or 36C of the Internal Revenue Code of 1986), during the look-back period that with respect to such enrollment period, there was not a period of at least 63 continuous days during which the individual did not have creditable coverage.”
The penalty also will be assessed against young people who age out of their parents’ plans and do not sign up for their own insurance in the next open enrollment period.
It will apply, the Republican bill says, “in the case of an individual who had been enrolled under dependent coverage…and such dependent coverage of such individual ceased because of the age of such individual, is not enrolling during the first open enrollment period following the date on which such coverage ceased.”
The summary of the proposal published by the House Energy and Commerce Committee also points to this 30-percent increase in insurance premiums that the government will order insurance companies to impose on people who failed to buy insurance for 63 days.
“Beginning in open enrollment for benefit year 2019, there will be a 12-month lookback period to determine if the applicant went longer than 63 days without continuous health insurance coverage,” says the summary.
“If the applicant had a lapse in coverage for greater than 63 days, issuers will assess a flat 30 percent late-enrollment surcharge on top of their base premium based on their decision to forgo coverage,” says the summary. “This late-enrollment surcharge would be the same for all market entrants, regardless of health status, and discontinued after 12 months, incentivizing enrollees to remain covered.”
At the same time, the House Ways and Means Committee’s summary of the amendments that Republican leaders are proposing to the Obamacare law points out that one of those amendment would reduce the Obamacare penalty for not signing up for insurance to “zero.”
“Under current law, most individuals are required to purchase health insurance or pay a penalty,” says the Ways and Means summary. “This section would reduce the penalty to zero for failure to maintain minimum essential coverage; effectively repealing the individual mandate.”
In sum, the Republican plan to repeal and replace Obamacare would eliminate from existing law the penalty for not signing up for insurance and add to existing law a one-year 30 percent premium hike for anyone who fails to buy insurance for 63 days or more.
“Car insurance companies use to do this. Not sure IF they still do or not. This was in Texas . . .”
Around here if your car insurance lapses, the State MVA (Maryland) orders you to produce proof of insurance or turn in your tags immediately.
Exactly! Maybe we should repeal and replace Paul Ryan if this garbage is the best he can come up with.
I hope the President and/or his people are reading here on what is thought of this POS.
CGato
Me personally I’m not going to get my panties in a bunch about it. Keep in mind government covered half of the nation’s health care costs (1/6 of the nation’s economy) before Obamacare was introduced, and I’m sure the number is not that much different now. It’s not something that is just going to be acabacadabra disappeared away. Especially given the filibuster.
You miss the point entirely.
The way he was selected was unprecedented. He was installed by Boehner. He continues Boehner’s role of fulfilling Democrat agendas.
Federal control of healthcare is ILLEGAL!
Federal forcing an individual to buy something is ILLEGAL!
Forcing an individual to buy a car is ILLEGAL!
Forcing an individual to buy an iPhone is ILLEGAL!
Forcing an individual to buy a house is ILLEGAL!
Forcing an individual to buy healthcare is ILLEGAL!
I understand where you are coming from. It's our massive debt and unfunded liabilities that say all of this is unsustainable for the future and really unfair to future generations of America that is not even born yet.
Maybe we have a chance to fix it now but it could very well be a long shot. President Trump was quite a long shot too so who knows, we have to remain to have faith if we are to get things done.
CGato
You have a major point. :)
Thank you. It took fourteen comments before someone (you) pointed out the obvious.
The same people screaming in here would turn purple in the face if the law said you could wait until you got sick before buying insurance.
Not a good place to find out what’s actually in the law and to discuss how it will impact people, etc. And very disappointing in that regard.
Yes, although I’d argue that if you don’t sign up on time, then an insurance company should be able to require a physical and have the right to issue a rider denying coverage for any health issues found, or charge whatever their actuary determined was necessary to cover a particular pre-existing issue.
Every insurance company I've dealt with in the past 30 years has done this. It's to prevent people from buying a policy for a few months and then dropping it once the condition has been treated....and leaving the insurance company holding the bag for $100k paid out for your care.
>>I think there needs to be exceptions for unemployment. <<
I think that’s a good role for the states’ Medicaid programs. Let unemployed people apply to Medicaid for money to keep their premiums up. If Medicaid’s main goal becomes to get everyone insured, rather than paying all their healthcare costs, that will help on the healthcare cost front.
The bill doesn't remove the individual mandate. It revises the penalty to $0. This change is on page 83/84. It amends the Internal Revenue code 5000A and leaves the requirement for insurance in place.
It’s a flaw (covering pre-existing conditions) if it’s an open-ended feature, yes. But if it’s a one-time exception to get everyone going in a different direction, it’s not. It just allows an orderly transition.
If you look at it in a big picture way, where everyone ended up covered in the end, you’d have the insurance priced where it should be, high enough to pay all ongoing claims and leave a competitive profit margin for the insurance company.
That level, after all, is what would be reached after a decade or so if you started with only the healthy applicants. Eventually, many would develop health issues and the premiums for the entire group would rise to balance things out.
Insurance is not understood by most people. They sign up for it at work and really don’t use it that much. Most have never read their policy and find out what’s in it when someone gets sick. That’s why this whole Obamacare thing is so hard for the people who have never had insurance. They really don’t understand that whole $6,000 deductible on their bronze plan.
>>An insurance company that covers your medical expenses has a vested interest in seeing you die — quickly.<<
Just a thought. Maybe one should get life insurance from the same insurance company then?
IMO it should be 93 days. I had to wait three months for my insurance to kick in the last time I changed jobs.
Actually, that’s exactly how insurance is supposed to work. Only one house in a thousand might burn down, but our premiums are priced so that they’re high enough in aggregate to cover the cost of that house.
However, since healthcare bills can become so outrageous (in the millions in some cases), it would make sense to put a more realistic cap on total policy outlays per condition and just deny payment above that range, much like Medicare currently does. In those cases where care gets unusually expensive, don’t make the patient pay, but rather let the chips fall where they may.
Some doctors will provide care for free. Some patients will get crowd-funding or private charity. And some just won’t get a million dollars worth of treatment. Hopefully, under a free-market approach, the cost of healthcare will start to become more reasonable.
Why? It would mean the taxpayers would then be responsible to pay for your care while you're out of work? We need government OUT of the healthcare business ...not mandating the rest of us pay for those who don't or can't.
If you look hard enough....there are church groups, charities and even medical organizations who help those who truly need care. In Texas, there are Crisis centers and food banks in every county to connect you up when you have a catastrophe. Most Doctors will give you a discount rate if you pay out of pocket, which is much cheaper than paying a premium. (I did it for 3 years)
Not directing anything at you....but when did healthcare become a mandated constitutional right?
In a way....yes it does. When the insurance company is left holding the bag for hundreds of thousands of dollars for someone high risk.....they have no choice but to spread the cost (a hike in premiums) for the rest of us.....so they can stay in business.
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