Does ANYONE fully understand the new Health Care Bill?

[PhylisFeinerJohnson]

Where does Medicaid and SSI come in? I've spent 6 hours reading and researching and I've figured out the timeline and basics. I know the objective is to have every American insured by 2014. (You don't have to do the math, that's FOUR years away.)

According to analysis of the bill, Medicaid would be turned into a "true" program for the poor, rather than just covering about half the poor, mostly because of the way the eligibility rules differ from state to state.

The good news is: Everybody who is above Medicaid eligibility level becomes able to buy insurance through exchanges. Every state is authorized to set up an exchange. The states will get money from the federal government to set them up. But states are not obliged to do it. And they can defer to the federal government, which will also set up a multistate exchange. (Which threatens to be a mess.)

Subsidies will be available to people on a sliding scale. For example, those with the lowest incomes will only have to pay 2% of their income for a premium. The rest will be picked up by the subsidy.

But what if you have no income? What if you depend upon SSI? What happens then? And how to you find out? (Trust me, I Googled for hours.)

For the new Health Care Bill timeline, you can go to: http://www.cnn.com/2010/POLITICS/03/...ine/index.html

For other details, you can go to: http://www.pbs.org/newshour/indepth_.../healthreform/
http://www.pbs.org/newshour/bb/healt...th2_03-23.html
http://www.cbsnews.com/8301-503544_1...46-503544.html

They're all very helpful, but I don't think the details have addressed the truly poor and needy. Or if they plan to, I guess it needs to be ironed out. I sure hope something more definite is in the works.

Any revelations?

[Nakamova]

Nope, no-one understands the new Health Care bill!

At this point, since any reforms will take a while to be implemented, and since they will vary from state to state, your best bet is to stay in contact with your Representatives and Senators -- once the legislation has been digested for a bit, and the states figure out what their obligations are, the practical details will start to become available. Some states are considering joining with others to create regional exchanges, so that will also take time.

In addition, there are lawsuits challenging the Health Care Bill, and repeal efforts under way, so those may also change the picture.

[Bernard]

I want to caution that CWE is not the place to discuss politics (ie. whether you like the bill, hate the bill, D, R, etc.).

Discussing specifics of the bill and how it might affect your health care situation are fine.

[Rae1889]

Yeah,
I'm not american, but I tried to follow along, and can't figure that out either.
So I agree with Nakamova. When ever anything happens like that here, we get in contact with our reps, or call our city information line *311*

[Loopy Lou]

Being from the UK, i don't understand it at all, but when i asked, people got very defensive and quite angry about it.

Looks like it's a very controversial subject.

[PhylisFeinerJohnson]

I'd say it's real HOT. Like a "hot potato!" :-)

[Endless]

One aspect of the bill I'm curious about is when we'll be able to:

1) buy individual insurance through the national pool.
2) as adults, not be prevented from getting insurance because of pre-existing conditions

With epilepsy, getting new individual health insurance is practically impossible.

I think the pre-existing condition stuff starts for kids next year, adults in 2014. But the high-risk insurance pool where we could get insurance starts in next year. A good thing for us. Wahooo!

[RobinN]

I think the pre-existing condition stuff starts for kids next year, adults in 2014. But the high-risk insurance pool where we could get insurance starts in next year. A good thing for us. Wahooo!

There seems to be a problem with the pre-exisiting clause for minors. As of right now it is not clear.

http://www.google.com/hostednews/ap/...7rN-AD9EKTKIG0

[Endless]

Well, darn. It's disappointing that the provision for insuring kids turns out to be full of holes. At least many state governments have insurance plans available for low income or uninsurable kids. I guess that's the stopgap for now, in addition to the high-risk pool.

[Chatter-box]

The day this bill was being voted on I put up a post on this bill, meaning it as a poll: "Are you for it or against it"? The idea was that this bill...law, now...has it's good points and it's bad ones. For example, how would you deal with being pushed to generic drugs when they are not effective but do save money? You may have some creative ideas. That was all that was meant. But look back at the log of topics. That thread was locked as insiteful and polorizing. But here we are with an adult, rational discussion on this same topic. I wonder why this is not also locked as insiteful and polorizing. Nakamova, any ideas?

[Endless]

Is there anything in the bill specifically addressing generics? I didn't see anything like that listed.

I am lucky enough to have health insurance right now. The insurance company pretty much holds me economic hostage to using generics, if generics are available. I can't afford to stray from their formulary and get the name brand stuff. I don't know how the health care bill will affect this, for the better or not. It can't get any worse for me, other than not covering meds at all, which isn't a possibility. I don't know how it will affect everyone else and their insurance plans.

The best thing I can do right now is get my generic from the same neighborhood pharmacy I always use. They know me, and they inform me when they are going to switch suppliers for any type of generic med, which doesn't happen very often. It's at least a chance at consistency.

There was another thread in here about generics vs. name brand. Hmmm... now where is it?

[RobinN]

There is a difference between talking about the specifics of the bill and "Are you for or against it".

[Endless]

Well, I read a surprise today.

My diagnosis of epilepsy had kind of shook my healthcare security. I found out that besides health insurance, I can't get long term care insurance either. I'm not rich. I'm not poor, either. So I fall into that dreaded middle category where medicaid doesn't pay for long term care, and I wouldn't have the money for it, either.

This amendment to the health care bill came as a complete surprise to me.
The Patient Protection and Affordable Care Act (H.R.3590) provides for voluntary national long term care insurance, they say at a much lower cost than private insurance. It pays for in-home or nursing home care, including non-medical care. It takes effect in 2011.

I don't have long term care insuance and want it. But I waited to long. An E diagnosis means I can't get private LT care insurance now. Hearing about HR 3590 is a relief to me.

I don't know what the rates will be. The program pays for itself, so it will be at-cost, whatever that turns out to be. I guess private insurance rates minus insuance company profits, however much that is. You have to have paid into the system for at least 5 years to qualify.

More information here: http://www.kff.org/healthreform/upload/7996.pdf


Here's also a link to a very good summary of the health care bill and a timeline for implementation: http://www.kff.org/healthreform/8060.cfm

[Nakamova]

A clarification regarding this thread and others:

A recent thread about health care reform was locked (as was a previous one from last year) because it asked "pro or con." Debating "for or against" in last year's thread brought out passionate opinions on both sides and became quite heated in a way that detracted from CWE's congenial atmosphere.

Now that the bill has been enacted, this discussion is (ideally) about how its specifics may affect our individual health care situations. If this thread starts to run amok, then it too may become locked -- not in the name of censorship or relevance, but to keep CWE's dinner party a friendly one.

[PhylisFeinerJohnson]

Endless, I couldn't find the Generic vs. Name Brand drugs thread here either, but you can find it by clicking: http://epilepsytalk.com/?s=generic+v...me+brand+drugs

[BuckeyeFan]

This amendment to the health care bill came as a complete surprise to me.
The Patient Protection and Affordable Care Act (H.R.3590) provides for voluntary national long term care insurance, they say at a much lower cost than private insurance. It pays for in-home or nursing home care, including non-medical care. It takes effect in 2011.

I don't have long term care insuance and want it. But I waited to long. An E diagnosis means I can't get private LT care insurance now. Hearing about HR 3590 is a relief to me.

I don't know what the rates will be. The program pays for itself, so it will be at-cost, whatever that turns out to be. I guess private insurance rates minus insuance company profits, however much that is. You have to have paid into the system for at least 5 years to qualify.

NOTE: Not intended for debating - just clarification.

This is actually one of the most under reported parts of the bill and is known in the senate bill as CLASS. Yes it is a long term insurance plan into which you pay premiums, in theory building an account for future use. CBO projections show this bringing in premiums for 10-15 years before any payments out.

Where that became controversial is the premiums in will be used to pay for the other parts of the program, thus not actually setting money aside for future LT care.

Hopefully, they get this portion figured out before people start buying the LT insurance.

[PhylisFeinerJohnson]

Whatever the provisions, it's certainly better than dishing out hundreds of dollars per month for Long Term Care. It's a major seller among the insurance companies, so I bet they're not too pleased...unless they've be appeased somehow.

[Bernard]

Endless, I couldn't find the Generic vs. Name Brand drugs thread here either ...

http://www.coping-with-epilepsy.com/...s/generic.html

[PhylisFeinerJohnson]

Thanks "Super Sleuth!"

[picklenose]

It's almost 3,000 pages. I doubt there are many lawyers who fully understand it. How we're supposed to sort it all out and figure out how it relates to us is beyond me.