Health Choices Commissioner: Absolute Power

Speaker Pelosi’s  Health Care Bill is a monument to duplicity and deceit.  It passed the House last week, and apparently will be introduced in the Senate soon.

One of many misleading features is the title of a new federal official, the “Health Choices Commissioner.” One might infer from the title that the Commissioner’s job will be to ensure that citizens have health choices.  One would be wrong.

If PelosiCare passes the Commissioner will oversee a five year process of eliminating virtually all choices now available to individuals and employers.  The Commissioner will have absolute power over what medical services Americans will be eligible to receive.  The Commissioner will have the power to dramatically increase or reduce the cost of health insurance for all individuals and families.

The Commissioner’s duties include:

Establishment and operation of the Health Benefits Exchange

The exchange will be owned and operated by government. Under PelosiCare no insurance policies will be available outside the exchange after five years.

Establish standards of qualified health benefits plans (QHBP).

Plans sold in the exchange must be QHBPs meeting these standards.  Eventually the only plans available will be those sold in the exchange.  Therefore the Commissioner’s standards will apply to every health plan.    “Standards” means the commissioner decides which medical services, treatments, and drugs will be provided and which will and will not be provided to insured patients.  He/she will also decide which services will be provided without any co-payment, which will require co-payments and how much the co-payments will be.

Administration of individual affordability credits including determination of eligibility for such credits.

The new law requires every person to buy health insurance.  It also provides for “credits,” or government subsidies to help some people pay for their insurance.  The Commissioner will decide who qualifies for credits and who doesn’t.  It’s impossible to know in advance, before the Commissioner’s decrees, how much his health plans will cost, but estimates based on various assumptions range from $10,000 to $25,000 per year.  Thus, the Commissioner will have the leverage to coerce millions of families into reordering their lives to qualify for the coveted credits.

Public Option

The commissioner will establish the premiums to be charged by the “public option,” the new government owned and operated insurance company, as well as (as described below) writing and enforcing regulations of all private sector competitors.


If the Commissioner finds that a health plan violates any federal requirements he has the sole power, without any legal or court process, to:

  • Levy fines
  • Suspend the enrollment of individuals in the plan
  • Suspend premium payments
  • Terminate a plan

Partial List of Additional Powers of the Commissioner

  • Develop Studies measuring whatever the Commissioner wishes to measure, by whatever criteria the Commissioner wishes to apply.  Interpret those studies for Congress. Recommend changes in the law based on the interpretation of studies.
  • Decide if any insurance company is “discriminating” in providing benefits, and then take action against that company.
  • Establish uniform marketing standards that all insurance companies must meet.
  • Establish time limits for insurance company grievance and appeals mechanisms.
  • Conduct audits of health plans to ensure compliance with Commissioner’s standards.
  • Determine what constitutes “excessive” premiums and forbid them.
  • As he/she sees fit, wave the provisions of Federal Acquisition Regulations.
  • Write and enforce special rules for Indian health care providers.
  • Define “coercive practices” by insurance companies.
  • Dictate insurance company billing and collection procedures.
  • Design a process (quoting the bill) “under which Exchange-eligible individuals are automatically enrolled” an a health benefits plan.
  • Enter into contracts with non-profit entities (such as ACORN) to provide health insurance information to small businesses.
  • Enter into contracts with “eligible entities,” (such as ACORN) that will employ “Community Health Workers” (no specific training or experience required) who will:

“…educate, guide and provide outreach in a community setting regarding problems prevalent in medically underserved communities, especially racial and ethnic minority populations…”

  • Develop rules and regulations for “Consumer Operated and Oriented Plans” (CO-OP).  Determine which community organizations are qualified to set up and operate CO-OP plans, (ACORN?) and provide government grants and loans to start up the CO-OPs.
  • Decide how to verify the citizenship or legal immigrant status of applicants for affordability credits.

4 Comments so far

  1. jacksmith on November 16th, 2009

    Urgent!! Robert Reich on your healthcare

    Why A Strong Public Option Is Essential – By jacksmith – Working Class

    Robert Reich explains the pubic option:

    Hollywood Supports The Public Option 🙂

    Beautiful HEATHER GRAHAM 🙂

    It’s not just because more than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 77% of all Americans want a strong government-run public option on day one (86% of democrats, 75% of independents, and 72% republicans). Basically everyone.

    It’s not just because according to a new AARP POLL: 86 percent of seniors want universal healthcare security for All, including 93% of Democrats, 87% of Independents, and 78% of Republicans. With 79% of seniors supporting creating a new strong Government-run public option plan, available immediately. Including 89% of Democrats, 80% of Independents, and 61% of Republicans, STUNNING!!

    It’s not just because it will lower cost. Because a strong public option will dramatically lower cost for everyone. And dramatically improved the quality of care everyone receives in America and around the World. Rich, middle class, and poor a like.

    It’s not just because it will save trillions of dollars and prevent the needless deaths of millions more of YOU, caused by a rush to profit by the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX!

    It’s not just because every expert in every field, including economist, and Nobel laureates all agree that free market based healthcare systems don’t work. Never have and never will. The US has the only truly free market based healthcare system in the World. And as you all know now, IT IS A DISASTER!

    It’s not just because providing or denying medically necessary care for profit motivations is wrong. Because it is WRONG! It’s professionally, ethically, and morally REPUGNANT!, Animalistic, VILE and EVIL.


    The public option is ESSENTIAL because over 200 million of you are trapped in the forest of the wolves. Which is the forest of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! With no way out except through needless inhumane suffering, and DEATH. While the wolves tear at your flesh, and rip you limb from lib. Then feast on your lifeless bodies like a dead carcase for transplant parts.

    At the most vulnerable times of your lives (when you were sick and hurting), millions of you have had to fight and loose cruel, but heroic battles. Fighting against the big guns of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! in the forest of the wolves. All because you have no place else to go. You have no other CHOICE!

    But the PUBLIC OPTION will give you someplace safe to go. And it will give us someplace safe to take you. The public option will be your refugium (your refuge). Where the wolves cannot get at you when your down, hurting, and vulnerable. Where everyone who needs it can find rest, security, comfort and the care they need. Protected by the BIG GUNS of We The People Of The United States. THE MOST POWERFUL PEOPLE AND COUNTRY ON EARTH.

    This is why it is so critical that we do not lead another 50 million vulnerable, uninsured Americans into the forest of the wolves, without the protections of a Strong Government-run MEDICARE like public option. We The People Of The United States MUST NOT LET THAT HAPPEN to any more of our fellow Americans. If healthcare reform does not contain a strong MEDICARE like public option on day one. YOU MUST! KILL IT. Or you will do far more harm than good. And millions more will die needlessly. Rich, middle class, and poor a like.

    To those who would continue to obstruct good and true healthcare reform for the American people, and who seek to trap millions more vulnerable Americans in the forest of the wolves. We will continue to fight you. We are prepared to wage all out war against you, and will eagerly DESTROY! you. Time…is…UP! YOU HAVE BEEN WARNED! No Co-op’s! No Triggers! NO INDIVIDUAL MANDATES! without a Strong MEDICARE like public option on day one.

    Healthcare reform can be the GREATEST! Accomplishment of our time and century. A time when future generations may say of us, that we were all, AMERICAS GREATEST GENERATIONS.


    I therefore call on all my fellow Americans and the peoples of the World. To join us in this fight so that we may finish becoming the better America that we aspire to be for everyone.


    I have been privileged to be witness as many of you fought, and struggled to take your first breath, and your last breath on this earth. Rich, middle class, and poor a like. Life is precious.

    Whatever the cost. WE! MUST SUCCEED.

    God Bless You My Fellow Human Beings

    jacksmith – Working Class

    ATTENTION!! Congress Has The Votes Needed To Pass A Public Option – TODAY

    Things You Can Do To Help NOW!

    A majority of voters would rather have a Democrats only bill with a Public Option. Than a bipartisan bill without a Public Option.

    A state based insurance plan is NOT!! a Public Option. Nor is it a Strong, National, Medicare like Public Option.

    No Triggers!


    Krugman on heathcare (

    Senator Bernie Sanders on healthcare (

    John Garamendi on the Public Option and the Grassroots:

    Howard Dean on the Public Option

    We’re Number 37! in quality of health care

    Twitter search (#welovethenhs #NHS #hc09 #hcr #healthcar #obama #p2 #topprog #) Check it out.

  2. thousand flowers blooming on November 18th, 2009

    this is a simple choice between having government protections or letting insurance companies continue their 25 year rip off the American people

  3. Sam Pete on November 18th, 2009

    Loony right wing crap. Obama is finally doing what should have been done 30 or 40 or 100 years ago. Making health care a right.

    Strong measures are needed to keep insurance company death panels from deciding who lives and who dies and who gets no treatment.

  4. Drew on November 20th, 2009

    I see jackass is joined by the simple minded analysis of thousand brain cells – maybe -……..and Sam Screed.

    Slammin’ Sammy, would you care to give us a coherent argument as to why health care is a “right?” In your “analysis” please consider other human needs such as food, shelter, clothing, cell phones….

    And thousand brain cells – tops -: could you be specific about the “rip off?” I mean facts and figures, reasoned logic and such. I’ll start: insurance company profits are among the lowest of all corporate ventures.

    Enlighten us.