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.
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.