Republican Health Plans - Patient's Choice Act

According to cnsnews.com, there are currently three Republican bills introduced that offer solutions to health insurance reform.  Two of the links on the site do not work, mostly due to the way Thomas.loc.gov works.  However, I have found the bills and will do a brief summary of what I've discovered about them in each of a series of three articles.

First up, is H.R. 2520 Patients’ Choice Act of 2009.  (click the title for a PDF of the text, all excerpts and quotes are taken from the linked PDF file as it is the sole subject of this Opinion piece.)

This bill Orders the Secretary of Health and Human Services to do a study and come up with a list of National Priorities on Health Promotion and Disease Prevention to address lifestyle behavior modification and prevention measures.  (Sec. 101, page 4)

It shall establish and implement a national science based media campaign on health promotion and disease prevention.  It sets aside $500 Million for the ad campaign.  (Sec. 101(b), page 8)

It gives state grants for Outcome-based prevention efforts and pulls $50 Million from the CDC budget for those grants.   (Sec. 102, page 12)

It sets up a science based nutrition pamphlet for those on food stamps and sets up to create a list of foods that can not be purchased by food stamps due to lack of nutritional value.  (Sec. 103, page 16)

It cuts funding for states that do not get 80% of the target population immunized and gives a bonus to states reaching 90% coverage - setting aside $50 Million from the CDC budget for this.  (Sec. 104(b), page 17)

It sets up State Health Exchanges that must allow any insurance company to participate and the state cannot negotiate or set premiums in any way.  It states the requirements on the companies that participate in the Exchange cannot be different than those imposed on the companies in the plan for Congress. (Title II, Sec. 201, page 18)

It sets up Automatic Enrollment into these state Exchange programs. "Such mechanisms shall include automatic enrollment through various venues, which may include emergency rooms, the submission of State tax forms, places of employment in the State, and State departments of motor vehicles."  It also sets up "Incentives" for individuals to remain covered.  It also has an "Opt-Out" clause and "protection from Exorbitant Premiums." (Sec. 202(c), page 21)

It allows Pre-Existing Conditions Exclusions.  It references the IRS Code Sec. 9801, which states:

"(a) Limitation on preexisting condition exclusion period; crediting for periods of previous coverage

Subject to subsection (d), a group health plan may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if— (1) such exclusion relates to a condition (whether physical or mental), regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date; (2) such exclusion extends for a period of not more than 12 months (or 18 months in the case of a late enrollee) after the enrollment date; and (3) the period of any such preexisting condition exclusion is reduced by the length of the aggregate of the periods of creditable coverage (if any) applicable to the participant or beneficiary as of the enrollment date."

(Sec. 202(c)(4), page 22)

States may "pool" their Exchanges if they adopt "model legislation." (Sec. 202(g)(2), page 25)

It sets up Grants for creating the Exchanges and rewards those states that get the grant by a 1% increase in Medicaid payments. (Sec. 203, page 25-26)

It sets up some Refundable and Advanceable Tax Credits for "Certain" health coverage.  $2,290 per adult, with limitations and cost of living adjustments to be made. Unless tax revenue did not increase enough to cover the adjustments or tax credit.  There are a lot of complicated exclusions and exceptions.  The sum is broken into 12 parts and you loose the credit amount for any month you are not covered by health insurance.(Subtitle III, Sec. 301, page 27)

Qualified Coverage can have "reasonable" annual and lifetime limits.(Sec. 301(f)(1)(a), page 33)

It seems to take away employer tax benefits for their contributions to their employee's health care coverage if the employee qualifies for a Health Tax Credit.  A bit confusing because it references other laws and changes them by adding and striking paragraphs.(Sec. 303(a)(1), page 46)

It states that there is no intent to encourage states to tax health benefits - but doesn't forbid it.  I'm trying to be impartial, but that seems to say, "we're not saying you should... but... you know... its an idea." (Sec. 303(i), page 49)

It improves Health Savings Accounts.  It increases the amount you can put in to $3,000 a month for individual and $5,950 for family.  It allows pre-paid physician fees to be paid from Health Saving Accounts.(Subtitle B, Sec. 311, page 49 and (f), page 58)

Provides for Acute care for the Disabled and certain low-income individuals. (Sec. 1901, page 63)

It allocates money the U.S. has just sitting around doing nothing to pay to states to cover expenses created by the bill making states provide for Long-Term care. Starting at around $65 Billion and going up to a little over $89 Billion in 2019. (Sec. 1913, page 81-82)

Sec. 503, page 145, Reduces Government handouts to wealthier seniors.

Medicare Premium Reductions for Healthy Lifestyle, as judged by the bill.  (Sec. 504, page 153-154)

Pre and Post treatment disclosures of price and charges. (Sec. 505, page 154-155)

Prevents medicaid/care from using the Social Security Number for Identification and requires bio-metric identification. Increases Fraud Protection (Sec.511, page 157)

Encourages, with grants, states to set up Health Courts and reduce Tort cases regarding malpractice. (Sec.  601, page 172)

Creates Health Record Banks and lists requirements, etc. Seeks to improve adoption of Health Technology. (Sec. 701, page 192)

Establishes a Health Care Services Commission. (Sec. 801, page 206)

Terminates the Agency for Healthcare Research and Quality. (Sec. 831, page 216)

Sets up a nationwide network of Independent Health Record Trusts. (Sec. 842, page 216)

Terminates the Federal Coordinating Council for Comparative Effectiveness Research. (Sec. 903, page 246)

That sums up the bill and what it does.