Health Insurance Reform | Context is Everything Beetlejuice

It doesn't seem that Beetlejuice is in any mood to be reasoned with by the likes of me.

But on the offhand chance you're still reading and thinking, I want to counter his challenge about what's on "page 16" of H.R. 3200, America’s Affordable Health Choices Act of 2009 as proposed.

In a comment, Beetlejuice wrote:

BTW-here's p. 16 which states if you don't re-up your private insurance-you have to take the govt plan.

10 (1) LIMITATION ON NEW ENROLLMENT.—
11 (A) IN GENERAL.—Except as provided in
12 this paragraph, the individual health insurance
13 issuer offering such coverage does not enroll
14 any individual in such coverage if the first ef-
15 fective date of coverage is on or after the first
16 day of Y1.

Indeed, those words are on page 16. If you note the line numbers to the far left you see immediately that what's missing is lines one through nine and 17 through the end of the page (and what comes before and after page 16 for that matter).

The lines he quotes are a subsection beneath the header:

1 SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT
2 COVERAGE.

Line three sets the agenda for the next several lines:

3 (a) GRANDFATHERED HEALTH INSURANCE COV
4 ERAGE DEFINED

You can go there yourself. What you'll find as you read the offending lines in their context is that the section is explaining the term “Grandfathered Health Insurance Coverage” which means, "individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:" (and that gets us through line nine of page 16).

In general the passage explains that existing coverage is grandfathered into the new system (hence “Protecting the Choice To Keep Current Coverage”) if the coverage is in place before the new system begins. Otherwise it is new coverage, not grandfathered coverage.

New customers can’t be enrolled in grandfathered coverage—because, by definition that would be new coverage, not grandfathered coverage. The exception to this is dependents who may be added to grandfathered coverage

The section goes on to protect those enrolled in grandfathered coverage from reductions in benefits, increases in cost-sharing and what amounts to noncompetitive raises in the rate of premium increases. Strictly speaking, I suppose the passage prohibits increasing benefits and reducing cost-sharing in grandfathered coverage...but I don’t see any clear and present danger of insurers fighting Congress for the right to offer more benefits for less money.

It goes on to say that if your grandfathered coverage does not meet minimum standards for benefits, limits on cost-sharing and no annual or lifetime limits on coverage, with certain exceptions, the plan will have a five year grace period to raise the quality of coverage to meet or exceed that standard of consumer protection or be declared a non-qualifying benefit plan.

The notion that Congress seeks to pass a law protecting citizens from abuse by corporations with a demonstrated willingness to take advantage of their customers in any way the law does not explicitly forbid isn't even a little bit threatening.

I strongly recommend we take the the lines that so frighten Beetlejuice in context, the way they were drafted; the way they were meant. Otherwise we are stuck believing there is a conspiracy afoot at the end of which is Beetlejuice's conception of Ayn Rand's worst nightmare.


photo by shadarington