Senate Health Insurance Reform Bill

I had read the Senate health insurance reform bill a while ago, but, after having also read the house bill, could not remember what was in each bill. Reading it again seems like the prudent thing to do. I will be posting here, what I learn from the bill, both as a way to let others know just what is in the bill and as a way for me to keep track of it all.

First the government details out what must be covered (pages 104-126) and who pays what part of the individuals out-of-pocket expenses (pages 20-21). Both the state and federal governments are required to go through our tax returns & exchange information to see if any of us qualify for any state or federal program (medicare, medicaid, CHIP, etc), they are required to enroll you in that program (or report your name & SSN to the federal government, so thy can enroll you in their program). I don't know how anyone could possibly say this is not a government take over our health care system.

From pages 29-30 of the bill:

‘‘(a) IN GENERAL.—The plan sponsor of a group health plan (other than a self-insured plan) may not establish rules relating to the health insurance coverage eligibility (including continued eligibility) of any full-time employee under the terms of the plan that are based on the total hourly or annual salary of the employee or otherwise establish eligibility rules that have the effect of discriminating in favor of higher wage employees.

(b) LIMITATION.—Subsection (a) shall not be construed to prohibit a plan sponsor from establishing contribution requirements for enrollment in the plan or coverage that provide for the payment by employees with lower hourly or annual compensation of a lower dollar or percentage contribution than the payment required of similarly situated employees with a higher hourly or annual compensation."

So, employers CAN discriminate against employees in favor of lower wage employees. In fact, as you'll see below, they are encouraged to discriminate against higher paid employees.

Through 2013 insurance companies will be required to report how much they take in in premiums and how much they pay out in benefits. Anything over the government's standards must be paid back to the participants (pages 34-35). I think a lot of people would not have a problem with this - you know those evil insurance companies have been stealing all our money from us. Well, we could debate on that all day, but for right now I'll just say....if the government can do this to insurance companies, why can't they do it to food service companies, construction companies, computer programmers, etc? Where does their power end? I'm not sure why this stops in 2013.

The government will set the standards on how insurance companies do their paperwork and electronic standards for paying service providers (pages 61-79). This will be very expensive for small insurance companies and must be completed by April 1, 2014.

Insurance companies must charge the same premiums to everyone unless you're a tobacco user and based on age, but only by the amount the government allows and age brackets they set (page 81-83). Meaning that everyone's premiums will have to go up in order for the insurance company to stay in business.

Insurance companies cannot turn down anyone for coverage and cannot stop coverage for any reason (page 85-87). Again, many would say this is great, but if a company MUST take on new clients even if they cannot provide them with services, they cannot stay in business.

Employer's are required to have wellness programs for their employees and must report to the government if they provide rewards in the program (page 87-93). It is not an employer's responsibility to make sure you take care of yourself - and this is just another "tax" on employer's that will stifle the job market. If I were an employer, I would do everything possible to not have to report things to the government for a number of reasons (resources it takes to file such paperwork, hassle of being audited, having to adhere to the government's ever changing and confusing regulations, etc). Thus, I would not want to give rewards for the program. If there are no rewards for participating in the program, why would employee's participate? Some would, but most wouldn't. If they wanted to take care of their health, wouldn't they be doing that already? So, if few are participating in the program, what's the benefit?

The government will also set up a wellness program that will be run by the Treasury & Labor Dept Secretaries (page 93). What does the Labor Dept have to do with our health?

The States must set up Insurance Exchanges for purchasing insurance policies, which will be paid for with our federal & state tax dollars (page 130-144). I don't understand why we need to spend money setting up/maintaining exchanges? We don't need exchanges in shopping for auto insurance - that's what the internet is for.

Insurance companies can only do business with health care providers that "utilize a patient safety evaluation system, implement a discharge program for discharge and implement such mechanisms as the Secretary may by regulation require" (page 150). Yep, more government involvement in our health care and those regulations are yet to be determined.

The government will give grants to organizations (including unions, specifically) that inform people about what health plans are available, tax credits, etc (page 152). Can you say, asking for corruption and abuse?

The government will provide loans & grants to States to set up a "community health insurance option", more commonly known as a public option (pages 169-183) and MUST have this public option plan available in the exchange unless the State passes a law prohibiting them. If anyone is in this plan and receives a federal tax credit or cost sharing reduction and the State has a stricter benefits mandate than the federal standards of coverage, the State is required to defray the cost of those benefits. This goes back to the original argument against the "public option". It will put insurance companies out of business and we will all HAVE to go on the public option plan.

There will be a new social program for providing health coverage to those are considered low income, but not low enough to enroll in the current government health coverage program (pages 201-219). Because our current social programs are working so well.

States can decide to let insurance companies from other states into their exchanges - if they make an agreement with that state to do so AND the federal government approves of it (page 221). Again, why do we need more government bureaucracy to purchase insurance across state lines? Oh, and they CANNOT be in effect until 2016.

Tax Credits and Cost-Sharing Reductions will be available for those who's income is 100% to 400% of the poverty line and their income is based on their adjusted gross income (pages 244-262). Here is the poverty guidelines for 2009 (I could not find any for 2010). As you can see, a single individual making over $43,000 a year will be eligible for Federal aid.

The 2009 Poverty Guidelines for the
48 Contiguous States and the District of Columbia

Persons in family	Poverty guideline
1	$10,830
2	14,570
3	18,310
4	22,050
5	25,790
6	29,530
7	33,270
8	37,010
For families with more than 8 persons, add $3,740 for each additional person.

Indians that are at or below 300% of the poverty line will have 100% of their cost-sharing expenses paid for by the US taxpayers (page 263).

Large employers (those with more than 50 full time employees) that have waiting periods exceeding 30 days, but less than 60 days, will pay a fine of $400 for each full time employee to whom the extended waiting period applies. For waiting periods exceeding 60 days, the fine is $600 (pages 345-346).

Large employers that offer an employer sponsored plan and have at least one full time employee that is allowed or receives a premium tax credit or cost sharing reduction will pay a fine of $250.00 per full time employee (not per employee that is allowed or receives a tax credit/cost sharing reduction, EVERY employee - minimum of $12,500) per month (pages 346-353). This amount will increase every year starting in 2015 (adding inflation, I believe). It looks like the point here is to raise wages, which we all know hurts business and only promotes moving jobs & product production over seas. So, the government is using private business to redistribute the wealth. In many situations, it will be more logical to raise someone's wages, rather than pay the government's tax. Raise the wages of someone that hasn't been with company as long as you, someone that doesn't do their job as well as you do, but they have more children than you do, so they have the right to make more than you. Because, as detailed above, tax credits & cost sharing reductions are based on your gross adjusted income - NOT your net income.

In year 2017, the states will be required to pay at least 30.3%* (see note below) of Medicaid for newly eligible individuals. At least 31.3% in 2018. And in January 2019 there will be an increase of 32.3% with a 1% increase every quarter there-after (pages 395-398). But don't worry - it can never go above 95%. They have to make sure they have SOME control over the states.
*NOTE: States that do not pay for health coverage of those at or below the poverty line will be required to pay 34.3% in 2017 and 33.3% in 2018. The 1% & 32.3% increases still apply.

I'm only on page 422, so there is lots more to go through. Will post more as I get through it.

Today's Views

Today I want to just get some things out there that have really been bothering me about the things that are currently going on in our country.

First, I would like to address Scott Brown's win in MA. I have to admit, I cried a little the night he was elected. Not because I was so excited that Brown, the man, won, but because Brown, the movement, won. The majority took a step in the right direction by not letting the other 20% of the country control our freedom. I do not know if I would have voted for Brown, because I do not feel he is a conservative and just didn't trust someone who seemed to use the Tea Party movement to get elected. But, in a state like MA, maybe he's the most conservative you can get. I'm glad I didn't have to make that choice.

Now I see that he is turning out to be just what I thought he was - used the Tea Party to get into power and then threw them to the side. It will be interesting to see how he votes once he's in office, but I am pretty ticked at him for disregarding the Tea Party's involvement in his win. Note: I am not disappointed in him, as I expected it. I am ticked because I think that his words make the Tea Party members tentative about supporting other supposedly conservative candidates.

I know, I know, he was running on the GOP ticket. Right now we have a two party system, so that is the system that the Tea Party is working in. I hope that will change soon - I'm hoping with Patrick Hughes in Illinois. It would just be awesome to vote in a real conservative that is not part of either of the major parties. I urge you, conservatives, to vote for the person you believe in, not the lesser of two evils. The conservative may not win that election because the vote is split, but if that is what continues to happen, eventually one of the two parties are going to wake up and the conservatives will start winning the primaries. Yes, it will be a long, hard road, but it MUST be done. We cannot continue to allow the two party system to steal our freedoms from us.

Secondly, I'd like to address President Obama's budget proposal and State of the Union Address. I don't understand why we continue to let our politicians get away with the accounting tactics they use. The budget allows for revenue from a health care tax and a cap and trade tax. Neither of which are law. What are the real numbers based on our actual laws?

Then he states that he will impliment a spending freeze. What he did not tell us is that it's only on about 17% of our Federal Budget and it's not like they are not going to spend the money, they're just not going to spend more than they have allocated for a few programs. Why aren't they doing that ALL the time? And he basically stated that he wants to cut spending on those programs he is against, but raise spending on those programs that he is for. So, we can look forward to raising taxes (because he's against the people having control of their own money) and more government programs (because he's for the government having power over you through taxation).

It's pretty obvious that they are not just going to stop spending our money, so we need to stop them. They won't listen to us, that's pretty obvious by the health care votes, but there are many actions we can take to control their spending of our money. We can replace them with those that have the same values we do. We can get the word out to everyone we know about what is really going on in Washington and how they are spending our money. We can bring our concerns to the public via protests, discussions, advertisements, etc. We can be sure to keep up on all that they are doing in Washington and contacting our representatives on each and every vote that comes up. Let them know that you are keeping an eye on them. Lastly, we can stop paying taxes. We will go to jail, but once we have, we can sue the government for requiring us to pay unconstitutional taxes.

Then he stated that Congress did not pass the law that he wanted to form a committee. So, he issued an executive order. Not only does it just validate the opinion that he thinks he's a dictator and we will do what he wants - he insists on it. But, it's just another waste of our tax dollars. The committee has no legal authority, thus they will be paid to sit there and come up with ideas that no one (well, except Obama himself) will listen to. More job creation by creating more government jobs. This is the only way that he knows how to create a job - creating them in the private sector requires relinquishing power. Not something Obama is capable of.

Third, I would like to talk about health insurance reform. I think that the administration is not talking about it much because they don't want us to know what is going on. Then they will sneak it through in the middle of the night again. Do not trust them. Keep pressing for REAL health insurance reform - tort reform, stop giving tax incentives to employers for providing health insurance, allow the purchasing of health insurance across state lines, etc.

Forth, I would like to address the bank bailouts and adding a tax to the 50 largest banks (excluding Fannie, Freddie & GM). Some of those banks did not take any bailout money, so why do they have to pay it back. Of those that did take bailout money, much of that money has been paid back with interest (not from Fannie, Freddie & GM, though). So, when he says "we want our money back", what money? If it's already been paid back plus interest, what money are we suppose to be getting "back"? But, let's say that it hadn't been paid back........if we had to give them the money because the bank would collapse with out it - how can it be good to then require them to pay even more money? It doesn't make any sense?! Then there's the fact that the government made a deal with this banks. We'll give you this amount of money at this interest rate. Now they want forcefully change their agreement with these banks. How can we trust the government, if they are changing the rules on us? When does it stop? Are they going to add another tax next year and a fee the year after that? How long are the banks stuck under the federal government's thumb? Now they are talking about using some of the TARP money, which is suppose to go back to the tax payers not back to the government, to bailout smaller banks (can't use the excuse of too big to fail here). If I were those banks, I would bring in CSPAN to air the discussions and then refuse any money the government wants to loan due to the fact that I cannot trust that they will not just change the agreement after I have accepted the money.

This same principle applies to the small businesses that he wants to "help". Be very wary of his proposals. Very wary.

And finally, I want to address the general idea that conservatives need to compromise all the time. We have been compromising and compromising. Giving away our freedoms one inch at a time (sometimes feet at a time from things like Social Security). Why? Why doesn't the left have to compromise, but the right does. And when does it stop? If you want to live in a nanny state - move to one, but don't think you can nudge this great country into one. We will not stand for it any more. I want my freedom back!

Facts About the Facts on Health Care Reform

Below is my response to the facts about the facts on health care reform from the White House.

The items in blue are taken directly from the white house website. 

Lie #1: "We Can Afford Reform, We Can’t Afford the Status Quo

Jared Bernstein, Chief Economist for the Vice President and Executive Director of the Middle Class Task Force, debunks the myth that we can’t afford health insurance reform. To the contrary, not only has the President demanded that reform not add to the deficit in the short term, but reform is the only way to get skyrocketing health care costs under control that will be devastating not for families , businesses, and for government deficits in the long term under the status quo."

The "status quo" is not what we are promoting. We are promoting freedom. The government has NO RIGHT to force us to have health insurance and they sure do not have the right to set up their a health insurance system. In the past, we have allowed the federal government to take away our freedoms in exchange for "security" and it has been proven that we give them an inch of our freedoms and they want more. Over and over again they have done it. Inch by inch they are stealing our freedoms. It's time for us to start taking back our freedoms.

We want the government to de-regulate and remove the government regulation that prevents us from accessing the thousands of health insurance companies outside of our states. Think of the competition there would be, if you just open the market! It seems like such a "duh" thing to do, why is no one considering it in Washington?

And as far as "not only has the President demanded that reform not add to the deficit in the short term"....so if the furniture company says to me that they will not charge my credit card for the furniture I purchased for a whole year, does that mean I'm not in debt? What a ludicrous statement.

Lie #2: "Congress did not vote to exempt themselves from reform

Linda Douglass of the White House Office of Health Reform answers a question from outside the recent town hall in New Hampshire on why Congress voted to exempt themselves from reform. This is a myth: there is no exemption and there has not been any such vote. To the contrary, reform gives all Americans access to an insurance exchange much like the one Congress has enjoyed, and just like Congress, Americans will be free to make their own choices."

Well, partial lie. It's true that Congress did not vote to exempt themselves from reform, because Congress has not voted on the bill, yet. But stating that we will receive the same access to insurance options as Congress is a lie. Congress has access to so many plans that they get to choose from from all across the country. We will only have access to the same plans we have access to now - those that are in our state. If the government would lift it's restrictions and let me buy insurance from ANY company in ANY state, that would really encourage competition and actually give us the same access Congress has to health insurance plans.

Lie #3 "Reform will expand your choices, not limit them

Linda Douglass of the White House Office of Health Reform answers a question from outside the recent town hall in New Hampshire on whether any government involvement in health care will end up limiting choices for consumers. This is a myth: even the addition of a public option will be just that – another option –and will not eliminate any choices to the consumer. To the contrary, this would bring down costs and expand choice."

While it is true that adding the public option as a plan, does expand our choices (by one). Again, if they really want to give us choices, they wold allow us to purchase insurance from outside of our state. But the way this bill has been written, they ARE limiting our choices because they have included language in it that limits the plans that can be offered. The basic plan, of which the government mandates what is covered. The enhanced plan, which is the basic plan with a lower level of cost-sharing. The premium plan, which is the enhanced plan with an even lower level of cost-sharing. Then there's the premium plus plan, which is the premium plan that also provides additional benefits, such as adult oral health and vision care, approved by the Commissioner. Really, it will only be the wealthy, that can purchase any kind of coverage beyond the basic plan - thus most of us will all be on the same plan - how is this expanding choices? And even the rich will have to have the services covered by their premium-plan approved by the government. (Note: this is where rationing has the potential for coming into play.)

Lie #4: "There is no panel to decide end-of-life care

Linda Douglass of the White House Office of Health Reform answers a question from outside the recent town hall in New Hampshire on why reform will empower a panel to decide end-of-life care for Americans. This is a myth that has unfortunately been spread far and wide by defenders of the status quo. There is no such panel in any of the bills being considered in Congress, period. To the contrary, the House bill gives Americans and their families more choice and access to counseling and information on these most difficult decisions if, and only if, they choose to pursue it."

This is a half lie. The bill does empower a panel to decide end of life care (as the panel will decide all health care decisions), but there is not specifically an end of life panel. Though, when those usually talking about end of life, they are talking about the section that talks about the government paying doctors to discuss end of life issues with their patients. This section does not include a panel, but says this "Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization".

Lie #5: "No bill puts off care for the disabled for "further study"

Linda Douglass of the White House Office of Health Reform answers a question from outside the recent town hall in New Hampshire on why a specific section of the House legislation (“section 1177”) puts off care for the disable pending "further study." This is a myth: for the disabled or their families, they can keep whatever care and coverage they currently have, but they will have additional options through Medicare for other voluntary programs. To the contrary, reform will make insurance more affordable, provide more options, and eliminate discrimination in purchasing health insurance so families won't be turned down if a parent or child has a pre-existing disability or other health condition."

To be honest, I cannot understand section 1177 as it only refers to other bills. Though, the reform purposed in HR3200 would not make insurance more affordable or provide more options. I will need to research this more, but for now this is what it says specifically:

SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS PLANS TO RESTRICT ENROLLMENT.

(a) In General- Section 1859(f)(1) of the Social Security Act (42 U.S.C. 1395w-28(f)(1)) is amended by striking ‘January 1, 2011’ and inserting ‘January 1, 2013 (or January 1, 2016, in the case of a plan described in section 1177(b)(1) of the America’s Affordable Health Choices Act of 2009)’.


(b) Grandfathering of Certain Plans-

(1) PLANS DESCRIBED- For purposes of section 1859(f)(1) of the Social Security Act (42 U.S.C. 1395w-28(f)(1)), a plan described in this paragraph is a plan that had a contract with a State that had a State program to operate an integrated Medicaid-Medicare program that had been approved by the Centers for Medicare & Medicaid Services as of January 1, 2004.


(2) ANALYSIS; REPORT- The Secretary of Health and Human Services shall provide, through a contract with an independent health services evaluation organization, for an analysis of the plans described in paragraph (1) with regard to the impact of such plans on cost, quality of care, patient satisfaction, and other subjects as specified by the Secretary. Not later than December 31, 2011, the Secretary shall submit to Congress a report on such analysis and shall include in such report such recommendations with regard to the treatment of such plans as the Secretary deems appropriate.

Lie #6: "The Indian Health Service will be fine and Native Americans will benefit

Kimberly Teehee, Policy Advisor for Native American Affairs at the White House Domestic Policy Council, debunks myths being spread about how health insurance reform will affect the Indian Health Service. To the contrary, reform will allow Native Americans to keep the care they have now and has benefits for every American."

The Indian Health Service is currently not fine and this bill does pretty much nothing for the service. Indian Health Services is just another failed government program that will continue to be a failure.

Lie #7: "Reform will stop "rationing" - not increase it

Kavita Patel, who works with Senior Adviser Valerie Jarrett and who worked for years before as a physician, debunks the myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies."

Again, this is a half lie. There is nothing in the bill that says the government will ration care. But the bill sets up the structure for the government to ration care. ALL countries that have socialized health care ration, because they cannot afford not to. They either outright ration or ration by not having health care accessible.

Here is a brief overview of the French system, which is known as the best Universal Health Care system:

The overall rate of social security and tax on the average wage in France in 2005 was 71.3% of gross salary. The government pays an average of 80% of the bill - leaving the other 20% (on average) for the citizen to cover either out of pocket or by purchasing additional insurance.

To counter the rise in health-care costs, the government has closed hospitals and installed a mandatory co-pay for a doctor visit, each box of medicine prescribed, and a fee per day for hospital stays and for expensive procedures.

A government body, ANAES, Agence Nationale d'Accréditation et d'Evaluation en Santé (The National Agency for Accreditation and Health Care Evaluation) is responsible for issuing recommendations and practice guidelines. There are recommendations on clinical practice (RPC), relating to the diagnosis, treatment and supervision of certain conditions, and in some cases, to the evaluation of reimbursement arrangements. ANAES also publishes practice guidelines which are recommendations on good practice that doctors are required to follow according to the terms of agreements signed between their professional representatives and the health insurance funds.

Lie #8: "The "euthanasia" distortion on help for families

Melody Barnes, the President's Director of the Domestic Policy Council, debunks the malicious myth that reform would encourage or even require euthanasia for seniors."

Again, this is a half lie. There is nothing in the bill that says the government will require euthanasia for seniors. But the bill sets up the structure for the government to be able to require euthanasia for seniors or any some other group.

Lie #9: "Vets' health care is safe and sound

Matt Flavin, Director of Veterans and Wounded Warrior Policy, explains that nothing in health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget greatly expands coverage for veterans who have been denied access in the past."

I cannot find anything in this bill to support "the President's budget greatly expands coverage for veterans who have been denied access in the past". Largely because I do now know why a veteran would have be denied access. The only things in the bill concerning the VA is that when dolling out grants, preference will be given to "Training the greatest percentage, or significantly improving the percentage, of public health professionals serving in the Federal Government or a State, local, or tribal government". And "VA- Coverage under the veteran’s health care program under chapter 17 of title 38, United States Code, but only if the coverage for the individual involved is determined by the Secretary in coordination with the Health Choices Commissioner to be not less than the level specified by the Secretary of the Treasury, in coordination with the Secretary of Veteran’s Affairs and the Health Choices Commissioner, based on the individual’s priority for services as provided under section 1705(a) of such title."

Now, if there are vets that really do not have access to care. I am all for getting it to them. But, really, they need to fix the quality of care. The VA system is such a mess and I cannot believe how bad we treat them. I don't just want more vets to have access to care, I want them all to have access to quality care. Unfortunately, this is not something that the government has done or ever will do well.

Lie #10: "Reform will benefit small business - not burden it

Christina Romer, Chair of the Council of Economic Advisers, debunks the myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses and help level the playing field with big firms who pay much less to cover their employees on average."

Yet another half lie. Those small companies that currently do not offer health insurance coverage because they cannot afford it will be hurt by having to pay the fees and taxes charged to businesses. Those small companies that do currently offer health insurance will be helped (well, that's as long as the fees & taxes applied to them do not go up). The average employer pay 12% of gross wages to health insurance premiums. The bill will have employers paying an 8% of gross wages into the government if they do not provide insurance for their employees. That is part of the problem as so many will be dumped from their current insurance. Did someone say Trojan horse?

Lie #11: "Your Medicare is safe, and stronger with reform

Robert Kocher of the National Economic Council debunks the myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform would simply eliminate waste and unnecessary subsidies to insurance companies."

Once a citizen is eligible for Medicare, they will automatically enrolled. Which mean the number of people on Medicare will rise - even though Medicare cannot pay their current costs. And if so much can be saved by eliminating waste and unnecessary subsidies, why have they not already done this? Maybe then the program wouldn't be billions of dollars in debt.

Lie #12: "You can keep your own insurance

Linda Douglass of the White House Office of Health Reform debunks the myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them."

As stated above, most businesses will opt for paying 8% of wages over 12%. Also, you care only allowed to keep your insurance if it does not change (don't get married, or have a child or change jobs). But, lets say that it does not change, this "grandfathered" cause expires in 5 years. Again, as stated above, it expands your choices in insurance companies by one.


I would like to address the idea of an insurance company not being allowed to refuse coverage to anyone and not being allowed to charge more to someone based on their health status. Can you tell me how they could afford to do such things without either going out of business or having to charge EVERYONE higher premiums to cover the costs? Trojan horse.

If we actually opened up competition by allowing us to purchase insurance from any company, the would be a market for those with health concerns bringing down their premium costs.

One more thing I would like to address, as there doesn't seem to be much about this out there. Private insurers will only be allowed to sell the plans that the government allows. Basically, we will all have the same plan (unless we can afford a premium-plus plan).


"(c) Specification of Benefit Levels for Plans-

(1) IN GENERAL- The Commissioner shall establish the following standards consistent with this subsection and title I:

(A) BASIC, ENHANCED, AND PREMIUM PLANS- Standards for 3 levels of Exchange-participating health benefits plans: basic, enhanced, and premium (in this division referred to as a ‘basic plan’, ‘enhanced plan’, and ‘premium plan’, respectively).


(B) PREMIUM-PLUS PLAN BENEFITS- Standards for additional benefits that may be offered, consistent with this subsection and subtitle C of title I, under a premium plan (such a plan with additional benefits referred to in this division as a ‘premium-plus plan’).

(2) BASIC PLAN-

(A) IN GENERAL- A basic plan shall offer the essential benefits package required under title I for a qualified health benefits plan.

(3) ENHANCED PLAN- A enhanced plan shall offer, in addition to the level of benefits under the basic plan, a lower level of cost-sharing as provided under title I consistent with section 123(b)(5)(A).

(4) PREMIUM PLAN- A premium plan shall offer, in addition to the level of benefits under the basic plan, a lower level of cost-sharing as provided under title I consistent with section 123(b)(5)(B).

(5) PREMIUM-PLUS PLAN- A premium-plus plan is a premium plan that also provides additional benefits, such as adult oral health and vision care, approved by the Commissioner. The portion of the premium that is attributable to such additional benefits shall be separately specified."

The only difference between the basic plan, enhanced plan, and premium plans are a lower level of cost-sharing - what is covered does not change. And these are the only plans that can be sold. If you go to the store to purchase Oreo's and one package of Oreo's cost $2.00 and another package costs $2.20, which Oreo's do you think most will purchase? Likewise, how many will pay more for the same insurance plan?

Trojan Horse