AP:
A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.
The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.
As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.
Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."
[...]"We don't know who put it in, or why it was put in," said Stephen Finan, a policy expert with the cancer society's advocacy affiliate.
[...]"The primary purpose of insurance is to protect people against catastrophic loss," Finan said. "If you put a limit on benefits, by definition it's going to affect people who are dealing with catastrophic loss."
[...]But Finan said the change in the Senate bill essentially invalidates the legislation's ban on lifetime limits.
"If you can have annual limits, saying there's no lifetime limits becomes meaningless," he said.
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i love how they stuck that in the 'no limits' section
if this bill makes it into law, i'm secretly hoping that stays in -- anything to make people hate the insurance industry more is fine with me at this point.
It certainly gives us aother thing to bring up next year
They're making the bill so bad, that hcr will be still be very much alive next year even if it passes. We can make the bill itself the issue, and maybe get Harry Reid thrown out along the way.
Another problem - this with the House bill
but I understand that a similar provision is under discussion for the Senate bill -
According to Weiner (and I do think I can pass this along) the 85% medical loss ratio requirement only applies to not-for-profit insurers who participate in the exchanges, not to for-profits. Just another example of how lame what regulation of insurers there is in these abominations.
We can't afford not to have single-payer!
yep
although in the nebulous future, all insurance is allegedly magickally going to migrate to the exchanges.
in hr3200 the medicare advantage and private medicaid plans also had to have mlr = 85%. i forget if this made it into whatever passed out of the house.
the wording on mlr has been squishy throughout the process, and i've given up trying to figure out where it stands now, but essentially all the bills appear to have loopholes of some kind or another for the individual and/or small group plans to have lower than 85% mlr. one example: in hr3200 [though again i don't know if it made into hr 3962] insurance companies could put unspecified amounts of $$ into 'quality improvement' and this would NOT be counted in the mlr calculation.
bruce webb and i had a little discussion about this over at open left [and there was this discussion on hr676 in general too].