Why Wal-Mart is happy with HR3200

lambert's picture

Check out Taibbi's "Sick and Wrong" videos here. And be sure to check out the last video on the mandate.

Taibbi points out -- and I'd like a policy wonk to confirm this -- that in HR3200, existing insurance is grandfathered, but new insurance has to meet the higher standards imposed by the bill.*

What that means is that employees of every humongous corporation that gives its employees crap insurance -- Wal-Mart, say -- are forced to keep that insurance, but that start-ups and new companies have to meet the new standards. That's a barrier to entry for them, and reinforces Wal-Mart's dominance. Any wonder they support the bill?

NOTE * Does anyone know if HR3200 bans rescission? The news coverage mentions other forms of regulation, but not that one.

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dblhelix's picture

yes,

Does anyone know if HR3200 bans rescission?

but it's redundant as it was already banned in 1996.

lambert's picture

So, er...

... they're still doing it because they gamed the system? (Link on the 1996 thing? That's good stuff.)

First they ignore you, then they ridicule you, then they fight you, then you win. -- Mahatma Gandhi

realpolitik's picture

On Rescission...

Here's a decent link...

http://finance.varolmak.com/2009/08/resc...

Stemmed from the enactment of HIPAA.

Neoliberalization has led to the financialization of everything. (Harvey, A Brief History of Neoliberalism, Chapter 1).

a little night musing's picture

Your link proves HIPAA did NOT ban rescission

Guaranteed renewal is not applied, for example, if the insurer can not offer an insurance plan in the market, if the insured moves to a network service area, or - more relevant to today's debate - if the insured has acted fraudulently or makes a false statement of a material fact under the hood.

[my emphasis]

The policies that are being rescinded in the stories we hear, are rescinded for small, almost meaningless "lies" including patients not having disclosed health conditions the patient did not even know about. This is plainly not banned by the regulation you point to. (I don't know if that's what you meant to say or not.)

We can't afford not to have single-payer!

realpolitik's picture

Which...

...if you follow the conversation above, was what the topic was about. HIPAA attempted it, loopholes exist.

Neoliberalization has led to the financialization of everything. (Harvey, A Brief History of Neoliberalism, Chapter 1).

realpolitik's picture

*cough*....So, what was your problem with the link?

Let me say that we share the concern of the President of the recent reports that in some circumstances, insurers in the market, perhaps through the cancellation as a means to circumvent the requirements for renewal of the security provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA is very clear that with few exceptions, an individual insurance policy is entitled to "ensure renewal" - in other words, the insurer must renew or continue in force for one person coverage, unless a specific exception is met .

That's the first paragraph and directly in line with what we were talking about.

Neoliberalization has led to the financialization of everything. (Harvey, A Brief History of Neoliberalism, Chapter 1).

a little night musing's picture

The problem is

that the later paragraph I quoted shows that HIPAA contained a loophole large enough to drive an 18-wheeler through.

We can't afford not to have single-payer!

realpolitik's picture

Yep,

which is why HIPAA's mistakes shouldn't be allowed to become repeated within HR3200. because no matter what the 'purposes' of the bill were, it's obvious the loopholes were put in there for a reason, or, to be less conspiratorial...capital's "inventiveness" matched government's folly.

Neoliberalization has led to the financialization of everything. (Harvey, A Brief History of Neoliberalism, Chapter 1).

a little night musing's picture

I agree completely

There do appear to be loopholes in HR 3200, to my eye, and they are not being discussed in the mainstream discussion of the bill (which has a tendency to turn into Team A - conservative talking points - versus Team B - in favor of "health care reform", whatever that is.)

And, as I've said before, the long timeline over which the bill would come into effect means we wouldn't get to see how the loopholes played out until a decade or more down the line.

We can't afford not to have single-payer!

a little night musing's picture

On HR 3200

Taibbi points out -- and I'd like a policy wonk to confirm this -- that in HR3200, existing insurance is grandfathered, but new insurance has to meet the higher standards imposed by the bill.*

Existing insurance is grandfathered, but the regulations in HR 3200 which apply to the "qualifying plans" are extended to all plans starting in 2018 (i.e. year 5). These include whatever caps on out-of-pocket expenses are in the bill, how much the insurer has to spend on health care out of the premium dollar, things like that.

Rescission is banned, yes. I don't recall the exact language.

I have no idea what dbhelix is on about. There are individual states which have regulations banning rescission - NY State does. Well, let me be more correct: We have guaranteed issue, which seems to settle the rescission question*, and geographically-based community rating. In fact, some of the conservative and libertarian opponents of health insurance reforms have pointed to NY as an example of how "awful" such regulations are, because our premiums are relatively high. (The state also mandates that a whole menu of things be covered.)

* I guess it's possible an insurer could cancel your policy if you had lied about something like your identity. I don't know whether that would be illegal. But guaranteed issue means that they must issue you a policy regardless of your health status now or in the past. Community rating means that plan won't be more expensive than it would be if you were any other typical person in your county.

We can't afford not to have single-payer!

a little night musing's picture

I don't want to appear more sanguine about HR 3200

than I actually am. So adding to this comment:

From my several readings of the bill, the problems of insurers refusing to pay for covered services (and then relenting after a series of appeals), and of not paying for out-of-network treatments, still remain, among other things.

One of my biggest concerns about this bill is that it's so complicated, and would be put into effect over such a long period of time, that it will be a decade or so until we see what practical effect it has on people's experience and on health care costs. Meanwhile, a whole lot of money has been spent.

Well, I've said this before.

[Edited to add, because I now can't edit the previous comment: guaranteed issue, in effect, bans rescission. HR 3200 has guaranteed issue. I guess that's all you need to know to answer the question of whether or not it bans rescission, except possibly in the odd case of lying about identity or the like.]

We can't afford not to have single-payer!

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