If you are covered by a group plan, VA or in the Military, you can't choose the
By ParaTed2k
@ParaTed2k (22940)
Sheboygan, Wisconsin
August 6, 2009 6:05am CST
"public option".
Under the provisions of this plan, if you are covered under a employer group plan, the VA or you are in the military you CAN'T participate in the "public option", even if you want to.
I'm a vet, because of my disibility rating, I am enrolled in the VA medical system. According to the language of this legislation, I can't choose the "public option" istead.
If you are currently on active duty, you can't choose the plan either. Some would wonder why any servicemember would care if they already have military medical benefits. It may come as a suprise to people, but there are a lot of troops, NCOs and Officers who pay out of pocket for private medical insurance. There are others who are on the plans of their spouse. According to this "reform" they can't make that choice anymore.
You also can't opt for the "public option" if you are covered by Medicare/Medicaid, a or a "grandfathered" plan.
This "reform" is long on "public" but short on "option".
(2) ACCEPTABLE COVERAGE.—For purposes of
7 this division, the term ‘‘acceptable coverage’’ means
8 any of the following:
9 (A) QUALIFIED HEALTH BENEFITS PLAN
10 COVERAGE.—Coverage under a qualified health
11 benefits plan.
12 (B) GRANDFATHERED HEALTH INSURANCE
13 COVERAGE; COVERAGE UNDER CURRENT GROUP
14 HEALTH PLAN.—Coverage under a grand15
fathered health insurance coverage (as defined
16 in subsection (a) of section 102) or under a
17 current group health plan (described in sub18
section (b) of such section).
19 (C) MEDICARE.—Coverage under part A of
20 title XVIII of the Social Security Act.
21 (D) MEDICAID.—Coverage for medical as22
sistance under title XIX of the Social Security
23 Act, excluding such coverage that is only avail24
able because of the application of subsection
77
1 (E) MEMBERS OF THE ARMED FORCES
2 AND DEPENDENTS (INCLUDING TRICARE).—
3 Coverage under chapter 55 of title 10, United
4 States Code, including similar coverage fur5
nished under section 1781 of title 38 of such
6 Code.
7 (F) VA.—Coverage under the veteran’s
8 health care program under chapter 17 of title
9 38, United States Code, but only if the cov10
erage for the individual involved is determined
11 by the Commissioner in coordination with the
12 Secretary of Treasury to be not less than a level
13 specified by the Commissioner and Secretary of
14 Veteran’s Affairs, in coordination with the Sec15
retary of Treasury, based on the individual’s
16 priority for services as provided under section
17 1705(a) of such title.
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
3 responses
@ParaTed2k (22940)
• Sheboygan, Wisconsin
6 Aug 09
It just says VA, it doesn't get specific to programs within the VA.
Basically it's saying that you can't drop any "acceptable coverage" to choose the "public option" just because you want to.
@spalladino (17891)
• United States
6 Aug 09
There shouldn't be any changes to CHAMPVA, no. If there are it would come from the V.A.
@ParaTed2k (22940)
• Sheboygan, Wisconsin
6 Aug 09
All I know is what this bill says. If you are already covered by the VA, you can't choose this plan as an option.
@spalladino (17891)
• United States
6 Aug 09
I haven't seen anything in the bill...at least not yet...that forces anyone to give up the individual health coverage that they have to supplement the V.A., medicaid or medicare coverage. This section also doesn't indicate that someone covered under any of those plans would no longer be covered under a spouse's employer provided plan. What this section says is that, if you don't already have coverage, you qualify for the public option and then lists what "acceptable coverage" is. I don't read it as taking anything away from anyone or denying those already covered by acceptable plans from enrolling in private plans.
@ParaTed2k (22940)
• Sheboygan, Wisconsin
7 Aug 09
But if you already have any of the plans listed as "acceptable benefits", you can't drop them in favor of the "public option".
@spalladino (17891)
• United States
7 Aug 09
Why would you want the public option if you already had one of these plans?
@spalladino (17891)
• United States
6 Aug 09
I didn't see where it prohibits a veteran from also being covered as a dependent on someone else's employer provided plan, Ted. I also have to ask you, why are you assuming that the public option will be better than the private insurance plans? Haven't I seen discussion after discussion about how terrible a "public plan" will be? Now you're bytching because folks who already have coverage can't use it? All plans are going to have to conform to the same standards of affordability, etc, as we discussed in another conversation.
"SEC. 202. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.
(a) Access to Coverage- In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance Exchange unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage."
Doesn't this section focus on people who currently have no coverage, either private or through their employer? Isn't that why this section also addresses the transition periods for individuals, small and large employers?
@ParaTed2k (22940)
• Sheboygan, Wisconsin
6 Aug 09
With this part, I am pointing out the lie that there is a choice here. If I am covered by the VA, but would rather see my own doctor, this doesn't give me a choice. According to this, I have to subject myself to the VA system.
