Thursday, September 3, 2009
(CNSNews.com) – The health care bill under consideration in the House of Representatives would give President Obama the authority to name a new federal “Health Choices Commissioner” who would have sweeping power to govern the health insurance plans offered in a so-called “exchange” where millions of Americans would get their health insurance if the bill is enacted.
These powers would include deciding which treatments are covered, which companies can participate, which states can run their own exchange, and enrolling individuals into the public exchange.
Though the bill, House Resolution 3200, faces many political hurdles, it has passed three House committees and could be ready for a floor vote after Congress returns from recess. The overhaul package calls for establishing a health insurance exchange where people earning up to 400 percent of the poverty level will be able to purchase health insurance with the help of federal subsidies. This exchange would include a “public option” government-run health care plan as well as private plans that provide a minimum benefits package dictated by the government.
The Health Choices Commissioner would establish “the benefits to be made available under Exchange-participating health benefit plans during each plan year,” according to page 84 of the 1,018-page bill. That means the commissioner would determine what benefits the participating insurance companies must offer participating customers in the exchange.
The commissioner would also set rules for insurance companies to participate in the health insurance exchange, and establish criteria for individuals to receive federal subsidies to purchase insurance in the exchange, according to section 142 on page 42 of the legislation.
Further, the commissioner would have the authority to establish “automatic enrollment” of individuals who qualify for the health insurance exchange.
“The Commissioner shall provide a process under which individuals who are Exchange-eligible individuals described in subparagraph (B) are automatically enrolled under an appropriate Exchange participating health benefits plan,” the legislation says, beginning on page 97. “Such process may involve a random assignment or some other form of assignment that takes into account the health care providers used by the individual involved or such other relevant factors as the Commissioner may specify.”
The exchange eligible individuals [determined by subparagraph (B)] include someone who “has not opted out from receiving such affordability credit,” someone who “does not otherwise enroll in another exchange participating health benefits plan,” and someone “enrolled in an Exchange-participating plan that is terminated (during or at the end of the plan year) and who does not otherwise enroll in another Exchange participating health benefits plan.”
This article was posted: Thursday, September 3, 2009 at 9:00 am