My research as to why the HR3200 Health Care plan will not work

I’ll preface this post with the idea that health care is NOT a right under the U.S. Constitution, but unfortunately many apparently think it is and as such the government needs to subsidize and control it. For Constitutionally oriented people of this school of thought, I’ll ask if the right to own a gun (Second Amendment) means the government should subsidize the purchase of one? I don’t support the government doing either.

Since there has been so much public debate on the issue, and lots of name calling and allegations of misinformation, I decided to look into the bill from the source:

http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.3200:

This is the official 1,017 page government version located at the Library of Congress website. It’s not run by Fox News, and Glenn Beck, Rush Limbaugh et al had no hand in the PDF document you download from there. I’ve not received any instructions or compensation from anyone on this. This process took several hours over a period of two days to research on my own.

My first concern is taxes:

If you choose to not have health insurance, you will be taxed unless you:

1) Are a dependent of one with acceptable coverage;

2) Are a non-resident alien;

3) Live outside the US;

4) Live in a US possession or territory; or

5) Have a  religious objection and file such with the Secretary.

The tax surcharge was proven when I read page 167, Title VIII Subpart A lines 16-23 and page 168 lines 1-4. Here is the exact language, I have removed the line numbers and unrelated formatting for legibility:

Subpart A—Tax on Individuals Without Acceptable Health Care Coverage
Sec. 59B. Tax on individuals without acceptable health care coverage.
SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
(a) TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of—

Page 168

(1) the taxpayer’s modified adjusted gross income for the taxable year, over

(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.

This started me on a quest to see if my current (known as a catastrophic) plan would be covered.

I pay for my doctor visits in cash, as I calculated after retirement that paying a higher premium wasted money in my case. It was more economical to pay a lower premium and still retain coverage for major illnesses/expenses.

Here is the text of my research into finding out what "acceptable health coverage" is under HR 3200:
I started here- to determine if I have to pay the tax. Page 167-
‘‘PART VIII—HEALTH CARE RELATED TAXES
‘‘SUBPART A. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE
COVERAGE.
‘‘Subpart A—Tax on Individuals Without Acceptable Health Care Coverage
‘‘Sec. 59B. Tax on individuals without acceptable health care coverage.
‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
HEALTH CARE COVERAGE.
‘‘(a) TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of—
with BILLS
Page 168
‘‘(1) the taxpayer’s modified adjusted gross income for the taxable year, over ‘‘(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.

Now I need to define acceptable health care coverage, so now I need to read subsection (d), on page 171-
‘‘(d) ACCEPTABLE COVERAGE REQUIREMENT.—
‘‘(1) IN GENERAL.—The requirements of this subsection are met with respect to any individual for any period if such individual (and each qualifying child of such individual) is covered by acceptable coverage at all times during such period.
‘‘(2) ACCEPTABLE COVERAGE.—For purposes of this section, the term ‘acceptable coverage’ means any of the following:
‘‘(A) QUALIFIED HEALTH BENEFITS PLAN COVERAGE.—Coverage under a qualified health benefits plan (as defined in section 100(c) of the America’s Affordable Health Choices Act of 2009).with BILLS

Next up, section 100(c), page 8-
(c) GENERAL 1 DEFINITIONS.—Except as otherwise provided, in this division:
(1) ACCEPTABLE COVERAGE.—The term ‘‘acceptable coverage’’ has the meaning given such term in section 202(d)(2).

Almost there! Now we go to section 202(d)(2), page 76-
(2) ACCEPTABLE COVERAGE.—For purposes of this division, the term ‘‘acceptable coverage’’ means any of the following:
(A) QUALIFIED HEALTH BENEFITS PLAN COVERAGE.—Coverage under a qualified health benefits plan.
(B) GRANDFATHERED HEALTH INSURANCE COVERAGE; COVERAGE UNDER CURRENT GROUP HEALTH PLAN.—Coverage under a grandfathered health insurance coverage (as defined in subsection (a) of section 102) or under a current group health plan (described in subsection (b) of such section).
 (G) OTHER COVERAGE.—Such other health benefits coverage, such as a State health benefits risk pool, as the Commissioner, in coordination with the Secretary of the Treasury, recognizes for purposes of this paragraph.
The Commissioner shall make determinations under this paragraph in coordination with the Secretary of the Treasury.

So, what is a “qualified health benefits plan”? Back to section 100(c)20., page 13-
(20) QUALIFIED HEALTH BENEFITS PLAN.—
The term ‘‘qualified health benefits plan’’ means a health benefits plan that meets the requirements for such a plan under title I and includes the public health insurance option.

I searched for Title I. Found it on page 2-
Title 1 has subtitles A through G. I found Subtitle A section 101(b) on page 15-
(b) REQUIREMENTS FOR QUALIFIED HEALTH BENEFITS PLANS.—On or after the first day of Y1, a health benefits plan shall not be a qualified health benefits plan under this division unless the plan meets the applicable requirements of the following subtitles for the type of plan and plan year involved:
(1) Subtitle B (relating to affordable coverage).
(2) Subtitle C (relating to essential benefits).
(3) Subtitle D (relating to consumer protection).

What is Y1? That was easy! Found this in section 100(c)25. on page 15-
(25) Y1, Y2, ETC.—The terms ‘‘Y1’’ , ‘‘Y2’’, Y3’’, ‘‘Y4’’, ‘‘Y5’’, and similar subsequently numbered terms, mean 2013 and subsequent years, respectively.

OK, on to Subtitles B, C, and D. First up: Subtitle B, page 19. Wow! These Subtitles are lengthy: 6 pages (B), 11 pages (C), and 4 pages (D). Here are the section titles-
Subtitle B-
SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLUSIONS.
SEC. 112. GUARANTEED ISSUE AND RENEWAL FOR INSURED PLANS.
SEC. 113. INSURANCE RATING RULES.
SEC. 114. NONDISCRIMINATION IN BENEFITS; PARITY IN MENTAL HEALTH AND SUBSTANCE ABUSE DISORDER BENEFITS.
SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.
SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.

Subtitle C-
SEC. 121. COVERAGE OF ESSENTIAL BENEFITS PACKAGE.
SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED.
SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
SEC. 124. PROCESS FOR ADOPTION OF RECOMMENDATIONS; ADOPTION OF BENEFIT STANDARDS.

Subtitle D-
SEC. 131. REQUIRING FAIR MARKETING PRACTICES BY HEALTH INSURERS.
SEC. 132. REQUIRING FAIR GRIEVANCE AND APPEALS MECHANISMS.
SEC. 133. REQUIRING INFORMATION TRANSPARENCY AND PLAN DISCLOSURE.
SEC. 134. APPLICATION TO QUALIFIED HEALTH BENEFITS PLANS NOT OFFERED THROUGH THE HEALTH INSURANCE EXCHANGE.
SEC. 135. TIMELY PAYMENT OF CLAIMS.
SEC. 136. STANDARDIZED RULES FOR COORDINATION AND SUBROGATION OF BENEFITS.
SEC. 137. APPLICATION OF ADMINISTRATIVE SIMPLIFICATION.

I will need 2 days and 2 lawyers to read all of that. It may be easier just to call my insurance company & see if my plan qualifies!

I eventually found my answer:
After looking at Subtitle C, section 122, I found my answer:
My plan does not qualify since it has a maximum benefit per calendar year (122(a)(3)) and it does not provide prescription drug coverage (122(b)(5)).

The funniest thing in the whole bill? It’s right here:
Section 133(a)2., page 39-
(2) PLAIN LANGUAGE.—In this subsection, the term ‘‘plain language’’ means language that the intended audience, including individuals with limited English proficiency, can readily understand and use because that language is clean, concise, well-organized, and follows other best practices of plain language writing.

Hypocrisy much?

Seriously, this plan is excessively complex. Who can understand this stuff? You have to jump through five hoops just to get to the part to see if your plan is "acceptable".

The net result- I cannot keep my current plan despite the statements made by the President as recently as August 11. I either pay the tax surcharge  or a higher premium, or go with the public option.

I’ll state that I also take issue with the plan adding to our already unwieldy IRS tax code. The idea of taxing the rich to give to the poor is an invalid concept to me. Charity should be voluntary, not at the heel of the government’s boot on your wallet.