Diary

"Acceptable Coverage"

(c) GENERAL DEFINITIONS.—Except as otherwise

2 provided, in this division:

3 (1) ACCEPTABLE COVERAGE.—The term ‘‘acceptable coverage’’ has the meaning given such term

5 in section 302(d)(2).

It is important to note that here in the first pages of this legislation is where I have my greatest problems ideologically.  As long as government has the right to define “acceptable coverage” we’re going to butt heads.  See, they can actually pass this legislation and next week, when no one is watching, then they come back and say “acceptable coverage” must include abortion, sex changes, or any of a myriad of things that many would prefer not be in their tax dollars.  I haven’t chased this term down to it’s source yet, but if acceptable coverage is actually determined by a non-elected body, then we have more serious problems because the public doesn’t even get to have a voice and certainly doesn’t get to see the decision making on this.  Since I have promised this project a finite amount of time, I will make this piece a two part series.  Ponder how awful it is when four lines of legislation requires two or three hours to chase down.

 

 

One could be excused for suggesting that this legislation is intentionally confusing.  The fact that it is probably confusing without intent speaks to the specialized talents of the authors.  What is acceptable coverage?  According to the definition, it has the meaning that has been given to it in section 302(d)(2), where there is no definition.  Section 302(d)(2) tells us that if you have Medicaid, Medicare, VA, or military insurance, you are golden.  No worries, you have acceptable coverage.  This is odd on it’s face, as they intend to cut huge chunks out of medicare, btw…

The only other kind of acceptable coverage is “qualified health benefits plan coverage” defined as “coverage under a qualified health benefits plan”.  Super!  Now what is acceptable coverage?  Well, I suppose we have to look up a qualified health benefits plan.

 

That definition is on page 15.  Basically, that definition says a “qualified health benefits plan” is a plan that “meets the requirements for such a plan under title II and includes the public health insurance option and is offered by a QHBP offering entity that meets the applicable requirements of such title with respect to such a plan”.  Yikes!  What does that mean?  I suppose we have to look up title II to get specifics while realizing that if your insurer offers the plan they approve without being a qualified offering entity, your plan still might not qualify.  This seems like a lot of hoops to jump through to find out what most folks will want to know about this plan, namely, if their plan counts or will they have to jump ship or be tossed off.

 

OK, this is the **to be continued** spot.  Next time we will find out if the average health care plan (that would be mine) has “acceptable coverage”.