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Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS) |
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03-21-2010, 10:59 PM | #21 | |||
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I just want to note one fly in the ointment that hasn't gotten a lot of press, in terms of the national insurance market. My concern is that sooner or later the Supreme Court will put us in the same situation we are with credit cards today: that the laws of the incorporating state of the issuer govern all aspects of the contract.
It is my understanding that, at least prior to the adoption of national legislation, that may not be entirely true in the case of "surplus lines" from "non-admitted carriers," as a general proposition. By example, see links to the following web pages of The Surplus Line Association of California: "Non-Admitted Does Not Mean Non-Regulated" http://www.sla-cal.org/publications/pb_nonadmitted.htmlBut how this works now out in practice is another thing indeed. See, eGlobalHealth Insurers Agency, LLC, "Differences between Admitted U.S. Insurance & Surplus Lines International Medical Insurance Programs & What it means to you" at http://www.eglobalhealth.com/Pre-exi...formation.html and in particular, the following: . . . Admitted policies are approved by U.S. regulators and the policy definitions & contract wording need to conform to strict standards set forth by U.S. regulators, state by state (there are a few states in the US -- ie; NY for one -- that are very strict and may not even allow certain US insurance companies to provide insurance in that particular state). Non-admitted carriers (ie; Surplus Lines like Lloyds of London, etc) are not required to follow any particular US or State regulations. One case in point, the Pre-existing language can be very different between an Admitted and Surplus Lines health insurance program. As a result, admitted wording tends to be more consumer friendly. Even though you may very well pay more for an admitted plan, it could end up being that you could, in certain circumstances, pay more in the long run, especially if you thought your pre-existing ailment or condition would be covered under your plan and it turns out it is excluded due to specific language or exclusionary riders placed on the policy prior to your acceptance in the program.And note well: a "non-admitted carrier" doesn't have to be from overseas, it can just be from another state and has chosen not to be licensed as an "admitted carrier." where you live. Thereby exempting itself from a substantial part from your state's insurance regulation. So, is there is any specific language in the legislation pertaining to the right of an individual state to regulate health insurance purchased in the "national market place" created by Healthcare Reform (whatever its formal title) or whether, merely through the creation of a national insurance market as a creature of federal statute, that alone may be seen as an "occupation of the field" pre-empting the laws and regulations of any state except that in which the carrier is domiciled? In this regard, we are guided by the Supreme Court's decision in Marquette Nat. Bank of Minneapolis v. First of Omaha Service Corp. (439 U.S. 299), a unanimous 1978 decision holding that state anti-usury laws regulating interest rates cannot be enforced against nationally-chartered banks based in other states. In that opinion Justice William Brennan (of all people) wrote that it was clearly the intent of Congress when it passed the National Banking Act that nationally-chartered banks would be subject only to federal regulation by the Comptroller of Currency and the laws of the state in which they were chartered, and that only Congress or the appropriate state legislature could pass the laws regulating them. Full text of opinion at: http://caselaw.lp.findlaw.com/cgi-bi...=439&invol=299 And from which followed the "race to the bottom" to see which states would offer the least demanding set of regulation, including the de facto abolition of usury laws. So the question becomes what "intent" - with respect to the ability of individual states to regulate the health insurance sold within its borders - will be found in the present legislation? If anyone has an understanding of the legislation on this point, I would love to know about it. Mike Last edited by fmichael; 03-22-2010 at 12:38 AM. |
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"Thanks for this!" says: | Kakimbo (03-21-2010) |
03-22-2010, 03:22 AM | #22 | |||
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Senior Member
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First of all, instead of a single national insurance exchange, as proposed in the House Bill, both the Senate Bill and the reconciliation version establishes 50 state-administered insurance marketplaces to allow small businesses and people without employer sponsored coverage to buy insurance that meets new federal standards. http://www.aafp.org/online/en/home/p...ormpasses.html and http://www.washingtonpost.com/wp-dyn...031905407.html
Turns out that until the language of the Reconciliation Bill was worked out, my concerns were well founded. Please see the following from the San Jose Mercury News: National health reform could jeopardize California patient protectionshttp://www.mercurynews.com/breaking-news/ci_14051028 But, as it developed, it looks like I needn’t have worried: H.R.4872http://thomas.loc.gov/cgi-bin/query/...5qPS:e1297986: Accordingly, on passage of the Reconciliation Act of 2010 by recorded vote: 220 - 211 (Roll no. 167) at 11:36 pm on March 21, 2010, the House has apparently adopted language that shouts to the courts that, AS A GENERAL MATTER, THERE WILL BE NO PREEMPTION OF STATE LAW, REGULATION AND REMIDIES, except as ERISA preemption already applies. I'll take that. Mike |
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"Thanks for this!" says: | Kakimbo (03-22-2010) |
03-22-2010, 10:51 AM | #23 | |||
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Magnate
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If you go to FoxNews.com and go down to roll call you will see which reps in your state voted for the healthcare. Run off a copy and save it for Nov. Since RSD patients have short term memories this will be a reminder. It goes on my wall until Nov. Least we forget.
I did hear this morning that the pre-existing condition part won't go into effect until 2014 after hearing a Democrat say yesterday it starts imediately. If nothing else, the whole thing is confusing. Ada Last edited by dreambeliever128; 03-22-2010 at 11:12 AM. |
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03-22-2010, 03:07 PM | #24 | ||
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Quote:
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"Thanks for this!" says: | Kakimbo (03-22-2010) |
03-22-2010, 03:46 PM | #25 | |||
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Magnate
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Both my grandson's are planning on going to college. I don't feel like my son-in-law should have to pay for their insurance until they are 26. What responsibility is that teaching them? He is their step-dad and he will do it I am sure and not complain once but it's not right. The way I understand this it's only if they go to college and it is mandated to where they have to carry the insurance, in other words they don't have a choice. So wrong.
Ada |
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03-22-2010, 03:52 PM | #26 | ||
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I believe you are correct Ada. The reason I posted those parts of the bill is apparently it is these issues that will go into effect very quickly.
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03-22-2010, 04:07 PM | #27 | |||
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It's my inderstanding that the bar against excluding children with pre-existing conditions will also take effect six months from either the date the Senate Bill or the date H.R.4872, the Reconciliation Act of 2010, is passed by the Senate and signed into law. (Not sure which, but believe it's the latter.) Which should be just in time for the mid-term elections. I imagine there will be all sort of poster-children enrolled in that time period leading right up to the mid-terms, so that on the eve of the election, the Democrats can and will remind voters that any vote to repeal the legislation will be a vote to take back health insurance from those kids who will by then have it: a well played move, if I may say so. (Or you have to respect if even if you don't like it.) Mike Last edited by fmichael; 03-22-2010 at 09:09 PM. |
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"Thanks for this!" says: | Kakimbo (03-22-2010) |
03-22-2010, 05:05 PM | #28 | |||
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Magnate
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I talked to my sister today. She has 2 daughters that are single Mom's and their kids are already on gov. insurance. It's called Medicaid. I am glad they are able to be on it for them. My thing is if we already have Medicaid, what have they got to brag about. More Medicaid. LOL
Ada |
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03-22-2010, 05:21 PM | #29 | ||
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Check with the college's health center - often they have a bare bones insurance policy that the kids can purchase that's not too expensive.
However, once you have a family policy, it doesn't cost any add'l $$ to add another child. IMHO, it is far safer to keep your kid covered by health insurance until they get a job and can get their own coverage then risk financial disaster by not having any insurance at all. That feature is one of the few things I agree with in this whole fiasco. Check out the polls on MSNBC.com and FoxNews.com. Close to 1,000,000 votes tallied so far - and more than 65% of voters on both sites are NOT in favor of Obamacare. Approx 25% are in favor. No one understands what was really passed - how many political favors or "pork" were buried in that bill? Bummer. I feel like I've been had. Quote:
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"Thanks for this!" says: | Kakimbo (03-22-2010) |
03-22-2010, 05:36 PM | #30 | |||
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The bill(s) offer significant low income subsidies to purchase "real insurance" that is much better than Medicaid. I believe the cut off line is 125% of the federal poverty line, but it may be higher in sime circumstances. That said, it's still not completely free, but it's going to be significantly more affordable. This is by far the most expensive part of the legislation and is paid for by a 1% surcharge on those with an adgusted gross income between $350,000 and $500,000, 1.5% between $500,000 and a million, and 5.4% on the balance of AGI's over a million, effective January 1, 2011, with the 1% and 1.5% marginal rates to rise to 2% and 3%, respectively, effective January 1, 2013. [See, H.R. 4872, Reconciliation Act of 2010 (Reported in House), Sec. 441, SURCHARGE ON HIGH INCOME INDIVIDUALS, amending IRC Sec. 59, availabile at http://thomas.loc.gov by inputting "H.R. 4872" when prompted for "bill number."] Now that's a tax incease! Except technically it's not, because the surcharges don't take effect if certain benchmarks for federal healthcare savings are met, based upon a complicated formula in the proposed statute. So there's a reason the Republican Party doesn't like the bill, to say nothing of the requirement that employers with over 50 employees provide health insurance by 2014. Not a hit with the Chamber of Commerce either. Mike Last edited by fmichael; 03-22-2010 at 10:18 PM. Reason: fixed tyos & found more exact information re changes in marginal "surcharge" rates |
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"Thanks for this!" says: | Kakimbo (03-22-2010) |
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