Health Care Gobbledygook

During these Dog Days of Summer, it's not hard to find something in the Democratic health care bills in Congress that make you shake your head and want to sit by the pool with a cold beverage instead.

Just go to page 17 of the bill that was introduced in the Energy and Commerce Committee in the House, which you can find at http://bit.ly/nSL2A - that is not the amended version approved by that panel.  That is not yet available on line.

So, on page 17, it says:

(B) EXCEPTION FOR LIMITED BENEFITS PLANS. -- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:

(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).

This section deals with a grace period for regular insurance companies to make sure their policy offerings meet certain minimum requirements set out by the feds.

But when you go to Section 3001 of the stimulus law mentioned in subparagraph (i), you better find the right one, because there are a couple.

One of them deals with Health Information Technology, the other is on COBRA insurance, and that's the section being referred to here.

So what exactly does Section 3001(a)(1)(B)(ii)(IV) lay out?  First, let's review what COBRA is.  It's a program that allows workers to continue buying health insurance from through their company plan after getting laid off, or it allows a spouse or children to get benefits if the worker has died or retired.  The cost is paid by the individual, not the company.

This section of the stimulus law would allow people to continue buying their insurance as usual in COBRA, but allow them to choose a different plan offered through the employer than the one originally in use.

But there are three exceptions listed, laying out that the new coverage is not:

"(aa) coverage that provides only dental, vision, counseling, or referral services (or a combination of such services); (bb) a flexible spending arrangement (as defined in section 106(c)(2) of the Internal Revenue Code of 1986); or(cc) coverage that provides coverage for services or treatments furnished in an on-site medical facility maintained by the employer and that consists primarily of first-aid services, prevention and wellness care, or similar care (or a combination of such care)."

So, the way I read this is that if an insurance company offers plans that are like (aa)(bb) and (cc) from the stimulus law, then they don't get any grace period to make them conform to the new standards of insurance care to be issued by the feds?

Does that mean you can't sell just dental insurance? Or just vision insurance? (Does anyone sell just those anyway?)

Does this put in jeopardy so-called "flex spending" accounts? Or am I just being dense and not reading this correctly?

This little two paragraph example from page 17 of the bill is emblematic of why so many people are frustrated about this health reform effort.

I have spent an hour trying to distill this down into something that I can explain on my blog. An hour for less than half of a page in the bill, and I don't understand it.

Read it yourself and let me know what you think.