House passes landmark health care bill

Nurses Activism

Published

philadelphia inquirer

posted on sat, nov. 7, 2009

[color=#005266]house narrowly passes landmark health care bill -

david espo

the associated press

washington - in a victory for president barack obama, the democratic-controlled house narrowly passed landmark health care legislation saturday night to expand coverage to tens of millions who lack it and place tough new restrictions on the insurance industry. republican opposition was nearly unanimous.

the 220-215 vote cleared the way for the senate to begin debate on the issue that has come to overshadow all others in congress.

a triumphant speaker nancy pelosi likened the legislation to the passage of social security in 1935 and medicare 30 years later.

"it provides coverage for 96 percent of americans. it offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it," said rep. john dingell, the 83-year-old michigan lawmaker who has introduced national health insurance in every congress since succeeding his father in 1955.

in the run-up to a final vote, conservatives from the two political parties joined forces to impose tough new restrictions on abortion coverage in insurance policies to be sold to many individuals and small groups. they prevailed on a roll call of 240-194.

ironically, that only solidified support for the legislation, clearing the way for conservative democrats to vote for it.

the legislation would require most americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. large companies would have to offer coverage to their employees. both consumers and companies would be slapped with penalties if they defied the government's mandates.

insurance industry practices such as denying coverage on the basis of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. in a further slap, the industry would lose its exemption from federal antitrust restrictions on price gouging, bid rigging and market allocation....

[color=#005266]key details of democrats' health overhaul bill

the house health care bill passed saturday would:

  • require most americans to purchase health insurance or pay a fine.
  • expand health care coverage to 36 million more people over the next decade.
  • require employers with payrolls above $500,000 to provide insurance to their employees or pay a fine.
  • prohibit insurance companies from denying coverage because of pre-existing medical conditions.
  • end premium disparities between men and women.
  • impose a 5.4 percent income tax surcharge on income above $500,000 annually for individuals and above $1 million annually for households.
  • establish a government-run insurance plan to compete with private insurers beginning in 2013.
  • cost $1.2 trillion over 10 years.
  • cut medicare spending by more than $400 billion over 10 years.

hr3962 bill link:

http://www.gpo.gov/fdsys/search/page...ls-111hr3962ih

go to formats text (2713 kb) | pdf (3438 kb) | xml (3499 kb)

Specializes in Vents, Telemetry, Home Care, Home infusion.

MEDICAID in PA will pay for transport to doctors and dialysis ---one way of making sure that low income patients are able to show up due to limited financial means along with keeping people OUT of hospital beds--- cost effective strategy. We have 3 rural counties with NO doctors. Transport is a big deal when you have no car/no taxis in community.

I know that the house bill means nothing right now, but it does show how out of touch some of the congressmen are. There is a provision in the house bill that would require employers to provide insurance to their employees and pay 75% of the premiums for that insurance. If the employers don't pay, they face a fine. If that provision remains in the final combined bill, it will be devastating to the small businesses in my hometown. The small businesses in my hometown already operate on a very small profit-loss margin. Most of the small businesses would close their doors because they simply couldn't afford to pay the fine or provide insurance.

As far as those that talked about expanding medicaid being a good thing, come to my home state of Illinois. The state is so far behind in its medicaid payments that many nursing homes and clinics are facing bankruptcy. Physicians refuse to accept any new medicaid patients because they are not being paid.

I used to be in nursing management. I sat in meetings talking about the budget and having to charge more for procedures, supplies, and equipment. We raised prices because we were not being paid by medicaid. We couldn't keep on eating the costs of the medicaid patients and keep the doors of the hospitals open. How about we pass some healthcare reform that would require states to pay their medicaid bills. That's reform I would support.

Specializes in Vents, Telemetry, Home Care, Home infusion.

from reading the bill, small employers with less than 100 employees will be able to deduct from taxes 50% of their costs for health coverage.

see

division a—affordable health care choices

subtitle b—credit for small business employee health coverage expenses

pdf pg 317

at our health systems manager inservice for open enrollment benefits, we were informed system checked with local employers --average paying only 75% costs. so they are decreasing from current 85% contribution to 75% over next 3 years. my premiums going up $6.00/month next year.

at least pa medicaid pays the bills if you can worm auth out of them for homecare...they are really being frugal with their expenditures since springtime. however, 100+ day without state budget until october so all payments were placed on hold.

from reading the bill, small employers with less than 100 employees will be able to deduct from taxes 50% of their costs for health coverage.

see

division a--affordable health care choices

subtitle b--credit for small business employee health coverage expenses

pdf pg 317

i have not sat down and read the whole bill. i don't have to time to read 1990 pages of legal language and sections that refer back to previously passed legislation. the small businesses i was referring to in my previous post, do not offer insurance to their employees. they can't afford to. according to the house bill, they either have to or they will be fined. they can't afford the fine. they can't afford to start offering insurance benefits even if they get a tax credit. tax credits do nothing to offset the up front costs of insurance. the small businesses in my area are doing good if they break even at the end of the month.

Well, that was certainly a helpful reply. I was talking about our particular situation. We have put in over a dozen requests over the last few years and every one was turned down. Our congessman's office said no go. The local Social Security office has told us that Medicare will not pay for transportation.

If you know something else to try why not share it?

I've told you all I know about it. Could be a state issue. The post just after your post I'm quoting gives more info. The patient I sign for couldn't get transportation because he lives outside the bus or local transportation progrm. I suppose it's cheaper for Medicare to pay for transport than acute dialysis in the hospital plus the cost of the hospital stay.

HD clinics are working harder to keep patients out of the hospital. That is revenue driven, yes. But it's good for the patients too. Hospitals can cause more problems. I'm doing acutes now in the hospital and just about every patient we have now have acquired C-diff a few days after admission.

Maybe you aren't rural and have public transportation available and that's why you can get re-imbursement

Specializes in Critical care, tele, Medical-Surgical.
I've told you all I know about it. Could be a state issue. The post just after your post I'm quoting gives more info. The patient I sign for couldn't get transportation because he lives outside the bus or local transportation progrm. I suppose it's cheaper for Medicare to pay for transport than acute dialysis in the hospital plus the cost of the hospital stay.

HD clinics are working harder to keep patients out of the hospital. That is revenue driven, yes. But it's good for the patients too. Hospitals can cause more problems. I'm doing acutes now in the hospital and just about every patient we have now have acquired C-diff a few days after admission.

Maybe you aren't rural and have public transportation available and that's why you can get re-imbursement

Seems like your patients are getting whet they need.

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