SUMMARY AS OF:
3/23/2010--Public Law. (There are 3 other summaries)
(This measure has not been amended since it was passed by the Senate on December 24, 2009.
The summary of that version is repeated here.)
Patient Protection and Affordable Care Act -
Title I: Quality, Affordable Health Care for All Americans -
Subtitle A: Immediate Improvements in Health Care Coverage for All Americans -
(Sec. 1001, as modified by Sec. 10101) Amends the Public Health Service Act to prohibit a health plan ("health plan” under this subtitle excludes any “grandfathered health plan” as defined in section 1251) from establishing lifetime limits or annual limits on the dollar value of benefits for any participant or beneficiary after January 1, 2014.
Permits a restricted annual limit for plan years beginning prior to January 1, 2014.
Declares that a health plan shall not be prevented from placing annual or lifetime per-beneficiary limits on covered benefits that are not essential health benefits to the extent that such limits are otherwise permitted.
this is an indication of continued limitation of benefits for plans which are in existance as of the date of enactment of this entitlement
Prohibits a health plan from rescinding coverage of an enrollee except in the case of fraud or intentional misrepresentation of material fact.
Requires health plans to provide coverage for, and to not impose any cost sharing requirements for:
- (1) specified preventive items or services;
- (2) recommended immunizations; and
- (3) recommended preventive care and screenings for women and children.
Requires a health plan that provides dependent coverage of children to make such coverage available for an unmarried, adult child until the child turns 26 years of age.
Requires the Secretary of Health and Human Services (HHS) to develop standards for health plans to provide an accurate summary of benefits and coverage explanation.
Directs each health plan, prior to any enrollment restriction, to provide such a summary of benefits and coverage explanation to:
- (1) the applicant at the time of application;
- (2) an enrollee prior to the time of enrollment or re-enrollment; and (3) a policy or certificate holder at the time of issuance of the policy or delivery of the certificate.
Requires group health plans to comply with requirements relating to the prohibition against discrimination in favor of highly compensated individuals.
Requires the Secretary to develop reporting requirements for health plans on benefits or reimbursement structures that:
- (1) improve health outcomes;
- (2) prevent hospital re-admissions;
- (3) improve patient safety and reduce medical errors; and
- (4) promote wellness and health.
Requires a health plan to:
- (1) submit to the Secretary a report concerning the ratio of the incurred loss (or incurred claims) plus the loss adjustment expense (or change in contract reserves) to earned premiums; and
- (2) provide an annual rebate to each enrollee if the ratio of the amount of premium revenue expended by the issuer on reimbursement for clinical services provided to enrollees and activities that improve health care quality to the total amount of premium revenue for the plan year is less than a 85% for large group markets or 80% for small group or individual markets.
Requires a health plan to implement an effective process for appeals of coverage determinations and claims.
more bureaucracy and paper work for Health Care providers which means more cost, someone has to pay for the additional regulation requirements
Sets forth requirements for health plans related to:
- (1) designation of a primary care provider;
- (2) coverage of emergency services; and
- (3) elimination of referral requirements for obstetrical or gynecological care.
(Sec. 1002) Requires the Secretary to award grants to States for offices of health insurance consumer assistance or health insurance ombudsman programs.
from personal experience, these persons usually will afford you lip-service to you about your problem you are experiencing but when It comes to actual assistance, I have witnessed those who did have an impact but mostly they did not, remember this, we pay their salary from tax monies - more bureaucracy
(Sec. 1003, as modified by Sec. 10101) Requires the Secretary to establish a process for the annual review of unreasonable increases in premiums for health insurance coverage.
government deciding how much you will be paying for your policy which is not an efficient system
(Sec. 1004) Makes this subtitle effective for plan years beginning six months after enactment of this Act, with certain exceptions.
Subtitle B: Immediate Actions to Preserve and Expand Coverage -
(Sec. 1101) Requires the Secretary to establish a temporary high risk health insurance pool program to provide health insurance coverage to eligible individuals with a preexisting condition. Terminates such coverage on January 1, 2014, and provides for a transition to an American Health Benefit Exchange (Exchange).
High cost - not much better than what they presently have..
(Sec. 1102, as modified by Sec. 10102) Requires the Secretary to establish a temporary reinsurance program to provide reimbursement to participating employment-based plans for a portion of the cost of providing health insurance coverage to early retirees before January 1, 2014.
(Sec. 1103, as modified by Sec. 10102) Requires the Secretary to establish a mechanism, including an Internet website, through which a resident of, or small business in, any State may identify affordable health insurance coverage options in that State.
(Sec. 1104) Sets forth provisions governing electronic health care transactions. Establishes penalties for health plans failing to comply with requirements.
this is going to affect costs and availability of services, possible closures of facilities for non-expeditious compliance
(Sec. 1105) Makes this subtitle effective on the date of enactment of this Act.
Subtitle C: Quality Health Insurance Coverage for All Americans -
Part I: Health Insurance Market Reforms -
(Sec. 1201, as modified by Sec. 10103) Prohibits a health plan ("health plan” under this subtitle excludes any “grandfathered health plan” as defined in section 1251) from:
- (1) imposing any preexisting condition exclusion; or
- (2) discriminating on the basis of any health status-related factor. Allows premium rates to vary only by individual or family coverage, rating area, age, or tobacco use.
- (1) accept every employer and individual in the State that applies for coverage; and
- (2) renew or continue coverage at the option of the plan sponsor or the individual, as applicable.
Sets forth provisions governing wellness programs under the health plan, including allowing cost variances for coverage for participation in such a program.
good intentions but this will probably have unintented consquences
Prohibits a health plan from discriminating with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law.
Requires health plans that offer health insurance coverage in the individual or small group market to ensure that such coverage includes the essential health benefits package. Requires a group health plan to ensure that any annual cost-sharing imposed under the plan does not exceed specified limitations.
How do you think this will affect cost??
Prohibits a health plan from:
- (1) applying any waiting period for coverage that exceeds 90 days; or
- (2) discriminating against individual participation in clinical trials with respect to treatment of cancer or any other life-threatening disease or condition.
Part II: Other Provisions -
(Sec. 1251, as modified by Sec. 10103) Provides that nothing in this Act shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on the date of enactment of this Act. Allows family members of individuals currently enrolled in a plan to enroll in such plan or coverage if such enrollment was permitted under the terms of the plan. Allows new employees and their families to enroll in a group health plan that provides coverage on the date of enactment of this Act.
How do you think this is going to affect individual employers overhead cost structure
Defines a "grandfathered health plan" as a group health plan or health insurance coverage in which an individual was enrolled on the date of enactment of this Act.
this statement is where they are getting the claim 'if you like wha tyou have you can keep it [for now! - wait unitl 2104 and afterwards to see if this still applies]
States that this subtitle and subtitle A shall not apply to:
- (1) a group health plan or health insurance coverage in which an individual was enrolled on the date of enactment of this Act, regardless of whether the individual renews such coverage after such date of enactment;
- (2) an existing group health plan that enrolls new employees under this section; and
- (3) health insurance coverage maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers that was ratified before the date of enactment of this Act until the date on which the last of the collective bargaining agreements relating to the coverage terminates.
Applies provisions related to uniform coverage documents and medical loss ratios to grandfathered health plans for plan years beginning after enactment of this Act.
(Sec. 1252) Requires uniform application of standards or requirements adopted by States to all health plans in each applicable insurance market.
Federal Government telling the State Insurance Commissioners what benefits the providers in each State will have to have, violates individual State Sovreignity under US Constitution!
(Sec. 1253, as added by Sec. 10103) Directs the Secretary of Labor to prepare an annual report on self-insured group health plans and self-insured employers.
down side of this can very well be the Federal Government requiring more and more coverage on those businesses and entities, which will increase cost to the participants, thus forcing them into a government run 'health care program'
(Sec. 1254, as added by Sec. 10103) Requires the HHS Secretary to conduct a study of the fully-insured and self-insured group health plan markets related to financial solvency and the effect of insurance market reforms.
WELL, how much financial infomation are they going to require from these entities?? IS the Federal Government going to decide who is allowed to continue in the market??
(Sec. 1255, as modified by Sec. 10103) Sets forth effective dates for specified provisions of this subtitle.
Subtitle D: Available Coverage Choices for All Americans -
Part I: Establishment of Qualified Health Plans -
(Sec. 1301, as modified by Sec. 10104) Defines "qualified health plan" to require that such a plan provides essential health benefits and offers at least one plan in the silver level at one plan in the gold level in each Exchange through which such plan is offered.
who is going to define "essential health benefits" - you know who - The Federal Government - Department of Health and Hunman Services.
(Sec. 1302, as modified by Sec. 10104) Requires the essential health benefits package to provide essential health benefits and limit cost-sharing. Directs the Secretary to:
- (1) define essential health benefits and include emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care;
- (2) ensure that the scope of the essential health benefits is equal to the scope of benefits provided under a typical employer plan; and
- (3) provide notice and an opportunity for public comment in defining the essential health benefits.
- (1) an annual limit on cost-sharing beginning in 2014; and
- (2) a limitation on the deductible under a small group market health plan.
Sets forth levels of coverage for health plans defined by a certain percentage of the costs paid by the plan.
Allows health plans in the individual market to offer catastrophic coverage for individuals under age 30, with certain limitations.
(Sec. 1303, as modified by Sec. 10104) Sets forth special rules for abortion coverage, including:
- (1) permitting States to elect to prohibit abortion coverage in qualified health plans offered through an Exchange in the State;
- (2) prohibiting federal funds from being used for abortion services; and
- (3) requiring separate accounts for payments for such services.
Abortion. ------------------------------------------------------------------------------------ 119
- 1. Public funding.---------------------------------------------------------------------------- 119
- No public funds will be used to pay for any abortion, except to save the mother's life.
- 2. Public policy.------------------------------------------------------------------------------119
The policy of Arkansas is to protect the life of every unborn child from conception until birth, to the extent permitted by the Federal Constitution.
[Hyde Amendment long standing law - does not permit funding of abortion other than the same conditions set forth by Arkansas Constitution]
- 3. Effect of amendment.--------------------------------------------------------------------119
This amendment will not affect contraceptives or require an appropriation of public funds.
(Sec. 1304, as modified by Sec. 10104) Sets forth definitions for terms used in this title.
Part II: Consumer Choices and Insurance Competition
Through Health Benefit Exchanges -
Through Health Benefit Exchanges -
(Sec. 1311, as modified by Sec. 10104) Requires States to establish an American Health Benefit Exchange that: [A State establiched but Federal Government controlled entity]
- (1) facilitates the purchase of qualified health plans; and
- (2) provides for the establishment of a Small Business Health Options Program (SHOP Exchange) that is designed to assist qualified small employers in facilitating the enrollment of their employees in qualified health plans offered in the small group market in the State.
Requires the Secretary to establish criteria for the certification of health plans as qualified health plans, including requirements for:
- (1) meeting market requirements; and
- (2) ensuring a sufficient choice of providers.
Sets forth the requirements for an Exchange, including that an Exchange:
- (1) must be a governmental agency or nonprofit entity that is established by a State;
- (2) may not make available any health plan that is not a qualified health plan;
- (3) must implement procedures for certification of health plans as qualified health plans; and
- (4) must require health plans seeking certification to submit a justification of any premium increase prior to implementation of such increase.
Permits States to require qualified health plans to offer additional benefits. Requires States to pay for the cost of such additional benefits.
Allows a State to establish one or more subsidiary Exchanges for geographically distinct areas of a certain size.
Applies mental health parity provisions to qualified health plans.
(Sec. 1312, as modified by Sec. 10104) Allows an employer to select a level of coverage to be made available to employees through an Exchange. Allows employees to choose to enroll in any qualified health plan that offers that level of coverage. Permits States to allow large employers to join an Exchange after 2017.
limitation of customer pool which always drives costs.. and the limitation of choice
(Sec. 1313, as modified by Sec. 10104) Requires an Exchange to keep an accurate accounting of all activities, receipts, and expenditures and to submit to the Secretary, annually, a report concerning such accounting's.
Requires the Secretary to take certain action to reduce fraud and abuse in the administration of this title. Requires the Comptroller General to conduct an ongoing study of Exchange activities and the enrollees in qualified health plans offered through Exchanges.
this is Federal Government, Dep't of Health and Human Services authority to Micro manage & control -
Part III: State Flexibility Relating to Exchanges -
(Sec. 1321) Requires the Secretary to issue regulations setting standards related to:
- (1) the establishment and operation of Exchanges;
- (2) the offering of qualified health plans through Exchanges; and
- (3) the establishment of the reinsurance and risk adjustment programs under part V.
Requires the Secretary to:
- (1) establish and operate an Exchange within a State if the State does not have one operational by January 1, 2014; and
- (2) presume that an Exchange operating in a State before January 1, 2010, that insures a specified percentage of its population meets the standards under this section.
<>(Sec. 1322, as modified by Sec. 10104) Requires the Secretary to establish the Consumer Operated and Oriented Plan (CO-OP) program to foster the creation of qualified nonprofit health insurance issuers to offer qualified health plans in the individual and small group markets.
Requires the Secretary to provide for loans and grants to persons applying to become qualified nonprofit health insurance issuers. Sets forth provisions governing the establishment and operation of CO-OP program plans.
If this is on a National basis this is great but what if only on a State level, not so great
(Sec. 1323, deleted by Sec. 10104)
(Sec. 1324, as modified by Sec. 10104) Declares that health insurance coverage offered by a private health insurance issuer shall not be subject to federal or State laws if a qualified health plan offered under the CO-OP program is not subject to such law.
Part IV: State Flexibility to Establish Alternative Programs -
(Sec. 1331, as modified by Sec. 10104) Requires the Secretary to establish a basic health program under which a State may enter into contracts to offer one or more standard health plans providing at least the essential health benefits to eligible individuals in lieu of offering such individuals coverage through an Exchange. Sets forth requirements for such a plan. Transfers funds that would have gone to the Exchange for such individuals to the State.
Federal Government is setting standards, not the State
(Sec. 1332) Authorizes a State to apply to the Secretary for the waiver of specified requirements under this Act with respect to health insurance coverage within that State for plan years beginning on or after January 1, 2017.
Directs the Secretary to provide for an alternative means by which the aggregate amounts of credits or reductions that would have been paid on behalf of participants in the Exchange will be paid to the State for purposes of implementing the State plan.
only plan years beginning on or after January 1, 2017.
(Sec. 1333, as modified by Sec. 10104) Requires the Secretary to issue regulations for the creation of health care choice compacts under which two or more States may enter into an agreement that:
- (1) qualified health plans could be offered in the individual markets in all such States only subject to the laws and regulations of the State in which the plan was written or issued; and
- (2) the issuer of any qualified health plan to which the compact applies would continue to be subject to certain laws of the State in which the purchaser resides, would be required to be licensed in each State, and must clearly notify consumers that the policy may not be subject to all the laws and regulations of the State in which the purchaser resides. Sets forth provisions regarding the Secretary's approval of such compacts
(Sec. 1334, as added by Sec. 10104) Requires the Director of the Office of Personnel Management (OPM) to:
- (1) enter into contracts with health insurance issuers to offer at least two multistate qualified health plans through each Exchange in each State to provide individual or group coverage; and
- (2) implement this subsection in a manner similar to the manner in which the Director implements the Federal Employees Health Benefits Program. Sets forth requirements for a multistate qualified health plan.
Part V: Reinsurance and Risk Adjustment -
(Sec. 1341, as modified by Sec. 10104) Directs each State, not later than January 1, 2014, to establish one or more reinsurance entities to carry out the reinsurance program under this section.
Requires the Secretary to establish standards to enable States to establish and maintain a reinsurance program under which:
- (1) health insurance issuers and third party administrators on behalf of group health plans are required to make payments to an applicable reinsurance entity for specified plan years; and
- (2) the applicable reinsurance entity uses amounts collected to make reinsurance payments to health insurance issuers that cover high risk individuals in the individual market. Directs the State to eliminate or modify any State high-risk pool to the extent necessary to carry out the reinsurance program established under this section.
(Sec. 1342) Requires the Secretary to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market shall participate in a payment adjusted system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Directs the Secretary to make payments when a plan's allowable costs exceed the target amount by a certain percentage and directs a plan to make payments to the Secretary when its allowable costs are less than target amount by a certain percentage.
(Sec. 1343) Requires each State to assess a charge on health plans and health insurance issuers if the actuarial risk of the enrollees of such plans or coverage for a year is less than the average actuarial risk of all enrollees in all plans or coverage in the State for the year.
Requires each State to provide a payment to health plans and health insurance issuers if the actuarial risk of the enrollees of such plan or coverage for a year is greater than the average actuarial risk of all enrollees in all plans and coverage in the State for the year. Excludes self-insured group health plans from this section.
WELL! consessions to companies such as Walmart!
Subtitle E: Affordable Coverage Choices for All Americans -
Part I: Premium Tax Credits and Cost-sharing Reductions -
Subpart A: Premium Tax Credits and Cost-sharing Reductions -
(Sec. 1401, as modified by section 10105) Amends the Internal Revenue Code to allow individual taxpayers whose household income equals or exceeds 100%, but does not exceed 400%, of the federal poverty line (as determined in the Social Security Act [SSA]) a refundable tax credit for a percentage of the cost of premiums for coverage under a qualified health plan. Sets forth formulae and rules for the calculation of credit amounts based upon taxpayer household income as a percentage of the poverty line.
but as this had been explained to me, the person or family will not receive this 'credit', it actually will be paid directly to teh insurance company,
Directs the Comptroller General, not later than five years after enactment of this Act, to conduct a study and report to specified congressional committees on the affordability of health insurance coverage.
(Sec. 1402) Requires reductions in the maximum limits for out-of-pocket expenses for individuals enrolled in qualified health plans whose incomes are between 100% and 400% of the poverty line.
but would it not stand to reason tha tmore of the cost would be born by us the taxpayer, County, State and Federal or employer?
Subpart B: Eligibility Determinations -
(Sec. 1411) - Requires the Secretary to establish a program for verifying the eligibility of applicants for participation in a qualified health plan offered through an Exchange or for a tax credit for premium assistance based upon their income or their citizenship or immigration status.
Requires an Exchange to submit information received from an applicant to the Secretary for verification of applicant eligibility. Provides for confidentiality of applicant information and for an appeals and redetermination process for denials of eligibility. Imposes civil penalties on applicants for providing false or fraudulent information relating to eligibility.
Here agian, Federal Government control with not local autonomy
Requires the Secretary to study and report to Congress by January 1, 2013, on procedures necessary to ensure the protection of privacy and due process rights in making eligibility and other determinations under this Act.
[Down side of this - Everyone's personal information will be included without your consent. provisions are included in this section]
(Sec. 1412) Requires the Secretary to establish a program for advance payments of the tax credit for premium assistance and for reductions of cost-sharing. Prohibits any federal payments, tax credit, or cost-sharing reductions for individuals who are not lawfully present in the United States.
(Sec. 1413) Requires the Secretary to establish a system to enroll State residents who apply to an Exchange in State health subsidy programs, including Medicaid or the Children's Health Insurance Program (CHIP, formerly known as SCHIP), if such residents are found to be eligible for such programs after screening.
this is the mechanism through which AUTOMATIC enrollment will procede
(Sec. 1414) Requires the Secretary of the Treasury to disclose to HHS personnel certain taxpayer information to determine eligibility for programs under this Act or certain other social security programs.
(Sec. 1415) Disregards the premium assistance tax credit and cost-sharing reductions in determining eligibility for federal and federally-assisted programs.
??? this is not the normal standard where all income sources MUST be counted including tax returns
(Sec. 1416, as added by section 10105) Directs the HHS Secretary to study and report to Congress by January 1, 2013, on the feasibility and implication of adjusting the application of the federal poverty level under this subtitle for different geographic areas in the United States, including its territories.
Part II: Small Business Tax Credit -
(Sec. 1421, as modified by section 10105) Allows qualified small employers to elect, beginning in 2010, a tax credit for 50% of their employee health care coverage expenses.
Defines "qualified small employer" as an employer who has no more than 25 employees with average annual compensation levels not exceeding $50,000. Requires a phase-out of such credit based on employer size and employee compensation.
[But this explanation does not tell you about these very same employers being levied the fines and 'excise' taxes for various compliance reasons]
Subtitle F: Shared Responsibility for Health Care -
Part I: Individual Responsibility -(Sec. 1501, as modified by section 10106) Requires individuals to maintain minimal essential health care coverage beginning in 2014. Imposes a penalty for failure to maintain such coverage beginning in 2014, except for certain low-income individuals who cannot afford coverage, members of Indian tribes, and individuals who suffer hardship. Exempts from the coverage requirement individuals who object to health care coverage on religious grounds, individuals not lawfully present in the United States, and individuals who are incarcerated.
(Sec. 1502) Requires providers of minimum essential coverage to file informational returns providing identifying information of covered individuals and the dates of coverage. Requires the IRS to send a notice to taxpayers who are not enrolled in minimum essential coverage about services available through the Exchange operating in their State.
Part II: Employer Responsibilities -
(Sec. 1511) Amends the Fair Labor Standards Act of 1938 to:
- (1) require employers with more than 200 full-time employees to automatically enroll new employees in a health care coverage and provide notice of the opportunity to opt-out of such coverage; and
- (2) provide notice to employees about an Exchange, the availability of a tax credit for premium assistance, and the loss of an employer's contribution to an employer-provided health benefit plan if the employee purchases a plan through an Exchange.
(Sec. 1513, as modified by section 10106) Imposes fines on large employers (employers with more than 50 full-time employees) who fail to offer their full-time employees the opportunity to enroll in minimum essential coverage or who have a waiting period for enrollment of more than 60 days.
Requires the Secretary of Labor to study and report to Congress on whether employees' wages are reduced due to fines imposed on employers.
(Sec. 1514, as modified by section 10106) Requires large employers to file a report with the Secretary of the Treasury on health insurance coverage provided to their full-time employees. Requires such reports to contain:
- (1) a certification as to whether such employers provide their full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan;
- (2) the length of any waiting period for such coverage;
- (3) the months during which such coverage was available;
- (4) the monthly premium for the lowest cost option in each of the enrollment categories under the plan;
- (5) the employer's share of the total allowed costs of benefits provided under the plan; and
- (6) identifying information about the employer and full-time employees. Imposes a penalty on employers who fail to provide such report.
(Sec. 1515) Allows certain small employers to include as a benefit in a tax-exempt cafeteria plan a qualified health plan offered through an Exchange.
All the above will bring an increased paperwork burden on all States and Employers. which will raise cost of doing business
Subtitle G: Miscellaneous Provisions -
(Sec. 1551) Applies the definitions under the Public Health Service Act related to health insurance coverage to this title.
(Sec. 1552) Requires the HHS Secretary to publish on the HHS website a list of all of the authorities provided to the Secretary under this Act.
(Sec. 1553) Prohibits the federal government, any State or local government or health care provider that receives federal financial assistance under this Act, or any health plan created under this Act from discriminating against an individual or institutional health care entity on the basis that such individual or entity does not provide a health care item or service furnished for the purpose of causing, or assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.
WELL! when will the mercy killings start for the 'less than viable' persons??
(Sec. 1554) Prohibits the Secretary from promulgating any regulation that:
- (1) creates an unreasonable barrier to the ability of individuals to obtain appropriate medical care;
- (2) impedes timely access to health care services;
- (3) interferes with communications regarding a full range of treatment options between the patient and the health care provider;
- (4) restricts the ability of health care providers to provide full disclosure of all relevant information to patients making health care decisions;
- (5) violates the principle of informed consent and the ethical standards of health care professionals; or
- (6) limits the availability of health care treatment for the full duration of a patient's medical needs.
(Sec. 1556) Amends the Black Lung Benefits Act, with respect to claims filed on or after the effective date of the Black Lung Benefits Amendments of 1981, to eliminate exceptions to:
- (1) the applicability of certain provisions regarding rebuttable presumptions; and
- (2) the prohibition against requiring eligible survivors of a miner determined to be eligible for black lung benefits to file a new claim or to refile or otherwise re-validate the miner's claim.
(Sec. 1558) Amends the Fair Labor Standards Act of 1938 to prohibit an employer from discharging or discriminating against any employee because the employee:
- (1) has received a health insurance credit or subsidy;
- (2) provides information relating to any violation of any provision of such Act; or
- (3) objects to, or refuses to participate in, any activity, policy, practice, or assigned task that the employee reasonably believed to be in violation of such Act.
(Sec. 1560) Declares that nothing in this title shall be construed to modify, impair, or supersede the operation of any antitrust laws.
still gives exemption to the Insurance industry against anti-trust
(Sec. 1561) Amends the Public Health Service Act to require the Secretary to:
- (1) develop interoperable and secure standards and protocols that facilitate enrollment of individuals in federal and State health and human services programs; and
- (2) award grants to develop and adapt technology systems to implement such standards and protocols.
(Sec. 1562, as added by Sec. 10107) Directs the Comptroller General to study denials by health plans of coverage for medical services and of applications to enroll in health insurance.
(Sec. 1563, as added by Sec. 10107) Disallows the waiver of laws or regulations establishing procurement requirements relating to small business concerns with respect to any contract awarded under any program or other authority under this Act.
(Sec. 1563 [sic], as modified by Sec. 10107) Makes technical and conforming amendments.
(Sec. 1563 [sic]) Expresses the sense of the Senate that:
- (1) the additional surplus in the Social Security Trust Fund generated by this Act should be reserved for Social Security; and
- (2) the net savings generated by the CLASS program (established under Title VIII of this Act) should be reserved for such program.
To Be Continued:
Title II: Role of Public Programs -
Subtitle A: Improved Access to Medicaid -