Health Reform Updates

[Herbert Hoover]

Shifting into high gear.

Overheard @: Consumers would ‘flock to public plan in droves’
Posted July 15, 2009 by By Bruce Shutan at 08:00AM. Comments (0)

A Lewin Group study estimates that 119 million Americans would trade their private health insurance for a public option if reimbursement rates are similar to Medicare. The figure amounts to 70% of 171.6 million people with non-group or private employer coverage.


Families on average would save about $2,500 a year and, thus, flock to a public plan in droves, observes John Sheils, the Falls Church, Va.-based firm’s vice president.


James Klein, president of health care reform for the American Benefits Council in Washington, D.C., doubts that a level playing field is possible for employer plans if a public plan is subject to a different set of rules governing taxable income and physician rates. The chief concern is that such an arrangement would exacerbate the cost shift to private payers, which has occurred with Medicare.


“How can the government be both the referee and player on the field at the same time?” he asks rhetorically. America’s Health Insurance Plans and the Blue Cross Blue Shield Association blasted the public plan option in a recent letter to senators.


One clear conceptual problem is that many public health plan advocates are stressing the need to base any action on current insurance market flaws when Klein says even the insurance industry acknowledges a need for massive reforms.


His larger point is that there’s no need to reinvent the wheel when all lawmakers need to do is simply reform the current system. Those steps include enacting consumer protections to eliminate pre-existing condition exclusions and medical underwriting, as well as champion guaranteed issue and renewability.


President Barack Obama recently told reporters at a White House news conference “if private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business?”


Although his senior adviser David Axelrod has indicated that the commander in chief isn’t likely to abandon his call for a public insurance option, White House Chief of Staff Rahm Emanuel is hoping for bipartisan support on the health care reform issue.


An olive branch has been offered by Sen. Kent Conrad (D-N.D.) who proposed an alternative that would establish private, nonprofit cooperatives that enable individuals and small businesses to pool their resources for affordable health insurance coverage.


Meantime, conflict is brewing over how providers would be paid in a public plan. Hospital rates under Medicare are about 68% of what private plans pay for the same service, while physician payments are about 81%, Sheils notes. He says the income of physicians in hospitals, who typically can’t afford to turn away Medicare patients, could fall anywhere between $16,000 and $45,000 a year under various proposals.


Lawmakers are considering paying physicians at the Medicare rate, plus an additional 10%, though Sen. Charles Schumer (D-N.Y.) has called for parity in any such rate structure – a scenario under which the Lewin Group predicts only up to 12 million people would move to a public plan.

http://ebn.benefitnews.com/blog/dail...2681310-1.html

[Herbert Hoover]

Lobbyists coming to Washington in droves.

Tip of the Day: Watch out! Brokers descending on D.C.

Posted July 13, 2009 by By Bruce Shutan at 01:00PM. Comments (0)

About 600 licensed insurance agents and brokers from five producer associations will descend on Capitol Hill July 14 to 15 as part of a massive health care reform lobbying effort on behalf of the employee benefits industry.


Key players include the Independent Insurance Agents & Brokers of America, which calls itself the Big “I,” AHIA, the health and employee benefits arm of the National Association of Insurance and Financial Advisors, Council of Insurance Agents & Brokers (CIAB), National Association of Health Underwriters and National Association of Insurance and Financial Advisors.


The groups are seeking provisions to the Senate Committee on Health, Education, Labor and Pensions’ (HELP) bill dictating who would be able to sell health insurance through the so-called gateways or insurance exchanges that would be created.
Considering that presidential aide Nancy-Ann DeParle and Health and Human Services Secretary Kathleen Sebelius believe insurance brokers add unnecessary costs to the nation’s health care system, the groups have their work cut out for them.


“We just want to educate lawmakers and their staffs about how a public plan would undermine the private system and make sure that everyone understands the role that brokers play in the current system and value we bring to the table,” says Joel Kopperud, CIAB’s director of government relations.


The chief objective is to convince lawmakers that the private sector is best suited to help them identify wasteful spending and reduce the nation’s soaring health care tab, which accounts for 17% of gross domestic product and is expected to reach 20% by 2017.


“We think there should be affordable options for people, and by that we mean there are too many mandates that carriers must provide particular coverages that some people just don’t want or need and don’t want to pay for,” explains AHIA President-Elect Bill Foudy, who also runs Foudy Insurance Agencies, Inc. in Los Angeles.


Among the reforms being supported: an individual mandate forcing everyone to buy health insurance, guaranteed issue, portability, community rated insurance pools for groups of fewer than 50 people, health insurance exchanges that expand access to care for the unemployed, self-employed or uninsured, and tort reform that would effectively end defensive medicine by capping malpractice claims.


Foudy says the trouble with an individual mandate is enforcement, noting how difficult it already is for states to force motorists to buy auto insurance alongside annual car registrations and occasional license renewals. It’s at a point where “people with auto insurance also buy uninsured motorist coverage to protect them from the people that are driving without auto insurance,” he observes.


A key strategy for the groups will be to show that they’re not trying to obstruct health care reform, want to improve competition in the private marketplace and promote a fair solution for consumers.


“We believe that it’s absolutely necessary to keep costs under control both for the economy and for the industry, but also need to express our concern about the direction things are going given the speed of the debate,” notes John Prible, the Big I’s assistant vice president for federal government affairs.

http://ebn.benefitnews.com/blog/dail...2681307-1.html

[Herbert Hoover]

Dems pledge to pass reform before the break. House bill would make health care a right.

Democrats push healthcare reform

President Obama has made healthcare reform a priority
Democrats in the US have unveiled their healthcare proposals, pledging to meet President Obama's goal of passing legislation before their August break.

The plan from Democrats in the House of Representatives would make healthcare a right for all Americans.

The scheme is estimated to cost more than $1 trillion (£0.6 trillion) and medical providers, employers and the wealthy would pay much of that.

Mr Obama said the US had no choice but to change a "broken system".

In the House of Representatives, the chairman of the Energy and Commerce committee, Democrat Henry Waxman of California, said:

"We cannot allow this issue to be delayed. We cannot put it off again.

"We, quite frankly, cannot go home for a recess unless the House and the Senate both pass bills to reform and restructure our healthcare system."

In the Senate, the Democratic Senate Majority Leader Harry Reid said he wanted debate to begin a week from Monday.

With the Senate Finance Committee still struggling to reach consensus, that timetable could slip. But talk of deadlines suggests a new sense of urgency, correspondents say.

President Obama himself has brought the issue into focus, deviating from prepared remarks to discuss healthcare during a speech in Michigan.

He has scheduled a Rose Garden news conference for Wednesday to make more comments on the subject.

"There's going to be a major debate over the next three weeks," President Obama said in Warren, Michigan.

"And don't be fooled by folks trying to scare you saying we can't change the healthcare system. We have no choice but to change the healthcare system because right now it's broken for too many Americans."

President Obama wants both houses to pass legislation before the August recess to slow rising costs and extend coverage to some 50 million Americans without insurance.

Affordable insurance

Some key points of the House Democrats' plan are:

• The federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan
• Individuals and employers would have new obligations to get coverage, or face hefty penalties
• There would be a 5.4% tax increase on individuals making more than $1m a year, with a gradual tax beginning at $280,000 for individuals
• Employers who do not provide coverage would be hit with a penalty equal to 8% of workers' wages, with an exemption for small businesses
• Individuals who decline an offer of affordable coverage would pay 2.5% of their incomes as a penalty, up to the average cost of a health insurance plan.

Business opposition

Three House committees will begin voting on the bill on Thursday.

Changes in the legislation may satisfy a group of moderate and conservative Democrats who have so far withheld support, correspondents say.

But the 1,000-page bill is unlikely to attract any Republican backing, and business groups and the insurance industry say it will undermine jobs.

The business groups also warned that the US healthcare system could be damaged by adding a government-run insurance plan and a federal council that would make some decisions on benefits, as called for in the legislation.

Thirty-one organisations signed a letter against the measures, including the US Chamber of Commerce, the Business Roundtable representing top corporate CEOs and the National Retail Federation.

In the Senate, the Health, Education, Labor and Pensions Committee is working to finish its version of the legislation on Wednesday.

The Finance Committee is trying to produce a bill by the end of the week, though the committee's chairman, Democratic Senator Max Baucus of Montana, acknowledged it would be a challenge to meet President Obama's timeline.

http://news.bbc.co.uk/2/hi/americas/8151210.stm

[Herbert Hoover]

Health reform bill passes first major committee.

Committee: Health care overhaul a yes


The Senate Health committee approved a massive health care overhaul bill in a party-line 13-10 vote Wednesday morning, a major step in the push to create a government run health insurance plan.


The committee was the first congressional panel to approve a health bill, but there's still much work to do in the Senate Finance Committee, which is struggling with how to pay for the bill. And the House version of the bill is dramatically different, with a surtax on the wealthy that may be a nonstarter in the Senate.


Still, the partisan passage of the $600 billion health bill in the Senate Health, Education, Labor and Pensions Committee was a landmark moment in the 60-year push by the Democratic Party for national health care. The Senate bill would provide a federal subsidy for health insurance for uninsured people making up to four times the federal poverty level, or nearly $90,000 for a family of four.


The bill made it out of the HELP Committee without Sen. Ted Kennedy (D-Mass.), who continues to recover from brain cancer, yet it was shepherded by his close friend Sen. Chris Dodd (D-Conn.), who chaired the markup.


Republicans on the committee, shut out on one partisan amendment after another, expressed their displeasure at the bill.


"It actually will penalize Americans who have insurance today who are happy with their doctors," said Sen. Richard Burr (R-N.C.). "We're headed in the wrong direction, and unfortunately there are only two numbers you need to remember, and that's 13 and 10" the number of Democrats who voted for and Republicans who voted against the bill.

http://www.politico.com/news/stories...xzz0LLFdirJq&D

[FormLetter]

Good thread idea.

[Herbert Hoover]

Lobbyists preparing for possibility of reconciliation.

Lobbying groups prepare for reconciliation process, step up fight on bill features
14. July 2009 04:50

Lobbyists are beginning to consider how their clients would fare if health reform moves to a reconciliation process to pass legislation, Roll Call reports.
"As the health care debate has grown increasingly partisan, lobbyists say they are taking more seriously the looming possibility of having many reforms added to reconciliation. 'I think almost everyone looks at reconciliation as a last resort,' said John Rother, executive vice president of policy and strategy for the seniors' lobby AARP. 'But we haven't made a lot of progress. Patience is running thin.'" A bill passed by reconciliation would need only 51 Senate votes instead of the filibuster-proof usual 60.

"On the reconciliation track, lobbyists say they are attempting to navigate Senate rules and procedures to figure out what health care items could go - and could not go - with reconciliation. In order to be included in the budget bill, policy measures would have to be scorable by the Congressional Budget Office and would be subject to Senate precedents and the Byrd rule, which prohibits 'extraneous matter' on reconciliation bills."

"The key question is what would be included under reconciliation and what would be the status of pre-existing industry deals, such as one struck with pharmaceutical companies that would reportedly raise $80 billion in revenue over 10 years or one with hospitals that agreed to take a $155 billion hit over a decade. Lobbyists with pharmaceutical and hospital clients said it's unclear for now what would happen to those deals, especially because budget reconciliation rules cover only a five-year period" (Ackley, 7/13).

Other lobbyists are concerned that the pharmaceutical and hospital cuts won't cut costs at all, but could make the problem worse, the Los Angeles Times reports: "Both (Senate and House) bills would create a government insurance program that senior Democrats say could pressure providers to lower costs. What is missing, critics contend, are bolder initiatives in the existing Medicare and Medicaid programs to reward doctors and hospitals that become more efficient -- and cut federal payments to those that do not. … Even the recent agreement between hospitals and the administration to cut federal payments to hospitals by $155 billion over the next decade does little to change the way providers are paid, said Mark McClellan, who headed the Centers for Medicare & Medicaid Services under the Bush administration. Nearly all these projected savings would come from cuts in federal reimbursements, which critics fear could prompt hospitals to simply charge private insurers more" (Levey, 7/13).

Some groups still pushing include:

The National Retail Federation "is launching a broad attack" against Wal-Mart's endorsement of an employer mandate to cover employees, the Wall Street Journal reports: "The National Retail Federation plans to send an aggressively worded letter Monday to its members encouraging them to take a stand against Wal-Mart's backing of an employer-health-care mandate. The federation is the primary lobbyist for the retail industry, which comprises 1.6 million businesses and employs roughly one in five working Americans. Wal-Mart isn't a member of the group" (Bustillo and Adamy, 7/13).

The Biotech industry "is moving closer to victory" in regard to legislation addressing generic drug competition, according to another story from the Wall Street Journal: "The Senate Health, Education, Labor and Pensions Committee will be looking at a bill this week that would grant so-called biologic drugs -- those engineered from living cells -- made by companies like Amgen Inc. a total of 13½ years of intellectual-property protection, which is about twice the length of time proposed by the White House" (Mundy, 7/13).

Grassroots, pro-reform groups are making their opinions known, according to the Columbus Dispatch: "With health-care reform a top priority of the Obama administration, insurance companies, drug- and device-makers, hospitals, medical groups and others are vying for a say in the policymaking. But so are individuals such as (self-employed contractor David) Cress, who are working at a grass-roots level. (Because of his medical bills), (h)e was invited by ABC News to be in the audience a couple of weeks ago at a health-care forum at the White House that was hosted by President Barack Obama. Cress is collecting health-care stories from other people and sending them to members of Congress" (Hoholik, 7/11).

Even hip-hop performers are putting in their two cents, according to the Chicago Tribune: "You don't normally think of rap stars as having much to do with Washington's health care debate. … But, even rappers get older, if they're lucky. Bodies begin to give out, doctor bills begin to pile up and suddenly that health care debate hits home. 'Normally I find it kind of hard being a part of things like this,' said hip-hop artist Malik Taylor, better known as 'Phife' or 'Phife Dawg' from the Billboard award-winning rap group A Tribe Called Quest. True that. 'This' was a health care round table co-sponsored by the New York-based Hip-Hop Theater Festival, which is something that is in town this week besides Congress" (Page, 7/11).

http://www.news-medical.net/news/200...-features.aspx

[Herbert Hoover]

SIIA update:

SIIA Legislative Update – Healthcare Reform July 14, 2009
Information Disclaimer Note: Congressional developments regarding health care reform are fluid and SIIA lobbyists are continually meeting with Members of Congress, key staff members and other industry stakeholders, which generate ongoing intelligence. In order to keep our members informed in “real time”, we will report relevant information as we become aware of it. Given that the political process is inherently unpredictable, information communicated in previous reports may be superseded in subsequent reports. Should you have any questions in between reports, please contact SIIA’s Washington, DC office directly at 202/463-8161.


House Leadership Releases Healthcare Reform Proposal Harmful to Employer-System and Private Market

SIIA’s Government Relations Staff moments ago received a copy of the legislative text of the House Democrats’ healthcare reform proposal to be formally introduced later this afternoon. The reform package seeks to inject significant government involvement in our nation’s healthcare system and many of the proposals would have devastating effects for the self-insurance industry, the Employer-Based Healthcare System and the private healthcare marketplace as a whole. The proposal includes provisions to have a government definition of acceptable benefits, government control over provider reimbursement rates, coverage mandates on individuals and businesses and numerous and burdensome tax increases on businesses and workers to pay for this massive overhaul of our nation’s healthcare system.

Formal consideration by one or all of the 3 House Committees of jurisdiction could start as early as tomorrow morning. This would give Members of Congress less than 24 hours to read-through, understand and formulate positions on a bill that’s over 1000 pages of complex legislative text – and a proposal that would be a complete restructuring of over 1/7th of our nation’s economy. Also, this incomprehensible short amount of time between language release and formal consideration gives the American public absolutely no opportunity to review the provisions and comment to their Federal elected-officials.

Unfortunately, this proposal runs counter to President Obama’s healthcare reform pledges; preservation of the employer-system, the ability to keep the coverage you like; and no new taxes on the middle-class.

The following is an initial summary of the provisions that would directly impact the self-insurance industry and the employer-based system:

· Insurance Market Reforms:

• Prohibits the application of preexisting conditions
• Guaranteed issue
• Rating rules
• Minimum “essential” benefits package – defined by bureaucrats of the proposed Benefits Advisory Committee
• Prohibition of cost-sharing for preventative services

· National Health Insurance Exchange:

• Within 3 years of enactment, employers of all sizes will be allowed to enter Exchange
• Bureaucrat defined level of benefits
• Employees of Exchange participating employers allowed to choose any Exchange plan
• Grandfathered Exchange eligibility for individuals (once eligible, continue to be so even if circumstances change)

· Government-Run Insurance Plan:

• Government-run and subsidized plan as a National Exchange option
• Provide bureaucrat defined benefits
• Tax-payer subsidized funding for initial administrative costs – advantage over private plans
• Bureaucrat controlled provider reimbursement rates – Medicare + 5% rates
• Tax-payer provided subsidies for Exchange participation for workers with up to $88,000 in income – (Subsidies prohibited for participation in employer-sponsored plans)

· Individual Coverage Mandate:

• Individuals required to obtain government-approved healthcare coverage
• Non-compliance penalty – 2.5% of income

· Employer Coverage Mandate:

• Mandates that employers offer their employees healthcare coverage
• Bureaucrat defined “acceptable coverage”
• Mandates minimum premium cost-sharing – 72.5% for individual coverage, 65% for family coverage
• Non-compliance penalty – 8% of the average salary times the number of full-time equivalent workers

· Tax on Self-Insured Health Plans:
Proposed per-capita tax on all self-insured health plans to fund the proposed Comparative Effectiveness Research Trust Fund – A government-controlled entity tasked with determining what treatments are not acceptable for insurance coverage

· Mandated Self-Insurance Health Plan Study to Determine:

• Types of employers by characteristics that self-insure verses full-insure
• The similarities and differences between self-insured and fully-insured plans
• The financial solvency and reserve levels of self-insured plans
• The risk of self-insured plans not being able to pay obligations
• Rating rules that encourage adverse selection or encourage small and mid-size employers to self-insure
• Requires a report to be submitted by the newly-created Health Choices Commissioner to make recommendations to ensure against incentives for small and mid-size employers to self-insure

SIIA Urges the Self-Insurance Industry to Make our Message Heard
SIIA urges all those in the self-insurance industry interested in preserving the way we do business and the benefits we provide to 75 million Americans covered by self-insured plans, to use the resources provided in SIIA’s Grassroots Toolkit and contact their Members of Congress to voice our message.

The threat to the self-insurance industry and the employer-based system under which we operate in has never been more significant. Now is the time to voice our powerful and unified voice to politicians in Washington that we will not stand for any proposals that would cause significant damage to our industry and to those lives we cover.

[Herbert Hoover]

SIIA update

SIIA Legislative Update – Healthcare Reform July 15, 2009
Information Disclaimer Note: Congressional developments regarding health care reform are fluid and SIIA lobbyists are continually meeting with Members of Congress, key staff members and other industry stakeholders, which generate ongoing intelligence. In order to keep our members informed in “real time”, we will report relevant information as we become aware of it. Given that the political process is inherently unpredictable, information communicated in previous reports may be superseded in subsequent reports. Should you have any questions in between reports, please contact SIIA’s Washington, DC office directly at 202/463-8161.


House Reform Bill Proposes Provisions Harmful to Self-Insurance
As reported by SIIA, yesterday the House Democrat Leadership formally released their healthcare reform proposal. There are many provisions included that would be harmful for the Employer-Based Healthcare System and the private marketplace as a whole. Listed below are descriptions of the provision that would negatively affect self-insurance specifically.

Study of self-insured health plans:

Tucked deep inside the over 1000 page proposal is a provision that would require a study to be done on the Federal level to; compare and contrast self-insured health plans to fully-insured ones, review solvency levels of self-insured plans and determine the risk of self-insured plans to not be able to pay obligations. The study would also require recommendations be presented to “discourage small and mid-size employers from self-insuring”.

The intent of this provision is to clearly find any negative data on self-insurance so that it can be used to limit its use. SIIA’s Government Relations Office immediately contacted the staff of Committee of jurisdiction over this issue (as well as all the Members of it) to express our strong concerns with this section.

SIIA’s formal comments opposing this provision are attached to this email.

Tax on self-insured health plans:

Also included in the proposal is a provision to impose a “fee” on all self-insured health plans. The fee would equal to the “fair share” per-capita amount determined as either a per-life assessment equal to the amount necessary to fund the Comparative Effectiveness Research Trust Fund (proposed as well in this bill) or a set per-life amount increased each year by the percent increased in the medical care component of the Consumer Price Index (CPI).

SIIA’s Government Relations Staff also formally commented our opposition to this provision to the appropriate House Committee and Members of it making the case that it would punish those employers doing “the right thing” by providing their employees healthcare coverage.

SIIA’s formal comments opposing this provision are attached to this email.


Senate Committee Finishes Formal Health Reform Consideration
The Senate Health, Education Labor and Pensions (HELP) Committee moments ago finished its almost 3 week consideration of its version of healthcare reform – passing its bill by a party-line vote. HELP’s bill is the first version to be formally completed by a Congressional Committee.

The HELP bill proposes a government-run healthcare plan as part of a larger Health Insurance Exchange (referred to as a “Gateway”), a mandate on employers to offer coverage, (with the ability for employers of any size to enter the Gateway) a mandate for individuals to obtain coverage and insurance market reforms.

As drafted, it would be very difficult for the employer-system and the private marketplace as a whole to be sustained as if enacted, there would be a significant takeover of our national healthcare system by the Federal government.


Upcoming Healthcare Reform Schedule
The House Education and Labor Committee will begin its Committee markup today and is expected to go through at least tomorrow.

The House Committee on Ways and Means will begin its Committee markup tomorrow and is expected to go through at least Friday.

The House Energy and Commerce Committee will begin its Committee markup tomorrow and is expected to go through at least next Wednesday.

It is possible that the Senate Finance Committee could have language to release as early as the end of this week, but next week is more likely. It is also possible, depending on when language is released, that they could begin their markup by the end of next week.


SIIA Urges the Self-Insurance Industry to Make our Message Heard
SIIA urges all those in the self-insurance industry interested in preserving the way we do business and the benefits we provide to 75 million Americans covered by self-insured plans, to use the resources provided in SIIA’s Grassroots Toolkit and contact their Members of Congress to voice our message.

The threat to the self-insurance industry and the employer-based system under which we operate in has never been more significant. Now is the time to voice our powerful and unified voice to politicians in Washington that we will not stand for any proposals that would cause significant damage to our industry and to those lives we cover.

[Brad Gile]

Originally Posted by FormLetter

Good thread idea.

I agree. Good work, HH.

[Werewolf]

House bill will trap individual insureds in the public option once elected, and will effectively destroy individual insurance.

http://www.ibdeditorials.com/IBDArti...32548165656854

Congress: It didn't take long to run into an "uh-oh" moment when reading the House's "health care for all Americans" bill. Right there on Page 16 is a provision making individual private medical insurance illegal.

When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.

It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of "Protecting The Choice To Keep Current Coverage," the "Limitation On New Enrollment" section of the bill clearly states:

"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.

So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won't be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.

From the beginning, opponents of the public option plan have warned that if the government gets into the business of offering subsidized health insurance coverage, the private insurance market will wither. Drawn by a public option that will be 30% to 40% cheaper than their current premiums because taxpayers will be funding it, employers will gladly scrap their private plans and go with Washington's coverage.

The nonpartisan Lewin Group estimated in April that 120 million or more Americans could lose their group coverage at work and end up in such a program. That would leave private carriers with 50 million or fewer customers. This could cause the market to, as Lewin Vice President John Sheils put it, "fizzle out altogether."

What wasn't known until now is that the bill itself will kill the market for private individual coverage by not letting any new policies be written after the public option becomes law.

The legislation is also likely to finish off health savings accounts, a goal that Democrats have had for years. They want to crush that alternative because nothing gives individuals more control over their medical care, and the government less, than HSAs.

With HSAs out of the way, a key obstacle to the left's expansion of the welfare state will be removed.

The public option won't be an option for many, but rather a mandate for buying government care. A free people should be outraged at this advance of soft tyranny.

Washington does not have the constitutional or moral authority to outlaw private markets in which parties voluntarily participate. It shouldn't be killing business opportunities, or limiting choices, or legislating major changes in Americans' lives.

It took just 16 pages of reading to find this naked attempt by the political powers to increase their reach. It's scary to think how many more breaches of liberty we'll come across in the final 1,002.

Questions for HH:

Is this feature of the plan in opposition to Obama's campaign promises?
Is this feature of the plan in opposition to how it's being marketed by proponents in Congress?
Is this plan good for actuaries?
Do you still support it?