Subtitle B—Public Health 2 Insurance Option 3 SEC. 221. ESTABLISHMENT AND ADMINISTRATION OF A 4 PUBLIC HEALTH INSURANCE OPTION AS AN 5 EXCHANGE-QUALIFIED HEALTH BENEFITS 6 PLAN. 7 (a) ESTABLISHMENT.—For years beginning with Y1, 8 the Secretary of Health and Human Services (in this sub9 title referred to as the ‘‘Secretary’’) shall provide for the 10 offering of an Exchange-participating health benefits plan 11 (in this division referred to as the ‘‘public health insurance 12 option’’) that ensures choice, competition, and stability of 13 affordable, high quality coverage throughout the United 14 States in accordance with this subtitle. In designing the 15 option, the Secretary’s primary responsibility is to create 16 a low-cost plan without comprimising quality or access to 17 care. 18 (b) OFFERING AS AN EXCHANGE-PARTICIPATING 19 HEALTH BENEFITS PLAN.— 20 (1) EXCLUSIVE TO THE EXCHANGE.—The pub21 lic health insurance option shall only be made avail22 able through the Health Insurance Exchange. 23 (2) ENSURING A LEVEL PLAYING FIELD.—Con24 sistent with this subtitle, the public health insurance 25 option shall comply with requirements that are ap- VerDate Nov 24 2008 23:22 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00116 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS 117 •HR 3200 IH 1 plicable under this title to an Exchange-participating 2 health benefits plan, including requirements related 3 to benefits, benefit levels, provider networks, notices, 4 consumer protections, and cost sharing. 5 (3) PROVISION OF BENEFIT LEVELS.—The pub6 lic health insurance option— 7 (A) shall offer basic, enhanced, and pre8 mium plans; and 9 (B) may offer premium-plus plans. 10 (c) ADMINISTRATIVE CONTRACTING.—The Secretary 11 may enter into contracts for the purpose of performing 12 administrative functions (including functions described in 13 subsection (a)(4) of section 1874A of the Social Security 14 Act) with respect to the public health insurance option in 15 the same manner as the Secretary may enter into con16 tracts under subsection (a)(1) of such section. The Sec17 retary has the same authority with respect to the public 18 health insurance option as the Secretary has under sub19 sections (a)(1) and (b) of section 1874A of the Social Se20 curity Act with respect to title XVIII of such Act. Con21 tracts under this subsection shall not involve the transfer 22 of insurance risk to such entity. 23 (d) OMBUDSMAN.—The Secretary shall establish an 24 office of the ombudsman for the public health insurance 25 option which shall have duties with respect to the public VerDate Nov 24 2008 23:22 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00117 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS 118 •HR 3200 IH 1 health insurance option similar to the duties of the Medi2 care Beneficiary Ombudsman under section 1808(c)(2) of 3 the Social Security Act. 4 (e) DATA COLLECTION.—The Secretary shall collect 5 such data as may be required to establish premiums and 6 payment rates for the public health insurance option and 7 for other purposes under this subtitle, including to im8 prove quality and to reduce racial, ethnic, and other dis9 parities in health and health care. 10 (f) TREATMENT OF PUBLIC HEALTH INSURANCE OP11 TION.—With respect to the public health insurance option, 12 the Secretary shall be treated as a QHBP offering entity 13 offering an Exchange-participating health benefits plan. 14 (g) ACCESS TO FEDERAL COURTS.—The provisions 15 of Medicare (and related provisions of title II of the Social 16 Security Act) relating to access of Medicare beneficiaries 17 to Federal courts for the enforcement of rights under 18 Medicare, including with respect to amounts in con19 troversy, shall apply to the public health insurance option 20 and individuals enrolled under such option under this title 21 in the same manner as such provisions apply to Medicare 22 and Medicare beneficiaries. 23 SEC. 222. PREMIUMS AND FINANCING. 24 (a) ESTABLISHMENT OF PREMIUMS.— VerDate Nov 24 2008 23:22 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00118 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS 119 •HR 3200 IH 1 (1) IN GENERAL.—The Secretary shall establish 2 geographically-adjusted premium rates for the public 3 health insurance option in a manner— 4 (A) that complies with the premium rules 5 established by the Commissioner under section 6 113 for Exchange-participating health benefit 7 plans; and 8 (B) at a level sufficient to fully finance the 9 costs of— 10 (i) health benefits provided by the 11 public health insurance option; and 12 (ii) administrative costs related to op13 erating the public health insurance option. 14 (2) CONTINGENCY MARGIN.—In establishing 15 premium rates under paragraph (1), the Secretary 16 shall include an appropriate amount for a contin17 gency margin. 18 (b) ACCOUNT.— 19 (1) ESTABLISHMENT.—There is established in 20 the Treasury of the United States an Account for 21 the receipts and disbursements attributable to the 22 operation of the public health insurance option, in23 cluding the start-up funding under paragraph (2). 24 Section 1854(g) of the Social Security Act shall 25 apply to receipts described in the previous sentence VerDate Nov 24 2008 23:22 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00119 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS 120 •HR 3200 IH 1 in the same manner as such section applies to pay2 ments or premiums described in such section. 3 (2) START-UP FUNDING.— 4 (A) IN GENERAL.—In order to provide for 5 the establishment of the public health insurance 6 option there is hereby appropriated to the Sec7 retary, out of any funds in the Treasury not 8 otherwise appropriated, $2,000,000,000. In 9 order to provide for initial claims reserves be10 fore the collection of premiums, there is hereby 11 appropriated to the Secretary, out of any funds 12 in the Treasury not otherwise appropriated, 13 such sums as necessary to cover 90 days worth 14 of claims reserves based on projected enroll15 ment. 16 (B) AMORTIZATION OF START-UP FUND17 ING.—The Secretary shall provide for the re18 payment of the startup funding provided under 19 subparagraph (A) to the Treasury in an amor20 tized manner over the 10-year period beginning 21 with Y1. 22 (C) LIMITATION ON FUNDING.—Nothing in 23 this section shall be construed as authorizing 24 any additional appropriations to the Account, 25 other than such amounts as are otherwise pro- VerDate Nov 24 2008 23:22 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00120 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS 121 •HR 3200 IH 1 vided with respect to other Exchange-partici2 pating health benefits plans.

You may find the content of HR 3200 here.

The media outlets on the "left", in general, just as those on the "right" are spending their resources reporting the "ground game", as TPM put it on its front page a few days ago.

Have you read any reporting here or at other "left" leaning media outlets which made an effort at explaining the content of the prevailing "reform" proposals? I haven't.

Getting all lathered up about folks carrying weapons outside of town hall meetings and Tom Delay's latest inanities is apparently more satisfying than is equipping TPM readers with facts with which to combat the lies of the desperate opponents to health insurance reform.

The lurid sells better than does the informative, as apparently TPM folks have discerned.

How much has been published here at TPM relative to the content of the legislation? None that I recall. Likewise with almost all other outlets.

If one wishes to make money in a "news" deliver business one must ultimately descend to appealing to the lowest common denominator to maximize its reader or viewership.

I'm guessing the 6% is roughly the same as the portion of the voting age population that rode the black helicopter; the Clintons killed Vince Foster; stop the UN; Roosevelt, Truman, Kennedy, and Johnson were communists, and etc. hobby horses.

They certainly receive an inordinate amount of media coverage, both from the old and new media, including here at TPM.

Why should I visit TPM when almost every other media outlet is coverage the "horse race" rather than the matter at hand?

Is this bill going to euthanize my grandmother? What are we talking about here?

In the health-care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that's because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia "durable power of attorney," you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you're unable to make those decisions.

This has been an issue for 35 years. All 50 states now have either durable powers of attorney or end-of-life directives and it's to protect children or a spouse from being put into a situation where they have to make a terrible decision as well as physicians from being put into a position where they have to practice defensive medicine because of the trial lawyers. It's just better for an individual to be able to clearly delineate what they want done in various sets of circumstances at the end of their life.

How did this become a question of euthanasia?

I have no idea. I understand -- and you have to check this out -- I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as [euthanasia] that is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.

And if you wish you may read the "death panel" provisions of HR 3200 here.

The is no provision which compels anyone to undergo "Advanced Care Planning Consultation". Such consultations are between “between the individual and a practitioner described in paragraph (2)“.

‘(2) A practitioner described in this paragraph is –

‘(A) a physician (as defined in subsection (r)(1));

‘(B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments.

I can't tell you how disappointed I am to learn the Obama drank Bud Light. The swill shouldn't be permitted to be called beer.

Also wouldn't be surprised if we weren't being baited by the AP Washington bureau--no friends of health care, Democrats, or responsible journalism they.

Nor do you, if I'm understanding your rather incoherent comment correctly.

I am simply stating my opinion as to TPM editorial policy. You don't agree.

BFD

Really? A politician copping to an affair. Yeah, really big story. John Ensign is really happy right now.

If that's the purpose, fine.

Not at all. There is however, investigations, such as which spawned TPM and gained the first ever journalism award to an online news organization.

What's the point of simply reporting what the traditional media and hundreds of other web based news and commentary sites are reporting?

I think the question is, "what is the purpose of TPM"? It seems, since the Nov. election, to be straying from its original, at least as I have understood it, noble and informative purposes.

I wish to make it completely clear that I greatly value what TPM has produced and achieved, and hope future journalistic awards for its efforts.

It's getting increasingly tabloidish.

This is the entity which, collaborating with it's devoted readers, earned a Polk Award for doing significant original reporting by digging up and attaching legs to the Attorneys General firings story.

A simple mention of the Sandford story in the news wire, and its updates, would do just fine, but still would be nothing more than has been reported in hundreds of other outlets.

I'm very sorry to say it, but TPM is becoming pedestrian.

A taste

“Lebanon is a telling case,” said Osama Safa, director of the Lebanese Center for Policy Studies here. “It is no longer relevant for the extremists to use the anti-American card. It does look like the U.S. is moving on to something new.”

In fact, some analysts said that it was possible that Lebanon’s election could be a harbinger of Friday’s presidential race in Iran, where a hard-line anti-American president, Mahmoud Ahmadinejad, may be losing ground against his main moderate challenger, Mir Hussein Moussavi.

While President Ahmadinejad has grown unpopular for many reasons, including his troubled stewardship of the economy, political analysts said that President Obama has blunted the appeal of Mr. Ahmadinejad’s confrontation with the West.