Posted on 03/22/2017 4:39:24 PM PDT by MaxistheBest
BREAK: House leadership now open to changes to the AHCA after learning new info about EHBs/the reconciliation process, per leadership aide
I hope not, it is no better than Obamacare. I would rather they slow down and do it right, because tomorrow never comes. I’ve heard these fantastic incremental changes for far too many years of my life and they never come to pass.
Nice bit of tactical retreating. Round two will be even better as Trump sizes up what’s happening.
Lou Dobbs on FBN is reporting the same.
As do I. Whatever they come up with, the GOP owns it, and we have to live with it, so by all means get this right.
Phil MattinglyVerified account @Phil_Mattingly 1h1 hour ago
More House leaders are now talking to the White House and members about the idea - this would be a big step forward w/ the Freedom Caucus 1 reply 22 retweets 14 likes Reply 1 Retweet 22 Like 14
Phil MattinglyVerified account @Phil_Mattingly 1h1 hour ago
More Up to this point EHBs had been left out of the bill out of concern that they wouldn't be Byrd Rule compliant 3 replies 6 retweets 7 likes Reply 3 Retweet 6 Like 7
Phil MattinglyVerified account @Phil_Mattingly 59m59 minutes ago
More While adding this into the bill would still certainly result in a Byrd rule challenge, info suggests it wouldn't be fatal to overall bill 3 replies 13 retweets 14 likes Reply 3 Retweet 13 Like 14
Phil MattinglyVerified account @Phil_Mattingly 54m54 minutes ago
More Of note: no deal has been made yet, but this is now in play - and a big reason Freedom Caucus folks are preaching "optimism" now 4 replies 12 retweets 17 likes
Phil MattinglyVerified account @Phil_Mattingly 47m47 minutes ago
More to add: the big issue for leadership has been the view that if EHB language was included, and found non-compliant, whole bill would die 2 replies 6 retweets 5 likes Reply 2 Retweet 6 Like 5
Phil MattinglyVerified account @Phil_Mattingly 44m44 minutes ago
More Now they believe if it's found to be non-compliant, the overall bill would still stand/still take 51 for passage 4 replies 2 retweets 2 likes
They can also simultaneously pass market-based reforms that drastically reduce the role of 3rd-party payers in healthcare.
- Expand health-savings accounts, no limit and up to $5,000 tax-credit
- Create High-deductible, catastrophic health insurance plans in which the premiums, co-pays, and deductibles can be claimed on tax-credits
- One-time block-grant Medicare & Medicaid to the states and shut down CMS (Ban illegals and abortions from receiving this aid package)
- Give the market incentives to create high-risk pools for pre-existing conditions
- Let insurers sell across state lines
- End all coverage mandates. I shouldn't have to be forced to pay for birth control being a guy
What’s an EHB?
EHBs?
I’m not 100% sure.
Essential Health Benefits???
I think....
Ambulatory patient services (Outpatient care). ...
Emergency Services (Trips to the emergency room). ...
Hospitalization (Treatment in the hospital for inpatient care). ...
Maternity and newborn care. ...
Mental health services and addiction treatment. ...
Prescription drugs.
Lab services
Pediatric services
Wellness services.....
Essential Health Benefits.
But that’s all I know; I can’t put them in context.
Couple things to clear up:
A part of a reconciliation bill can be found ‘fatal’- and the whole bill dies.
OR
A part can be found ‘non-compliant’ (corrupt) and that part can, and must, be dropped from the bill.
So these parts the Leadership is allowing may yet be dropped in the Senate.
And: the Leadership knew all along that these were not fatal.
See post #10
That would be a very big improvement.
Your details were very helpful.
Please interpret these acronyms for me. Explain it to me like I am a five year old.
What Are Essential Health Benefits?
Ten Essential Health Benefits must be offered at no dollar limits on every plan under the Affordable Care Act (ObamaCare). Essential Health Benefits consist of ten categories of items and services required for all individual and small group plans starting in 2014.
Large Group Plans are not required to offer an essential benefits package, but most already do, as these benefits were defined in the coverage typically provided by large employers.
Essential Health Benefits are the types of care you need to prevent and treat sickness and do not include elective and “non-essential treatments.” A full list of Essential Benefits under the Affordable Care Act with descriptions is provided below.
The Affordable Care Act’s Ten Essential health benefits include:
1.Ambulatory patient services (Outpatient care). Care you receive without being admitted to a hospital, such as at a doctor’s office, clinic or same-day (“outpatient”) surgery center. Also included in this category are home health services and hospice care (note: some plans may limit coverage to no more than 45 days).
2.Emergency Services (Trips to the emergency room). Care you receive for conditions that could lead to serious disability or death if not immediately treated, such as accidents or sudden illness. Typically, this is a trip to the emergency room and includes transport by ambulance. You cannot be penalized for going out-of-network or for not having prior authorization.
3.Hospitalization (Treatment in the hospital for inpatient care). Care you receive as a hospital patient, including care from doctors, nurses and other hospital staff, laboratory and other tests, medications you receive during your hospital stay, and room and board. Hospitalization coverage also includes surgeries, transplants and care received in a skilled nursing facility, such as a nursing home that specializes in the care of the elderly (note: some plans may limit skilled nursing facility coverage to no more than 45 days).
4.Maternity and newborn care. Care that women receive during pregnancy (prenatal care), throughout labor, delivery, and post-delivery, and care for newborn babies.
5.Mental health services and addiction treatment. Inpatient and outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. This includes behavioral health treatment, counseling, and psychotherapy. (note: some plans may limit coverage to 20 days each year. Limits must comply with state or federal parity laws. Read this document for more information on mental health benefits and the Affordable Care Act).
6.Prescription drugs. Medications that are prescribed by a doctor to treat an illness or condition. Examples include prescription antibiotics to treat an infection or medication used to treat an ongoing condition, such as high cholesterol. At least one prescription drug must be covered for each category and classification of federally approved drugs; however, limitations do apply.
Some prescription drugs can be excluded. “Over the counter” drugs are usually not covered even if a doctor writes you a prescription for them. Insurers may limit drugs they will cover, covering only generic versions of drugs where generics are available. Some medicines are excluded where a cheaper equally effective medicine is available, or the insurer may impose “Step” requirements (expensive drugs can only be prescribed if a doctor has tried a cheaper alternative and found that it was not effective). Some expensive drugs will need special approval.
7.Rehabilitative services and devices – Rehabilitative services (help recovering skills, like speech therapy after a stroke) and rehabilitative services (help developing skills, like speech therapy for children) and devices to help you gain or recover mental and physical skills lost to injury, disability or a chronic condition (this also includes devices needed for “rehabilitative reasons”).
Plans have to provide 30 visits each year for either physical or occupational therapy, or visits to the chiropractor. Plans must also cover 30 visits for speech therapy as well as 30 visits for cardiac or pulmonary rehab.
8.Laboratory services. Testing provided to help a doctor diagnose an injury, illness or condition, or to monitor the effectiveness of a particular treatment. Some preventive screenings, such as breast cancer screenings and prostrate exams, are provided free of charge.
9.Preventive services, wellness services, and chronic disease treatment. This includes counseling, preventive care, such as physicals, immunizations, and screenings, like cancer screenings, designed to prevent or detect certain medical conditions. Also, care for chronic conditions, such as asthma and diabetes. Note: please see our full list of Preventive services for details on which services are covered.
10.Pediatric services. Care provided to infants and children, including well-child visits and recommended vaccines and immunizations. Dental and vision care must be offered to children younger than 19. This includes two routine dental exams, an eye exam and corrective lenses each year.
While all qualified plans must offer the ten essential benefits, the scope and quantity of services offered under each category can vary. Each qualified plan must offer essential health benefits which overall are equal to the scope of benefits typically covered by employers, as shown by a Department of Labor survey of employer-sponsored coverage. (Ref: ACA, Section 1302 (b) (2) (a))
http://obamacarefacts.com/essential-health-benefits/
“More Of note: no deal has been made yet, but this is now in play - and a big reason Freedom Caucus folks are preaching “optimism” now”
$$$$$$$$$$$$$$$$$$$$$$$$$$$$
All else being equal, if the Freedom Caucus likes it, that is a good thing.
All else being equal, if the Freedom Caucus likes it, that is a good thing.
Yes!! A VERY good thing :)
Thanks for the info!
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