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heric BS: US Health Care Reform (1349* d) RE: BS: US Health Care Reform 31 Aug 09


One distinction stemming from HR 3200 leaving people on Medicaid: They can only get care from Medicaid providers. Wyden-Bennet requires all Medicare (i.e. about everyone) to participate, and they don't need to even do that since every provider will want to be on this program.

Note above there are other requirements beyond basic FEHBA coverage, including wellness care and several basic preventaive care items which the poor need but don't get very well from Medicaid, and these can have no co-pays or contribution requirements.


SEC. 112. SPECIFIC COVERAGE REQUIREMENTS.

(a) In General- Each HAPI plan offered through a HHA shall--

(1) provide for increased portability through limitations on the application of preexisting condition exclusions, consistent with that provided for under section 2701 of the Public Health Service Act (42 U.S.C. 300gg), as such section existed on the day before the date of enactment of this Act, except that the State shall develop procedures to ensure that preexisting exclusion limitations do not apply to new enrollees who had no applicable creditable coverage immediately prior to the first enrollment period;

(2) provide for the guaranteed availability of coverage to prospective enrollees in a manner similar to that provided for under section 2711 of the Public Health Service Act (42 U.S.C. 300gg-11), as such section existed on the day before the date of enactment of this Act;

(3) provide for the guaranteed renewability of coverage in a manner similar to that provided for under section 2712 of the Public Health Service Act (42 U.S.C. 300gg-12), as such section existed on the day before the date of enactment of this Act, except that the prohibition on market reentry provided for under such section shall be deemed to be 2 years;

(4) prohibit discrimination against individual enrollees and prospective enrollees based on health status in a manner similar to that provided for under section 2702 of the Public Health Service Act (42 U.S.C. 300gg-1), as such section existed on the day before the date of enactment of this Act;

(5) provide coverage protections for enrollees who are mothers and newborns in a manner similar to that provided for under section 2704 of the Public Health Service Act (42 U.S.C. 300gg-3), as such section existed on the day before the date of enactment of this Act;

(6) provide for full parity in the application of certain limits to mental health benefits in a manner similar to that provided for under section 2705 of the Public Health Service Act (42 U.S.C. 300gg-4), as such section existed on the day before the date of enactment of this Act;

(7) provide coverage for reconstructive surgery following a mastectomy in a manner similar to that provided for under section 2706 of the Public Health Service Act (42 U.S.C. 300gg-5), as such section existed on the day before the date of enactment of this Act; and

(8) prohibit discrimination on the basis of genetic information, as provided for under the amendments made by the Genetic Information Nondiscrimination Act of 2008 (Public Law 110-233).

(b) Guidelines- Not later than 1 year after the date of enactment of this Act, the Secretary shall develop guidelines for the application of the requirements of this section.


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