As critics have repeatedly point out, once Congress starts specifying minimum mandated coverage requirements for health insurance there will be no end to the lobbying to maximize the “minimum” that you will have to pay for in your health plan.
Well, it turns out Congress is already behaving exactly as predicted — and they haven’t even passed a bill yet!
The earlier House “Tri-Committee Bill” (H.R. 3200) lists in Section 122(b) the “Minimum Services to be Covered.” The new “Pelosi Bill” (H.R. 3962) includes the same language, only this time it appears as Section 222(b), and — ta-da! — it includes more required benefits!
Whereas the earlier bill had ten enumerated subsections — hospitalization, physician services, prescription drugs, etc. — the new bill adds an eleventh subsection requiring coverage for, “durable medical equipment, prosthetics, orthotics and related supplies.”
Also, subsection seven, which originally required coverage for “mental health and substance use disorder services,” has been expanded by adding the clause, “including behavior health treatments.”
As previously noted, these are just the “top-level” required benefits. It will be left to HHS to define in detail — in thousands of pages of regulation — the type, scope, frequency, and duration of the specific services that must be covered, along with the rules for which providers must be paid for providing which services, and the criteria under which specific patients qualify for different, specific services.
Of course, insurance companies and the HR departments of any employers still providing worker health benefits will be required to comply with all of these, constantly evolving and expanding, “minimum” benefit requirements.
Also, predictable is that anyone dissatisfied with some future ruling by the new health care czar or the HHS Secretary on some aspect of the detailed minimum benefit rules will go lobby Congress to get their own preference written into law.
It seems that in the new Pelosi-Reid health system, your most important contact won’t be your personal physician. It will be your personal lobbyist.
You do have a personal lobbyist, don’t you?
