The more carefully the bill is read, the more problems we find. Here is a collection from a variety of sources:
Regulation of health insurance: Diagrams by Leading Edge Policy and Strategy, on behalf of the U.S. Chamber of Commerce, of current and proposed regulation, show an immense increase in complexity.
National health ID cards: To allow “real-time…determination of an individual’s financial responsibility at the time of service,” and of “whether the individual is eligible for a specific service at a specific facility” may require use of a machine-readable beneficiary identification card (p. 52).
Left-wing “community organizers” to do “outreach” to “vulnerable” individuals: “Appropriate entities”—likely to include ACORN and AmeriCorps—will do outreach to children, as well as disabled, mentally ill, or cognitively impaired individuals (p. 95).
Dictatorial authority of Secretary to set payment rates: No one could sue the government monopoly for price-fixing because there is no judicial or administrative review of the Secretary’s determinations (p. 124).
Nonresident aliens exempt: Taxes, insurance purchasing mandates, and fines apply only to U.S. taxpayers.
Home visits to families who have children or are expecting children: This includes parental counseling (pp 838-845) (Eagle Forum Critical Health Care Update 7/28/09). Purposes may include “increasing birth intervals between pregnancies” and assessing “school readiness” (p. 768).
New auditing powers: A study shall examine “the financial solvency and capital reserve levels of employers that self-insure by employer size” (p 22).
Drug manufacturers must give rebates for full-benefit dual eligibles. (p. 358)
More affirmative action:
Grants and contracts for improving public health will be given preferentially to entities who train more individuals from minority groups. (See spreadsheet file of criticisms and explanations prepared by AAPS staff.)
Trustees’ Medicare bankruptcy warnings silenced: The Medicare Modernization Act of 1993 required trustees to warn if more than 45% of Medicare revenues were projected to come from general revenue over a 7-year period. Two consecutive warnings would require the President to propose, and the Congress to give expedited consideration, to reform legislation. There have been four consecutive warnings; three times Congress has passed rules suspending their responsibility to address Medicare’s unsustainability. H.R. 3200 repeals the requirement (p. 836) (Heritage Foundation 7/15/09).
The American Medical Association (AMA) and the American Osteopathic Association (AOA) have both endorsed H.R. 3200, and neither has mentioned the above problems, or ones noted in previous AAPS news briefings.
The AMA does complain about $4.3 billion in payment cuts for imaging service, and the ban on new physician-owned hospitals, plus restrictions on existing ones . The AOA notes that it has “concerns” about some unspecified provisions.