I bet you look real purty in a burka, baby...
May 2, 2006 1:23 PM   Subscribe

The Health Insurance Marketplace Modernization and Affordability Act (S. 1955) has passed out of committee and is now slated for a floor vote. The bill is ostensibly designed to save small employers money and extend health insurance options to employees who hadn’t had them. What it is actually likely to do is end basic health insurance coverage for women (and diabetics); birth control, regularly taken prescriptions, cancer screenings, maternity care, and more. Women in every state will lose benefits. S. 1955 would allow insurance plans to ignore important state laws that protect patients, directly affecting more than 90 million Americans. [more inside]
posted by dejah420 (42 comments total)
Of course, the party of "small government"couldn't introduce a bill without stripping the states of their rights - the bill guts state protections for coverage for prostate cancer screenings, ambulatory surgery, emergency services, and more. Moreover, S. 1955 prevents states from enforcing their own benefit protections. If states try to enforce their own insurance laws, insurance companies would be able to sue states in federal court, even though patients would have no such recourse.
posted by dejah420 at 1:23 PM on May 2, 2006

Men can still get boner pills though, right? It's really important that we have our boner pills subsidised.
posted by PinkStainlessTail at 1:29 PM on May 2, 2006

*loads rifle*
posted by Smedleyman at 1:31 PM on May 2, 2006

All you have to do is look at the list of co-sponsors to realize that this will be bad for the average American. These are the same folks responsible for trying to "fix" Social Security and Medicare Part D(isaster).

Thanks, dejah, for bringing it to our attention. Hopefully outraged citizens will be able to beat this one back as effectively as the Social Security debacle.
posted by JackFlash at 1:32 PM on May 2, 2006

Hey, remember when the government passed the "CAN-SPAM" act witch basically legalized spam and gutted lots of effective state-level anti-spam laws?

That was so funny.
posted by delmoi at 1:36 PM on May 2, 2006

I guess this isn't what most people have in mind when they say the US needs to reform its healthcare system.
posted by chunking express at 1:52 PM on May 2, 2006

We're giving the people options. Empowering them to take control of the decisions. Like whether to pay the mortgage or get Timmy on chemotherapy. It's their choice...and that's important.
posted by Thorzdad at 1:56 PM on May 2, 2006

I looked at the list in the last link and realized that, hey, this bill doesn't affect *me* one bit. My state already allows insurers to screw me (or the Lady Fez) over in any number of ways. Still, that's a pretty crappy thing to be trying to push through in an election year with the majority of people already vaguely pissed at you. So hope springs eternal, I guess.
posted by Fezboy! at 2:09 PM on May 2, 2006

Study Shows Americans Sicker Than English
White, middle-aged Americans — even those who are rich — are far less healthy than their peers in England, according to stunning new research that erases misconceptions and has experts scratching their heads.

Americans had higher rates of diabetes, heart disease, strokes, lung disease and cancer — findings that held true no matter what income or education level.

Those dismal results are despite the fact that U.S. health care spending is double what England spends on each of its citizens.

"Everybody should be discussing it: Why isn't the richest country in the world the healthiest country in the world?" asks study co-author Dr. Michael Marmot, an epidemiologist at University College London in England.

The study, based on government statistics in both countries, adds context to the already-known fact that the United States spends more on health care than any other industrialized nation, yet trails in rankings of life expectancy...
posted by taosbat at 2:25 PM on May 2, 2006

But our teeth are nice.
posted by NationalKato at 2:35 PM on May 2, 2006

Just want to chime in here that a close personal friend of mine has come down with recurring asthma attacks so severe he's on regular nebulizer treatments. His new job's new health insurance won't pay a GODAMN DIME towards the cat scans, surgery, and medicine his new astonished doctor wants to perform because the cocksuckers label it a pre existing condition since he was sick before he started working there. He has to wait until May 2007.

I know it's a derail, but FUCK YOU BIG PHARMA/INS!
posted by cavalier at 2:36 PM on May 2, 2006

Another step toward relieving corporations of health insurance
posted by Cranberry at 2:40 PM on May 2, 2006

Why would this pass? Don't they realize this is a big no-no if they want to get reelected in the fall?

Oh wait, all people care about is abortion and gays. Nevermind.
posted by SirOmega at 2:53 PM on May 2, 2006

The cynicism of the Republicans knows no bounds. "Clean Air Act" = not just more pollution, but financial encouragement for said pollution. "Saving Social Security" = killing it, and ensuring generations of homeless elderly folks. This if more of the same.

It won't solve all our problems, but please be sure to vote in November people. At least it's a start.

But our teeth are nice.

I made a similar joke to a British friend once, and for my trouble, I got a 30 minute briefing on how, in fact, this is utterly false. Dental care happens to be (*shock!*) affordable in the UK, and they have much better teeth than most Americans. I think my own choppers are in decent shape, but I've travelled in parts of America, rural and urban, where people have some pretty hideous orthodonture, either from an inability to afford a dentist or, more likely, plain neglect.

But hey, who needs healthy Americans when we embrace the people who come from third-world countries to fill our raging demand for illegally paid, illegally treated labor?
posted by bardic at 3:02 PM on May 2, 2006

Did your friend have coverage in his previous job? Has it been less than 60 days between those jobs? If so, he needs to get a letter declaring prior coverage from his previous employer. If he had coverage, the law says the new insurer has to cover the condition.
posted by Thorzdad at 3:08 PM on May 2, 2006

Time to start calling your Senators and raising hell.

This is a truely horrible piece of legislation.

It's uncanny how "conservatives" only support "states rights" when its convienent to thier narrow interests.
posted by clubfoote at 3:17 PM on May 2, 2006

end basic health insurance coverage for women...birth control...

Since when did health insurance cover birth control? I have one of the most comprehensive PPO's in the country, and even it doesn't cover BC.
posted by Asparagirl at 3:21 PM on May 2, 2006

Don't they realize this is a big no-no if they want to get reelected in the fall?

Or could it be that we've entered the period where the GOP's financial backers know they're fucked, so they're executing their Stop Loss Orders, as it were...
posted by mkultra at 3:24 PM on May 2, 2006


FWIW, I live in New York, and I've always had my birth control pills covered by my insurance. Er, when I had insurance, that is.
posted by discokitty at 3:25 PM on May 2, 2006

this really is appalling, but not at all surprising. They're probably rushing a ton of things thru the House hoping at least one thing becomes law before Congress changes hands.
posted by amberglow at 3:30 PM on May 2, 2006

Hey Cavalier, I'm not going to lie to you, I'm in the Citadel of Big Pharma right now, waiting for the Western Blots to get done).

WHY THE HELL would big pharma (or medium or even small pharma) want your friend not to be able to get the drugs he needs?

If government was owned by the darkest side of Big Pharma (as is often claimed) insurance companies would always have to pay for the newest shiniest pills and the projects that I've worked on that died in clinical testing (No worse than Brand X is a horrible marketing slogan) would all be on the market right now not doing much good but making money.
posted by Kid Charlemagne at 4:19 PM on May 2, 2006

Since when did health insurance cover birth control?

That change has been underway in just the last few years, mainly as a result of activism and a successful lawsuit.
posted by nakedcodemonkey at 5:27 PM on May 2, 2006

oh, the irony - proposed act #1955, the year the Republicans would like to throw us back to. can one trust a prospective law with the words "marketplace modernization" in the title? No? Didn't think so. Every day brings another reason to loathe the administration - every freakin' day.

I'm resigned to the fact that in America the state (as it exists) doesn't always cover BC, or things like feminine hygiene products; so be it. The feds not supplying essential public health services (mammography screening, maternity care, etc. etc.), however, is a real crime. George Bush doesn't care about anyone (black, woman, etc. etc.) that doesn't look like him. Personally I think it's all a plot to keep the pharmacos that sell high blood pressure meds in business - all the news from Republicans does is raise mine...
posted by rmm at 5:53 PM on May 2, 2006

Kid, it's the employers who want to cut costs, not big pharma--it's the employers who don't want to pay for those expensive drugs (or even those cheap drugs). It's the employers who are paying for very expensive drugs for millions and millions of retirees as well.
posted by amberglow at 6:43 PM on May 2, 2006

Asparagirl, Illinois recently passed legislation requiring health plans to cover birth control. It's not universal, but some states have passed similar laws. This bill would preempt such state insurance laws.

But if the birth control coverage doesn't apply to you, I would bet that health plans in your state cover pap smears. This bill would exclude that coverage. It would also require that women get referrals for yearly gyno exams.
posted by jennyb at 8:08 PM on May 2, 2006

right now, waiting for the Western Blots to get done).

Heh, its nice to hear I'm not the only one...
posted by c13 at 8:26 PM on May 2, 2006

Good post, dejah, thanks!

We'll lose benefits and, according to one health care policy expert, this bill wouldn't even address the affordability problem it was intended to address:

"Proponents of Enzi's bill claim that it would enable small businesses to pool their buying power, thereby getting better deals from insurers. While that makes sense in a free market, the market for health insurance is anything but free. In fact, with most local markets dominated by a single carrier, I'm not clear as to how group buying will help any employer gain any pricing power.

The health insurance market has become an oligopoly, generally defined as a market where 4 or fewer sellers control more than 40% of the market. In reality, a study released by the American Medical Association and supported by a newly-released GAO report, clearly shows we have passed this benchmark and are now approaching monopoly status in many markets."

(More commentary at Managed Care Matters).
posted by madamjujujive at 8:43 PM on May 2, 2006

Call we a socialist but why can't we just all pay our god damn taxes and all enjoy the benefits that they bring.
posted by Talez at 2:54 AM on May 3, 2006

...why can't we just all pay our god damn taxes and all enjoy the benefits that they bring.
You got Freedom in iraq®! What more do you want?
posted by Thorzdad at 5:33 AM on May 3, 2006

memo from Red America: affordable health care makes the American Baby Jesus cry.
let's hear it from Mr Lawrence Kudlow, the gracious host of the liberal media CNBC's "Kudlow & Company", and a nationally syndicated columnist:

Waking Up to Hillary's Big-Government Nightmare

Mr Larry "behold my cast-iron pinstripe suit" Kudlow is very worried: because during Sen Clinton's speech at The Economic Club of Chicago, poor Mrs Clinton, after praising -- among others -- Ike Eisenhower and Bill Frist, made the horrible social faux pas of mentioning "neglected infrastructure" and, holy crap, she also let it slip that the "costs of a middle class life, education, healthcare, transportation, retirement are all increasing. It's the first time since we've been keeping records that we've had four years of rising productivity and falling wages".

I mean, one might see Clinton's speech as very mild, humorless, uninspired DLC leftovers. but no, it must clearly be a "nightmare"
posted by matteo at 7:21 AM on May 3, 2006

Sorry been away for awhile:

thorzdad:Did your friend have coverage in his previous job? Has it been less than 60 days between those jobs?

Yeah, that's the bit, it was >60 days. The HR agent for both jobs says "tough shit". What blows my mind is why didn't the previous employer HR group talk to him about COBRA?? That's the loophole that he fell through. Good times.

Kid Charlemagne (get along):WHY THE HELL would big pharma (or medium or even small pharma) want your friend not to be able to get the drugs he needs?

In my frustration I point at both of them because, in a chicken and the egg sort of thing that amberglow pointed to, the employer doesn't want to pay the outrageous prices the insurer wants to charge for paying the pharma/provider bills at outrageous prices for the employee.

To wit, one of the medicines the doctor wants to prescribe apparently costs $425 for a month's dosage. I recognize that R&D has to make back its money on research and you only have so many years on a patent, but for fuck's sake, kill half of the lawyers or the marketing department, you really can't tell me $425 is just getting by, that's a godamn profit center once the research is paid for.

And I recognize by your blot that you're one of the R&D peeps, so I hope you appreciate that my seething hatred is not pointed at you but rather the filthy blood stained hands of the businessmen on the other side of your company.
posted by cavalier at 9:01 AM on May 3, 2006

Dejah's link from Planned Parenthood leads to a "take action" page that lets you email your senator asking him or her to oppose the bill.

Tell your senator to oppose S 1955.
posted by occhiblu at 9:20 AM on May 3, 2006

What blows my mind is why didn't the previous employer HR group talk to him about COBRA??

I'm no lawyer, but I'm almost posive that employers are required by law to notify employees of their COBRA rights for just this purpose. It probably wouldn't be a bad idea for your friend to talk to a benefits attorney.
posted by jennyb at 9:59 AM on May 3, 2006

Yeah, I felt like a dick for bringing it up thinking he had already signed on, and he was like 'double you tee eff cobra?'

He's a little shell shocked right now but when he's calmer I'll definitely bring that up. Maybe do some research. It's Texas, of course, so I imagine the odds are stacked in the business's favor. Thanks Jennyb!
posted by cavalier at 10:27 AM on May 3, 2006

These corporate lobbyists are writing legislation faster that the GOP can bring the bills up for votes!
Now if we can only get the GOP corruption indictments up to greater than the current average of 3 a day!
This bill is worse than pharma's Medicare Donut bill.
What do I fight today? Selling off the internet to AT&T or the elimination of health care insurance or the Dubya theocracy?
posted by nofundy at 12:20 PM on May 3, 2006

With proper time management, nofundy, I'd think you could manage appropriate indignation and political action against all three.
posted by occhiblu at 12:33 PM on May 3, 2006

he'd have to quit his job, leave his wife and stop sleeping, occhiblu
posted by matteo at 1:57 PM on May 3, 2006

and there are only 24 hours in a day anyway
posted by matteo at 1:58 PM on May 3, 2006

Not knowing what the med is it's hard to make any guess as to its cost or profitability, but I worked on a project that was an orphan - a drug for a condition that has few patients (and is God-awful horrible).

This means that we were, allegedly, working in a "relaxed" regulatory environment. I personally spent about six months developing my little assay, another three months doing some follow up work that the FDA wanted and another six months doing some work that EMEA wanted us to do to show our approach was as good as another approach our auditor was more familiar with.

If it makes you feel better, even the guys up top have some vestigal soul (or understand basic economics). The last big rush here involved increasing yield of a process so that we could sell the drug for less than the price of a sports car.
posted by Kid Charlemagne at 2:42 PM on May 3, 2006

Well, small active steps are better than throwing up your hands and giving up. With that Planned Parenthood link I emailed my senators and got a response back from Feinstein (who's voting against the bill, by the way) in a grand total of 30 minutes. I also wrote a letter to the editor of Salon about feminist issues, and read several articles about Colbert and the media's response to him; I'm sure I could have added to the chorus on that one, too.

Doesn't take that much time to make a small difference, or at least participate in the political debate. Sure, it's not like I organized a multi-city protest and lined up news coverage for it, but if you've got time to post here, you've got time to at least write to your elected representatives.
posted by occhiblu at 5:10 PM on May 3, 2006

Meanwhile: ... Study: Americans sicker than English
Study finds more serious illness despite greater U.S. spending

A higher rate of Americans tested positive for diabetes and heart disease than the English. Americans also self-reported more diabetes, heart attacks, strokes, lung disease and cancer.

The gap between the countries holds true for educated and uneducated, rich and poor.

"At every point in the social hierarchy there is more illness in the United States than in England and the differences are really dramatic," said study co-author Dr. Michael Marmot, an epidemiologist at University College London in England.

The study, appearing in Wednesday's Journal of the American Medical Association, adds context to the already-known fact that the United States spends more on health care than any other industrialized nation, yet trails in rankings of life expectancy.

The United States spends about $5,200 per person on health care while England spends about half that in adjusted dollars. ...

posted by amberglow at 6:45 PM on May 3, 2006


posted by taosbat at 4:51 PM on May 5, 2006

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