Health Choices Administration and hb 3200

This is post #5 on the proposed health care bill h b 3200.

The HCA is a new independent agency in the executive branch. The president will appoint a Commissioner with the approval of the Senate.

The Commissioner will:

1. establish qualified health benefits plan (QHBP) standards (define specific coverage)
2. enforce those standards
3. establish a Health Insurance Exchange (HIE)
4. administer affordability credits
5. promote accountability Quallified Health Benefits Plan offering entities (ins. cos.)
6. conduct random and targeted audits of ins. co. and employers
7. recoup audit costs from QHBP offering entities
8. collect data to promote quality and value, protect consumer, address disparities in health and health care, etc; share such data with Sec HHS
9. provide for civil money penalties
10. suspend enrollment of individuals in the plan
11. terminate the plan, if necessary
12. set standards for insurance definitions
13. issue regulations for the effective and efficient administration of the HIE
14. appoint an ombudsman
15. other duties as assigned

Through the HIE, the commissioner shall

1. establish standards for QHBP offering entities (ins. co)
2. negotiate with those entities for the basic, enhanced, premium and premium-plus plans
3. enter into contracts with those entities
4. facilitate outreach and enrollment into the plans (advertisements and door knockers)
5. establish risk pooling mechanisms
6. define: ‘‘employer’’, ‘‘employee’’, ‘‘full-time employee’’, and ‘‘part-time employee’’
7. may set an enrollment phase-in period for very large employers
8. execute a survey. The goal of the survey is to determine if there are significant groups and types of individuals and employers who are not Exchange eligible individuals or employers, but who would have improved benefits and affordability if made eligible for coverage in the Exchange. Specificall, the study shall examine the terms, conditions, and affordability of group health coverage offered by employers and QHBP offering entities outside of the Exchange compared to Exchange-participating health benefits plans; and the affordability-test standard for access of certain employed individuals to coverage in the HIE.
9. establish range of cost-sharing (ie 70%-97%)
10. ask the Sec of Treasury (tax cheat) for info about you.
11. seek info about you through means other than your tax return
12. establish penalties if you don't follow the rules