Short-lived adventures in bill-reading

Renee James Contributor
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I am what you might call completely average. By that I mean I watched the health-care debate come to life, heat up, and start to cool off. I listened to commentary by “journalists” and talk show hosts on everything from CNN to MSNBC to Fox; read pieces in The New York Times and The Wall Street Journal, on The Huffington Post and here on The Daily Caller. Oh, on Facebook, too.

This week, I attempted to read the bill and try to understand it. OpenCongress.org tracked 224,369 previous views of the bill posted on their site. That means 99,775,631 more people voted in the final round of “American Idol” last year than had read this bill on their site, or .224 percent of “American Idol” voters. What I found is by no means a definitive statement about anything; merely the observations of one American, as she tried to wade into the bill and extract a moment of clarity.

I started with two versions online. The first, dated July 14, 2009, is the America’s Affordable Health Choices Act of 2009 or AAHCA. The second, dated Oct. 29, 2009, is the Affordable Healthcare for America Act or the AHCAA. Conclusion: in just over three months, the name of the thing changed. I can’t quite explain the semantics surrounding America’s Affordable Health Choices Act and the Affordable Healthcare for America Act; maybe my representative can. Moving on.

The July PDF contained 1,018 pages. The October document stood at 1,990 pages. The bill approved by the House in November had 2,070 pages. I’m positive the March 2010 version ran even longer.

The shorter one contained three main divisions: Affordable Healthcare Choices, Medicare and Medicaid Improvements, and Public Health and Workforce Development. The longer version had these three plus Indian Health Care Improvement. I read this and thought: why health care for the people of India? They don’t mean Native Americans, right? Wait; they do. Moving on.

Honestly, I couldn’t read this thing. I tried, but the first 15 pages of AHCAA contain nothing more than the table of contents, divisions, titles, subtitles, terms and acronyms used throughout the document, and my eyes started crossing.

But I found some highlights to share:

Qualified Health Benefits Plan OFFERING ENTITY.—The terms ‘‘QHBP offering entity’’ means, with respect to a health benefits plan that is—(A) a group health plan (as defined, subject to subsection (d), in section 733(a)(1) of the Employee Retirement Income Security Act of 1974), the plan sponsor in relation to such group health plan, except that, in the case of a plan maintained jointly by 1 or more employers and 1 or more employee organizations and with respect to which an employer is the primary source of financing, such term means such employer… Got that?

Definitions “b” through “e” for a QHBP offering entity follow.

Another section requires at least a passing familiarity with about eight different sections of four different documents, plus “any other provision of law that references such provisions” to understand it:

TREATMENT AS CREDITABLE COVERAGE.—Coverage under the program shall be treated, for purposes of applying the definition of ‘‘creditable coverage’’ under the provisions of title XXVII of the Public Health Service Act, part 6 of subtitle B of title I of Employee Retirement Income Security Act of 1974, and chapter 100 of the Internal Revenue Code of 1986 (and any other provision of law that references such provisions) in the same manner as if it were coverage under a State health benefits risk pool described in section 2701(c)(1)(G) of the Public Health Service Act.


Here’s a piece that startled me by its directness:

IN GENERAL.—There is appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, $5,000,000,000 [you know…that extra five billion we always have hanging around…we can use that!] to pay claims against (and administrative costs of) the high-risk pool under this section in excess of the premiums collected with respect to eligible individuals enrolled in the high-risk pool. Such funds shall be available without fiscal year limitation.

INSUFFICIENT FUNDS.—If the Secretary estimates for any fiscal year that the aggregate amounts available for payment of expenses of the high-risk pool will be less than the amount of the expenses, [if we come up short] the Secretary shall make such adjustments as are necessary to eliminate such deficit, including reducing benefits, increasing premiums, or establishing waiting lists. (Emphasis my own.) So if we run out of money, we’ll get less, pay more and wait longer. Got it.

FYI – I had reached page 25 of the document at this point; only 1,965 to go. But instead, I moved on, with all manner of positive thought that this bill is an ultimate good, for all of us, even average Americans like me.

Renee James writes social commentary and keeps track of the things that mystify her on her blog: It’s not me, it’s you. Her e-mail address is raaj3@msn.com.