Michael

That is one of the areas that is going to be real tricky. Medicare and Medicaid are entitlements and not theoretically subsidies. Americans over 65 that do not qualify for Medicare can qualify for Medicaid if their income isn't large enough but under current law a LPR of less than 5 years can't. In fact many Americans over 65 are entitled to both Medicare and Medicaid and have both. How this will be handled under the new law is anyones guess. That could mean that Medicare and Medicaid may not be available to LPRs.

You'll also notice that the write up refers to the nuance for students and others but didn't refer to people on a L1, H1-B, O1, E3, E2 (may possibly be an issue with E2), TN-1, or TN-2 visas. I suspect that is probably not a problem since it can normally be assumed that those people will have employer sponsored health insurance for themselves and their family (therefore not need the preexisting condition subsidy) and will have enough income to not need the income based subsidy.

Mallory

I believe Medicare pays for dialysis and kidney transplantation, even if you are under 65. Have you looked into it?

Michael

However, as I think about it, the health care bill reforms health care in the US and suspect that the subsidies as well as medicaid will be treated the same for LPRs as US citizens in the future and medicaid will no longer be restricted for new immigrants. There could be restrictions if the over 65s live in the same house as others since medicaid and subsidies may possibly be based on household income.

That is just my opinion.

scrubbedexpat099

The first of many:

Consumer Protection Loopholes

Meanwhile, insurance companies are already finding ways to circumvent the consumer protections Mr. Obama has promised.

"Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions," the president said at the Virginia rally.

However, insurers say that they are not obligated to cover children with pre-existing conditions until 2014, when the rule kicks in for adults as well, the New York Times reports.

"The fine print differs from the larger political message," William Schiffbauer, a lawyer whose clients include employers and insurance companies, told the Times.

He and others argue an insurance company would be obligated to cover pre-existing conditions in any policy offered to a child -- but that the insurer is not obligated to sell insurance to that child in the first place.

Currently, insurers may choose to cover an entire family, including a child with a pre-existing condition, but choose to exclude coverage for that condition from the policy. Under the new rules, the Times reports, an insurer may opt to simply not cover that child at all rather than be forced to provide coverage for their condition.

Michael

I'm sure that insurance companies will try to get around the intent of the law. The department of health and human services will likely be responsible for interpreting the law and make rulings and then insurance companies will likely sue to try to get that ruling overturned. Businesses always try to find a loophole.

However, insurance companies may overplay their hand getting the public very resentful causing the public to support a public option or possibly a single payer system killing off health insurance companies.

Health insurance company executives are not the smartest people in the world. One week after they thought that health care reform was dead, they announced a 20%-40% increases in the cost of health insurance throughout the US. Doing something like that just reinvigorates the democrats to pass health care reform.

Doing something like that will only help the democrats to rally public opinion in support of health care reform faster. All they are doing is giving the democrats more ammunition because the inevitable will occur. Short term gains may be achieved but long term will not.

Michael

There was a republican strategist on TV a few minutes ago that brought up that issue and put a spin on it claiming that the democrats bill was ineffective and isn't going to accomplish what the democrats intended instead of blaming the insurance companies for trying to find loopholes.

Giantaxe

So can we conclude that the Republicans will either (i) propose legislation to close any loopholes that insurance companies claim they may have found, or (ii) propose either a public option or single-payer system so that private insurance companies have less or no scope to weasel their way out of things?

Michael

(iii) repeal the bill as ineffective.

Giantaxe

Cool... because we know know effective the current system is!