S.17.5-1: Southern Healthcare Act (defeated)

[Mr. Reactionary]

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Sponsor: IceAgeComing

[Terry the Fat Shark]

As noted on the other bill: Before anything else.....I would like to note my intention to provide healthcare for all residents (provided they want it) who make below 30,000$ a year (indexed to cost of living and inflation) in income.....willing to negotiate higher or lower.

[IceAgeComing]

Fellow delegates,

I would like to thank .  I would also like to thank the Speakers Office for preparing a set of explanatory notes, which will be provided to all members shortly.  Therefore, in this introductory speech I seek to explain my general thoughts on healthcare reform; my own personal red-lines, in order to best put together a high quality reform.

I fully do not expect this bill to pass in its current form.  Indeed, I don't expect any healthcare bill proposed to this house to pass in its initial form - one only has to look at the Federal law to see the significant differences between the initial version and the latter iterations.  Therefore, I designed this legislation to be flexible, to be anemable to amendments from all over this House.  There are some provisions in this bill - I note the existence of an individual mandate as one - which I know is incredibly unpopular with some within this Chamber, however this is my bill, and its only natural that I will introduce in my bill the model of reform that I want.  I do feel that a Market-based healthcare system where we require providers to cover everyone without requiring that everyone be covered strikes me as having the risk of being rather unstable; and that any system with a modest mandate like the one contained in this bill would be a lot more stable, and retain a private element longer.  The core principles of this legislation are simple: to incorporate the Federal Law into Regional Law; to ensure that high quality education is available for all Atlasians through either AtlasCare or a private alternative and to create a Regulatory Authority to manage private insurance.

My core red lines are as follow: I will not support any legislation that does not allow every resident in the South to enrol in AtlasCare and I will oppose any legislation that does not provide satisfactory protections for lower income Atlasians.  My argument for the former is fundamentally simple: its about choice and ensuring that high quality healthcare is available for all Southern residents.  I don't see why our healthcare system would be improved by denying our citizens access to a high quality healthcare alternative - after all; if its good enough for the elderly in our society as well as veterans then its good enough for all of our citizens.  Additionally it means that there is another option in the market, and as many on the other side of the Chamber have argued in opposing a system more like the Canadian system, competition is very important for lowing costs and improving quality.  There is also the fact that ensuring that AtlasCare is on the market for everyone means that we can guarantee from day 1 the availability of high quality comprehensive coverage for everyone: while a system without AtlasCare runs the risk of insurance companies being able to hold up the Southern Government for concessions in order to provide coverage in areas where they might not deem it profitable.

In terms of lower income citizens, I believe that no one should not be able to get healthcare because of their ability to pay.  That's the core thing that this healthcare reform exercise was intended to prevent, and I will strongly oppose any legislation that does not contain such a provision.  This bill was drafted within the remits of the Federal Law; however since I believe that the Governors Office wishes to go in a different direction I am putting together an amendment to this bill to ensure that lower income Southerners will be enrolled in Atlascare automatically, with financial assistance provided.  

Friends; that is the basics of this legislation.  I hope that we will be able to work together to ensure the passing of high quality universal healthcare coverage for all of our citizens.

[IceAgeComing]

Summary: Southern Healthcare bill

The goal of this bill is to implement Atlascare in the Southern Region and to pass certain regulations to prevent unfair health insurance practices.

Section 1 contains the definitions for the bill.

Section 2 Creates a Regulatory Board to regulate private insurers in the Southern Region. The Board has the powers listed at the conclusion of this summary. Section 2 also creates a common portal health insurance exchange and invites in the federal public option.

Section 3 imposes the following mandates:

- All Insurers must provide the minimum essential coverage provided by the federal public option

- All insurers must provide Coverage for various transgender related treatment and surgery

- All doctors may Conscientiously Object to procedures if there is another available doctor

- All insurers must allow children 25 and younger to remain on family plans

- Individual mandate to purchase health insurance, unless you are below the poverty line or younger than 27

- Tax on individuals who do not purchase health insurance

- Create a Trust Fund with the tax money to help defray coverage of persons with "serious" conditions

Section 4 places the start date in 2018.


Duties of the Southern Health Insurance Regulation Board
- Enforce minimum coverage mandate
- Draft consumer protection regulations
- Administer Health Insurance Exchange Portal
- Manage the Trust Fund for paying for the treatment of “serious” conditions

[Mr. Reactionary]

Bill update: This and the rival Atlascare proposal have both been on the floor for about 2 weeks. I am requesting input from my fellow delegates on how they would like to proceed on the healthcare debate. Considering the complexity and scope of the bill, I am uncomfortable with just calling a vote without more input. If I am mistaken, and the delegates fully understand the concepts of both bills, please let me know and I will schedule a vote. If you have questions pertaining to specific parts of either bill or would like some sort of townhall between the bill sponsors, please let me know so that answers can be provided. Otherwise, if no Delegate responds to this message by Monday, November 20, I am tempted to motion that we table both bills for the time being, and proceed with new business. Once tabled, I will gladly manuever to place them back upon the floor when more Delegates are prepared to proceed.

I am cross-posting this with the other Atlascare bill.

[IceAgeComing]

I oppose any motion to table; but feel that we need more discussion.

Just using this thread to also apologise for inactivity over the last while; been incredibly busy because I had like three big applications I had to do in a week period so I let this stuff lapse.  I'll look at the bills on the floor tomorrow afternoon

[Mr. Reactionary]

I oppose any motion to table; but feel that we need more discussion.

Just using this thread to also apologise for inactivity over the last while; been incredibly busy because I had like three big applications I had to do in a week period so I let this stuff lapse.  I'll look at the bills on the floor tomorrow afternoon

Generally, I am in agreement with you in wanting to resolve this sooner rather than later. I just want to make sure the Delegates understand what they are voting on.

[Lechasseur]

Bill update: This and the rival Atlascare proposal have both been on the floor for about 2 weeks. I am requesting input from my fellow delegates on how they would like to proceed on the healthcare debate. Considering the complexity and scope of the bill, I am uncomfortable with just calling a vote without more input. If I am mistaken, and the delegates fully understand the concepts of both bills, please let me know and I will schedule a vote. If you have questions pertaining to specific parts of either bill or would like some sort of townhall between the bill sponsors, please let me know so that answers can be provided. Otherwise, if no Delegate responds to this message by Monday, November 20, I am tempted to motion that we table both bills for the time being, and proceed with new business. Once tabled, I will gladly manuever to place them back upon the floor when more Delegates are prepared to proceed.

I am cross-posting this with the other Atlascare bill.

I prefer the other bill

[Mr. Reactionary]

*Cross-post*

So here is my tentative plan for the Atlascare bills. I did receive feedback, so I think we should have 1 more week of closing arguments and debates. I'll seek unanimous consent to proceed to a vote on Friday, December 1st. Presumably then, the final vote on both plans will proceed on Saturday, December 2nd for 100 hours. Hopefully everyone votes. Anyone is welcome to speak from the floor in favor or against either bill until that time. Thank you.

[Mr. Reactionary]

If no one else wants to comment, I will say the following:

I support a government program in the Southern Region that will cover the healthcare costs of persons making  $30K or less a year. While the Feds ended their participation in the Medicaid program, that does not preclude us from picking up where the left off. Most of the program as codified at the Regional level should still be intact, since we were the ones largely administering the program. The only real concern resulting from the federal pullout, is that they were 60% of the funding, which we now have to make up. We'll have some help, between Atlascare's HSA for everyone program as well as the federal high risk pools and federal coverage of persons previously under Medicare. But we will still have to fill in that funding hole. As imagined, Medicaid would largely be us depositing money into the patient's HSA rather than paying the dictor a fixed price. This is similar to how Medicaid Managed Organizations (MMOs) function now. So our only real concerns are funding and ensuring MMOs and other private insurers dont inflate costs. In my insurance reform bill, we have several mechanisms to prevent that, which means passing my bill positions us well for the future Regional-only Medicaid program. And those changes should not adversely affect the general health insurance market for everyone else. do not believe that the IceAgeComing bill will allow for as much price flexibility for non-Medicaid consumers which will make the market more expensive for everyone.

As far as funding goes, I plan on consulting with the Governor and GM on specific numbers. At the very least we can divert our sin taxes towards it and maybe consider a small payroll tax. Anyway, there's my 2 cents on how to cover healrhcare for the poor.

[Mr. Reactionary]

I hereby request unanimous consent to proceed with a final vote on this bill. 24 hrs to object.

[Mr. Reactionary]

Unanimous consent is achieved. Delegates have 100 hrs to vote, ending about 6pm EST on Wednesday.

[Mr. Reactionary]

Nay

[President Punxsutawney Phil]

Aye

[Lechasseur]

Nay

[Mr. Reactionary]

Vote is closed. Bill fails, 1-2-0; 4 not voting.