After all that crap about people not wanting some bureaucrat coming between them and their doctor, why is it suddenly okay for your boss to get in there?
Who says it is? I personally don't. Unfortunately, it being okay has been the de facto situation for years.
I don't think they do. It looks to me like they need a waiver under Section 1332, which is a HHS thing. Essentially they need to show they're providing equivalent coverage.And, actually, Vermont's plan will require an act of Congress. They have to pass an active amendment to the ACA to allow it. So, pretty much, Vermont's idea won't go anywhere.
Looking a little closer at Vermont's plan. They have indeed passed a single-payer plan, but they will need federal approval to use it in place of an exchange. So you're right, that language isn't in the ACA, but it seems possible to make it work. Not sure if it requires an act of Congress or just the executive branch.
I read section 1332. I also read through the rest of the law.
Here's the problem: The law does not, in any place, actually authorize a single-payer plan as acceptable. It tends to require that plans be equal to what is provided within the law itself, but still requires those plans to operate under the current healthcare system. A single-payer plan does not operate under that system.
I don't think they do. It looks to me like they need a waiver under Section 1332, which is a HHS thing. Essentially they need to show they're providing equivalent coverage.And, actually, Vermont's plan will require an act of Congress. They have to pass an active amendment to the ACA to allow it. So, pretty much, Vermont's idea won't go anywhere.
Looking a little closer at Vermont's plan. They have indeed passed a single-payer plan, but they will need federal approval to use it in place of an exchange. So you're right, that language isn't in the ACA, but it seems possible to make it work. Not sure if it requires an act of Congress or just the executive branch.I read section 1332. I also read through the rest of the law.
Here's the problem: The law does not, in any place, actually authorize a single-payer plan as acceptable. It tends to require that plans be equal to what is provided within the law itself, but still requires those plans to operate under the current healthcare system. A single-payer plan does not operate under that system.
Not explicitly, but as near as I can tell it just requires equivalent levels of coverage. It's a waiver to various portions of the ACA.
I'm no expert on reading legalese, but it definitely seems like it's commonly seen as a workable option.
Key word there is "equivalent." A single-payer plan would not qualify as equivalent because it is a lot more difficult for companies to compete against a government.
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It is a common misconception that health benefits amount to "somebody else paying for your stuff." They don't. They are part of your salary. Part of your compensation for your work.
Hobby Lobby is basically telling their workers what they can or cannot do with their wages. And the Supreme Court handed them the right to do so.Are health benefits legally considered the same as regular wages? I could see it going both ways, but I lean more toward the rule of "It's not your money until you cash the check".
Absolutely, look at your HR documents. They are considered part of your "total compensation package".
Note that they are talking about the premium contribution, not the actual payment that you hand to your doctor.
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Don't worry. The court hedged the opinion around with enough qualifiers that they can easily find excuses to not have it apply to any such out of the mainstream beliefs. Just that icky sex stuff.That wouldn't surprise me. I'm continually amazed the court can make decisions based of what they say are people's fundamental rights, and then base what those are and differentiate them from other very similar things they don't consider rights by what amounts to almost complete arbitrariness on their part because reasons.
Yeah... Try to avoid reading any of Scalia's opinions if that kind of thing bothers you. :/
Key word there is "equivalent." A single-payer plan would not qualify as equivalent because it is a lot more difficult for companies to compete against a government.I don't think they do. It looks to me like they need a waiver under Section 1332, which is a HHS thing. Essentially they need to show they're providing equivalent coverage.And, actually, Vermont's plan will require an act of Congress. They have to pass an active amendment to the ACA to allow it. So, pretty much, Vermont's idea won't go anywhere.
Looking a little closer at Vermont's plan. They have indeed passed a single-payer plan, but they will need federal approval to use it in place of an exchange. So you're right, that language isn't in the ACA, but it seems possible to make it work. Not sure if it requires an act of Congress or just the executive branch.I read section 1332. I also read through the rest of the law.
Here's the problem: The law does not, in any place, actually authorize a single-payer plan as acceptable. It tends to require that plans be equal to what is provided within the law itself, but still requires those plans to operate under the current healthcare system. A single-payer plan does not operate under that system.
Not explicitly, but as near as I can tell it just requires equivalent levels of coverage. It's a waiver to various portions of the ACA.
I'm no expert on reading legalese, but it definitely seems like it's commonly seen as a workable option.
"equivalent coverage". Not "equivalent in all ways".
(1) IN GENERAL
—The Secretary may grant a request for
a waiver under subsection (a)(1) only if the Secretary determines that the State plan—
(A) will provide coverage that is at least as comprehensive as the coverage defined in section 1302(b) and offered through Exchanges established under this title as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services based on sufficient data from the State and from comparable States about their experience with programs created by this Act and the provisions of this Act that would be waived;
(B) will provide coverage and cost sharing protections against excessive out-of-pocket spending that are at least as affordable as the provisions of this title would provide;
(C) will provide coverage to at least a comparable number of its residents as the provisions of this title would provide; and
(D) will not increase the Federal deficit.Not a word about "as easy for companies to compete with.
(A) is a little confusing, but I believe it's describing what the plan must be equivalent to, not saying it must also be offered through exchanges.
(A) is intended to be read both ways. It's a sneaky bit of wording that is intended to force the states to use the Exchange. And the reason why (A) is designed that way is this bit of text from (a)(1):
(1) IN GENERAL.—A State may apply to the Secretary for the waiver of all or any requirements described in paragraph (2) with respect to health insurance coverage within that State for plan years beginning on or after January 1, 2017. Such application shall—
(A) be filed at such time and in such manner as the Secretary may require;
(B) contain such information as the Secretary may require, including—
(i) a comprehensive description of the State legislation and program to implement a plan meeting the requirements for a waiver under this section; and
(ii) a 10-year budget plan for such plan that is budget neutral for the Federal Government; and
(C) provide an assurance that the State has enacted the law described in subsection (b)(2).
Note the date on that: 2017. Vermont will have to wait 2.5 years before it can get its plan to qualify, by which point the Exchange will be set up, in place, entrenched, and nearly impossible to remove without making an even bigger mess.
However, note this text from (a)(2):
(2) REQUIREMENTS.—The requirements described in this paragraph with respect to health insurance coverage within the State for plan years beginning on or after January 1, 2014, are as follows:
(A) Part I of subtitle D.
(B) Part II of subtitle D.
(C) Section 1402.
(D) Sections 36B, 4980H, and 5000A of the Internal Revenue Code of 1986.
Now we get into the meat and potatoes of what Vermont is actually trying to do and the actual legal requirements. Now, let's see the actual requirements:
(a) QUALIFIED HEALTH PLAN.—In this title:
(1) IN GENERAL.—The term ‘‘qualified health plan’’ means
a health plan that—
(A) has in effect a certification (which may include
a seal or other indication of approval) that such plan meets
the criteria for certification described in section 1311(c)
issued or recognized by each Exchange through which such
plan is offered;
(B) provides the essential health benefits package
described in section 1302(a); and
(C) is offered by a health insurance issuer that—
(i) is licensed and in good standing to offer health
insurance coverage in each State in which such issuer
offers health insurance coverage under this title;
(ii) agrees to offer at least one qualified health
plan in the silver level and at least one plan in the
gold level in each such Exchange;
(iii) agrees to charge the same premium rate for
each qualified health plan of the issuer without regard
to whether the plan is offered through an Exchange
or whether the plan is offered directly from the issuer
or through an agent; and
(iv) complies with the regulations developed by
the Secretary under section 1311(d) and such other
requirements as an applicable Exchange may establish.
Note the part I bolded. That text is actually incredibly key to this. Here's the relevant quote:
(c) RESPONSIBILITIES OF THE SECRETARY.—
(1) IN GENERAL.—The Secretary shall, by regulation, establish criteria for the certification of health plans as qualified health plans. Such criteria shall require that, to be certified, a plan shall, at a minimum—
(A) meet marketing requirements, and not employ marketing practices or benefit designs that have the effect of discouraging the enrollment in such plan by individuals with significant health needs;
(B) ensure a sufficient choice of providers (in a manner consistent with applicable network adequacy provisions under section 2702(c) of the Public Health Service Act), and provide information to enrollees and prospective enrollees on the availability of in-network and out-of-network providers;
(C) include within health insurance plan networks those essential community providers, where available, that serve predominately low-income, medically-underserved individuals, such as health care providers defined in section 340B(a)(4) of the Public Health Service Act and providers described in section 1927(c)(1)(D)(i)(IV) of the Social Security Act as set forth by section 221 of Public Law 111–8, except that nothing in this subparagraph shall be construed to require any health plan to provide coverage for any specific medical procedure;
(i) be accredited with respect to local performance on clinical quality measures such as the Healthcare Effectiveness Data and Information Set, patient experience ratings on a standardized Consumer Assessment of Healthcare Providers and Systems survey, as well as consumer access, utilization management, quality assurance, provider credentialing, complaints and appeals, network
adequacy and access, and patient information programs by any entity recognized by the Secretary for the accreditation of health insurance issuers or plans (so long as any such entity has transparent and rigorous methodological and scoring criteria); or
(ii) receive such accreditation within a period established by an Exchange for such accreditation that is applicable to all qualified health plans;
(E) implement a quality improvement strategy described in subsection (g)(1);
(F) utilize a uniform enrollment form that qualified individuals and qualified employers may use (either electronically or on paper) in enrolling in qualified health plans offered through such Exchange, and that takes into account criteria that the National Association of Insurance Commissioners develops and submits to the Secretary;
(G) utilize the standard format established for presenting health benefits plan options; and
(H) provide information to enrollees and prospective enrollees, and to each Exchange in which the plan is offered, on any quality measures for health plan performance endorsed under section 399JJ of the Public Health Service Act, as applicable.
In other words, this is intentionally set up to prevent single-payer plans because it requires the providers to compete against each other in a market.
After all that crap about people not wanting some bureaucrat coming between them and their doctor, why is it suddenly okay for your boss to get in there?
It became their boss's business the minute they demanded their boss pay for insurance directly. Haven't you heard the old expression, "He who pays the piper calls the tune"?
I wish insurance was never tied to employment in the first place. Just raise my salary to compensate, then I (and everyone else) could buy whatever kind of insurance I want, without my employer involved at all.
Except the ACA was written and passed with 0 GOP input or anything. It was purely from differing factions in the Democratic party. The ACA was a highly unpopular train wreck from the start.
(Note that I am a Libertarian Conservative or a Conservative Libertarian, so I am opposed to the whole thing.)
Except that is not true - the committee that wrote the ACA consisted of both Democrats and Republicans. In fact, in order to even get it before Congress both parties had to make concessions. Oh, and it did have GOP support - otherwise it would have never been passed into law as the Democrats did not have control of both the House and the Senate and would have required GOP support in order to get it passed. It was the conservative, not the moderate, members of the GOP that were opposed to it from the start.
Those are the very requirements that the waiver gets you out of. That's the whole point of getting the waiver.
Before I go on, there is one quote you need to see:
SEC. 1323. COMMUNITY HEALTH INSURANCE OPTION [STRICKEN].
[Section stricken by section 10104(m)]
All capacity for what Vermont is trying has been intentionally removed from this law.
That said, I need a bit of time to go over the text. But keep in mind this is a healthcare market reform. Not a medical system reform. There are limitations to the power of the Secretary of the HHS.
(c) SCOPE OF WAIVER.—
(1) IN GENERAL.—The Secretary shall determine the scope of a waiver of a requirement described in subsection (a)(2) granted to a State under subsection (a)(1).
(2) LIMITATION.—The Secretary may not waive under this section any Federal law or requirement that is not within the authority of the Secretary.
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Hit me up with the 16?I don't remember Hobby Lobby ever telling their employees that they can't spend their money on one of the 4 birth control methods if they want to. They cover 16 in their health coverage. They pay their full-time employees 90% more than minimum wage...almost twice the minimum wage. If you work for Hobby Lobby and are making that good working wage for what is usually a lower paying job and then you complain that you can't get a "morning after pill" for free when you had 16 other free methods available to not get pregnant then you can reach into your fatter-than-people-doing-comparable-jobs-in-comparable-companies pockets and pay for it.
I just don't understand it. Frickin' burger flippers trying to demand 15-20 $ an hour, people making almost double the minimum wage in a minimum wage job and complaining about how is covered in their healthcare....
I guess it's just me but I don't feel sorry for some idiot making almost double what he/she could be, who passes over 16 forms of covered contraceptives, who then gets pregnant and complains that the 4 methods of contraceptives that could then work are not covered while my wife, who also works for a corporation, has coverage that sucks in general.
I hope Hobby Lobby re-vamps their organization and offers all that crap, and then lowers wages to the market standard. If they are getting punished for trying to pay their employees better than normal then the employees complain about other non-issues, then just forget about trying to make the employees happy. Offer the same coverage and pay as other standards of the market.
It includes access, copay-free, to the following categories of FDA-approved birth-control:
Male condoms
Female condoms
Diaphragms with spermicide
Sponges with spermicide
Cervical caps with spermicide
Spermicide alone
Birth-control pills with estrogen and progestin (“Combined Pill)
Birth-control pills with progestin alone (“The Mini Pill)
Birth control pills (extended/continuous use)
Contraceptive patches
Contraceptive rings
Progestin injections
Implantable rods
Vasectomies
Female sterilization surgeries
Female sterilization implants
The only thing they didn't want to cover was "morning-after pills", "week-after pills", and 2 forms of IUDs that prevent a fertilized egg from attaching to a uterus lining. Their basic stance is that they will cover you to not get pregnant but once you fertilize an egg, you pay for it yourself.
People want to vilify them and say that it opens the door for companies to opt out of coverage and all that crap....who is forcing people to work for these companies? An employee has a choice. You take the options that a company offers you when you work for them or you find a company that has a better offer. If you don't like the benefits and pay that a company provides then don't work for them. It really is that simple. Some companies will certainly take advantage and strip down their benefits for a quick profit but in the long-term when the employee pool is getting less-experienced, less desirable employees and the company starts taking a hit, then they will either realize that they need to offer better benefits or they will fall to other companies that do.
Hobby Lobby has a very nice benefits package for it's employees.
Those are the very requirements that the waiver gets you out of. That's the whole point of getting the waiver.Before I go on, there is one quote you need to see:
SEC. 1323. COMMUNITY HEALTH INSURANCE OPTION [STRICKEN].
[Section stricken by section 10104(m)]All capacity for what Vermont is trying has been intentionally removed from this law.
That said, I need a bit of time to go over the text. But keep in mind this is a healthcare market reform. Not a medical system reform. There are limitations to the power of the Secretary of the HHS.
No. That was the "public option". That was not single payer, but a competing federal insurance plan. It's not even remotely related to what Vermont is trying. And it was Removed to get Lieberman's vote.
Look, I'm not an expert on parsing legal texts, I can't even tell what you're trying to argue here, but everything I've read about it says that states can use section 1322 to set up single payer plans at the state level as long as the provide equivalent levels of coverage. Vermont is moving ahead on their plan under this assumption. Perhaps you've seen some trap in the language their lawyers haven't. But I doubt it.
Here's the trap: Where does it say the Secretary of HHS has the power to allow a single-payer option? The competing federal insurance plan would have at least allowed a groundwork for arguing it.
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I just don't understand it. Frickin' burger flippers trying to demand 15-20 $ an hour, people making almost double the minimum wage in a minimum wage job and complaining about how is covered in their healthcare....
I guess it's just me but I don't feel sorry for some idiot making almost double what he/she could be, who passes over 16 forms of covered contraceptives, who then gets pregnant and complains that the 4 methods of contraceptives that could then work are not covered while my wife, who also works for a corporation, has coverage that sucks in general.
...
Please don't take this the wrong way, but it is probably the same lack of empathy for "some idiot" that results in your wife's poor health care. I'm guessing that you probably make well more then minimum wage, and that you make a decent living wage for your area. I'm guessing that you and your wife feel you deserve better care then you get and better care then that idiot you mentioned. Now there are many people making not twice, or four times, or even ten times, but 100 times more money then you make. If you work for a corporation, there are probably many who make decisions about your compensation and benefits. To them, you and your wife are the "idiots" who get paid far more then the minimum wage they feel you deserve. In their minds YOU should just be glad to have a job at all, since outsourcing your jobs would save them all kinds of money.
The measure of how deserving you are of healthcare is not based on the size of your bank account. That guy flipping burgers, or the CEO of Burgercorp is neither superior nor inferior to you. People deserve the best healthcare and education that the society can provide, not the most they can buy leaving the scraps for the poor.
I agree but the real argument here is more about a company that is being dragged through the gutter for some horrible "slight" towards it's employees, and not so much about how we should all have great medical coverage. I want us all to have equal, free access to everything possible in the healthcare industry but that is not going to happen in America. In the meantime, if you add up the perks to your job and find them lacking you need to move to a different job and not cry to the government to make them pay more, offer more benefits, give mandatory vacations, etc....nobody is forcing anyone to stay in their job. If you don't like it then find someone offering better.
Also I think Hobby Lobby has a special situation with regard to the health care insurance they provide. I don't know all the details, but I don't think it is the same as going to a regular insurance provider.
Most companies are going to get their insurance from a regular insurance company. Those companies aren't going to be interested in a 500 different specific policies. Instead they will say you can take A, B, or C (all of which will provide the coverage required by law). A company can say, we don't like X in plan A, Y in plan B, or X in plan C. But the insurance company will probably just say, that is nice, so do you want A, B, or C?
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The only thing they didn't want to cover was "morning-after pills", "week-after pills", and 2 forms of IUDs that prevent a fertilized egg from attaching to a uterus lining. Their basic stance is that they will cover you to not get pregnant but once you fertilize an egg, you pay for it yourself.
People want to vilify them and say that it opens the door for companies to opt out of coverage and all that crap....who is forcing people to work for these companies? An employee has a choice. You take the options that a company offers you when you work for them or you find a company that has a better offer. If you don't like the benefits and pay that a company provides then don't work for them. It really is that simple. Some companies will certainly take advantage and strip down their benefits for a quick profit but in the long-term when the employee pool is getting less-experienced, less desirable employees and the company starts taking a hit, then they will either realize that they need to offer better benefits or they will fall to other companies that do.
Hobby Lobby has a very nice benefits package for it's employees.
Sure, employees could look for work else where. By that same logic, I can just point out that Hobby Lobby's owners aren't required to employ workers. If they find the concept of NOT imposing their religious beliefs on others to be too onerous, they can just choose not to run their business.
If Hobby Lobby doesn't like the rules the rest of us have made, they can just close up shop and find another way to make a living.
That's the EXACT same logic as saying that employees can just go elsewhere for employment. Since it cuts both way, it's a moot point and doesn't actually help your argument.
Sex is a little more fundamental to human relationships than RPGs. People are going to have sex, whether or not birth control is covered. If birth control is covered, more people will use it and use more effective methods (IUDs and the pill rather than condoms.) More people using birth control means less unwanted children and less abortions, which I think we can all agree is a good thing.
And as an aside here, we're not just talking about one-night stands and casual sex. It applies just as much to the married couple that wants kids, but not one a year for the length of their marriage.
Others have pointed out cases where the pill is prescribed for reasons that have nothing to do with sex. I'd add cases where, for medical reasons, carrying a pregnancy to term would be dangerous for the woman. Though there it's still used as a contraceptive, the intent is to prevent risk of serious harm.
More broadly though, reliable contraception is an integral part of women's health care. Widespread access to reliable contraception changed women's lives. Changed the roles they could play in society. Without it, we go back to the bad old days. It's nowhere near so simple as "We can live without sex, so birth control is optional."
Okay I see your point. And did not know as others have reveal that their are health reasons. Those I fully support as most would I would imagine. I'll even add in if your job involves sex and pregnancies would get in the way.
But you statement of sex on human relationship...is very generalized. Also there is a lot of sexual things you can do without the risk of pregnancies.
But I kinda think you are to a certain point removing responsibility and forming a reliance on the government here that are very much dangerous to individual freedoms.
Also you refer to the 'bad old days'....where women were seen as sex objects(I am guessing here) and change it so they can still be viewed as sex objects...without the consequences. I don't see that being much better.
I will fight for your right to do anything(as long as you don't harm others)....but I kinda of grow concerned when the government get involved with anything and start having to pay for it.
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The only thing they didn't want to cover was "morning-after pills", "week-after pills", and 2 forms of IUDs that prevent a fertilized egg from attaching to a uterus lining. Their basic stance is that they will cover you to not get pregnant but once you fertilize an egg, you pay for it yourself.
People want to vilify them and say that it opens the door for companies to opt out of coverage and all that crap....who is forcing people to work for these companies? An employee has a choice. You take the options that a company offers you when you work for them or you find a company that has a better offer. If you don't like the benefits and pay that a company provides then don't work for them. It really is that simple. Some companies will certainly take advantage and strip down their benefits for a quick profit but in the long-term when the employee pool is getting less-experienced, less desirable employees and the company starts taking a hit, then they will either realize that they need to offer better benefits or they will fall to other companies that do.
Hobby Lobby has a very nice benefits package for it's employees.Sure, employees could look for work else where. By that same logic, I can just point out that Hobby Lobby's owners aren't required to employ workers. If they find the concept of NOT imposing their religious beliefs on others to be too onerous, they can just choose not to run their business.
If Hobby Lobby doesn't like the rules the rest of us have made, they can just close up shop and find another way to make a living.
That's the EXACT same logic as saying that employees can just go elsewhere for employment. Since it cuts both way, it's a moot point and doesn't actually help your argument.
And that is the self-entitled, self-important attitude which is why we have this issue going on currently. A company can operate under any reasoning that they want. Sure there are guidelines laid down by the government (which apparently it is great to have government interference in companies but none in our lives, dammit!lol) that make it illegal for companies to do X,Y, and Z. But if a company wants to operate within a certain religious stricture then they should be able to. Employees can choose not to work there and customers can choose not to buy there but the government should not be able to say "oh hells no you can't operate with the morals you want, you have to use ours". If it was a person being told that by the government then that would be a horrible, awful thing but a company made by that same person and grown upon the basis of that person's personal code....now it's OK to infringe on the freedoms of that individual and his company? Hobby Lobby is a company made by an individual or group of individuals who has a religiously imposed moral code. Why is it OK to protect the legal right and freedom of a religious individual and not that individual's company?
Here's the trap: Where does it say the Secretary of HHS has the power to allow a single-payer option? The competing federal insurance plan would have at least allowed a groundwork for arguing it.Those are the very requirements that the waiver gets you out of. That's the whole point of getting the waiver.Before I go on, there is one quote you need to see:
SEC. 1323. COMMUNITY HEALTH INSURANCE OPTION [STRICKEN].
[Section stricken by section 10104(m)]All capacity for what Vermont is trying has been intentionally removed from this law.
That said, I need a bit of time to go over the text. But keep in mind this is a healthcare market reform. Not a medical system reform. There are limitations to the power of the Secretary of the HHS.
No. That was the "public option". That was not single payer, but a competing federal insurance plan. It's not even remotely related to what Vermont is trying. And it was Removed to get Lieberman's vote.
Look, I'm not an expert on parsing legal texts, I can't even tell what you're trying to argue here, but everything I've read about it says that states can use section 1322 to set up single payer plans at the state level as long as the provide equivalent levels of coverage. Vermont is moving ahead on their plan under this assumption. Perhaps you've seen some trap in the language their lawyers haven't. But I doubt it.
To add to this: I've searched the entire law. It doesn't have anything allowing a single-payer plan.
It does provide for an argument for a state to set up its own insurance plan, but nothing within the law actually grants the Secretary of the HHS the power to, in effect, make a state immune to most of the provisions of the law in order to get a single-payer plan to work.
That's why Congress has to step in on this one.
1. How this decision may water down HIPAA - generally an employer has no right to any private health information for any of its employees, so it becomes very odd in how this will be handled. Especially if this exception for religious beliefs becomes more widespread. To my knowledge, there is no real way the CPT or diagnosis system is going to really differentiate between billing for "acceptable" vs. "unacceptable" birth control, especially as it will apparently vary by the company's current belief system. While individual medications may be added to a list, I don't know many health professionals that would know to or care to try to find a specific list of things they can't discuss with or prescribe to a patient because of who their employer happens to be.I'm not sure that's really an issue.
This is all done through the insurance company anyway, which already gets the information. Insurance companies already have lists of prescription drugs they do and do not cover or cover at various percentages and/or co-pays, so I assume this would be handled the same way.
Think I may have been unclear. Note the bolded part.
While I acknowledge there are ways that specific meds may excluded, I was more concerned about the expectations on health providers' billing (ex if Hobby Lobby thinks that they are going to be able to find out what birth control measures your MD spoke with you about, &/or prescribed for you, rather than the prescription you filled). In addition, many people these days also have separate Rx plans for their prescription drugs which have little to no information overlap with their actual medical coverage, so there is additional obfuscation from that point of view if the medical coverage is through the employer, but the employee has addition Rx coverage through a supplemental plan not tied to the employer.It's simple enough: The company auto-denies until the employee provides all of the necessary documentation as to what the procedure is actually for. There's no law against that thanks to that ruling.
I know of no companies who are directly billed for medical services, generally billing goes to the insurance company, managed care company, or Rx provider if it is not going directly to the member. In addition, there ARE many laws which prohibit automatic denials such as what you are describing, though most are on a state level or part of CMS criteria.
-TimD
Hit me up with the 16?I don't remember Hobby Lobby ever telling their employees that they can't spend their money on one of the 4 birth control methods if they want to. They cover 16 in their health coverage. They pay their full-time employees 90% more than minimum wage...almost twice the minimum wage. If you work for Hobby Lobby and are making that good working wage for what is usually a lower paying job and then you complain that you can't get a "morning after pill" for free when you had 16 other free methods available to not get pregnant then you can reach into your fatter-than-people-doing-comparable-jobs-in-comparable-companies pockets and pay for it.
I just don't understand it. Frickin' burger flippers trying to demand 15-20 $ an hour, people making almost double the minimum wage in a minimum wage job and complaining about how is covered in their healthcare....
I guess it's just me but I don't feel sorry for some idiot making almost double what he/she could be, who passes over 16 forms of covered contraceptives, who then gets pregnant and complains that the 4 methods of contraceptives that could then work are not covered while my wife, who also works for a corporation, has coverage that sucks in general.
I hope Hobby Lobby re-vamps their organization and offers all that crap, and then lowers wages to the market standard. If they are getting punished for trying to pay their employees better than normal then the employees complain about other non-issues, then just forget about trying to make the employees happy. Offer the same coverage and pay as other standards of the market.It includes access, copay-free, to the following categories of FDA-approved birth-control:
Male condoms
Female condoms
Diaphragms with spermicide
Sponges with spermicide
Cervical caps with spermicide
Spermicide alone
Birth-control pills with estrogen and progestin (“Combined Pill)
Birth-control pills with progestin alone (“The Mini Pill)
Birth control...
Those seem like some fairly arbitrary lines to draw. Any hormone-based birth control regimen works (either in whole or in part) by thinning the inner-uterine wall to prevent viable implantation of fertilized eggs.
If they are going to split the hair that some of those regimen (regimii?) work to prevent ovulation then some medical company should just create an IUD called "the goalie," which purports to "prevent pregnancy by guarding the net!" ... Also causing inner-uterine irritation which may prevent implantation.
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So how is this company infringing on it's employees' rights? They don't make you enter into a moral contract. They provide free condoms and everything else besides post-fertilization birth controls. You are free to still work there after using any of the un-covered birth controls, you just have to pay for it yourself. If this argument is about that now other companies can cease to provide coverage of birth control, so what? The government had no right forcing companies to provide stuff like that anyway. It shouldn't be mandatory to cover birth control UNLESS it is a need for the health of a person. My wife has such a need but her company only covers a certain amount for birth control and leave her to pay for some out of pocket because it is birth control and not a "real" medicine, even though a real medicine's prescription would be 100% covered.
Hobby Lobby is still the victim here.
I know of no companies who are directly billed for medical services, generally billing goes to the insurance company, managed care company, or Rx provider if it is not going directly to the member. In addition, there ARE many laws which prohibit automatic denials such as what you are describing, though most are on a state level or part of CMS criteria.
But since companies can refuse to pay for medical coverage related to birth control for religious reasons, how many of those laws still have standing?
If a company says, "We believe the treatment was birth control related and against our religion," can the states really say they are violating the law for denying coverage for the treatment now? And, in that case, the treatment has to be proven to not be related to birth control; the company can just point out that privacy laws prevent it from accessing medical records and it is using its own judgement. Which means that to challenge the denial, the employee must first prove they have a legal basis for challenging the denial. Which, in turn, requires giving up the medical information.
It really, really was a rather bad ruling.
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Those seem like some fairly arbitrary lines to draw. Any hormone-based birth control regimen works (either in whole or in part) by thinning the inner-uterine wall to prevent viable implantation of fertilized eggs.
If they are going to split the hair that some of those regimen (regimii?) work to prevent ovulation then some medical company should just create an IUD called "the goalie," which purports to "prevent pregnancy by guarding the net!" ... Also causing inner-uterine irritation which may prevent implantation.
Who cares about what lines they've drawn? They cover most birth control. For free. Wear a condom on each of you with sponges and spermicide and diaphragms while on the pill with implants and a patch. If you have free access to all that and still get an unwanted pregnancy why should they be forced to cover that for you? They gave you 16 Free ways to avoid a pregnancy. There are 4 they don't like and don't want to cover. How is this a major issue?
Well, one use of the IUD that is now no longer covered and is quite expensive, is to prevent hysterectomy. something other forms of birth control that are still covered, do not do. So this is a life-saving medical device for some people.
You sure you know what a "hysterectomy" is? Cause it sounds like you don't.
http://www.webmd.com/women/guide/hysterectomy
An IUD prevents a medical procedure? Only until it is removed....
I'm aware of what a hysterectomy is, and IUD's are an alternative to hysterectomy for treatment of some conditions http://www.ncbi.nlm.nih.gov/pubmed/21074150. IUD's that are not abortifacents, but are now no longer covered because the company erroneously believes them to be. And they aren't cheap either.
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Who cares about what lines they've drawn? They cover most birth control. For free. Wear a condom on each of you with sponges and spermicide and diaphragms while on the pill with implants and a patch. If you have free access to all that and still get an unwanted pregnancy why should they be forced to cover that for you? They gave you 16 Free ways to avoid a pregnancy. There are 4 they don't like and don't want to cover. How is this a major issue?Those seem like some fairly arbitrary lines to draw. Any hormone-based birth control regimen works (either in whole or in part) by thinning the inner-uterine wall to prevent viable implantation of fertilized eggs.
If they are going to split the hair that some of those regimen (regimii?) work to prevent ovulation then some medical company should just create an IUD called "the goalie," which purports to "prevent pregnancy by guarding the net!" ... Also causing inner-uterine irritation which may prevent implantation.
Several reasons this is a major issue. For one, preventing pregnancy is not the only purpose for several of these devices/drugs. Two, their complaints are based on the erroneous belief that they are cause abortions. Three, a for-profit corporation shouldn't have religious rights at all. Four, it's not a good idea to give a corporation final say over the medical needs of their employees, how long before cancer treatments aren't covered because cancer is a mark of the devil? Five, this ruling targets women specifically, Viagra and other Erectile Dysfunction treatments are still covered, along with prostate exams.
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Who cares about what lines they've drawn? They cover most birth control. For free. Wear a condom on each of you with sponges and spermicide and diaphragms while on the pill with implants and a patch. If you have free access to all that and still get an unwanted pregnancy why should they be forced to cover that for you? They gave you 16 Free ways to avoid a pregnancy. There are 4 they don't like and don't want to cover. How is this a major issue?Those seem like some fairly arbitrary lines to draw. Any hormone-based birth control regimen works (either in whole or in part) by thinning the inner-uterine wall to prevent viable implantation of fertilized eggs.
If they are going to split the hair that some of those regimen (regimii?) work to prevent ovulation then some medical company should just create an IUD called "the goalie," which purports to "prevent pregnancy by guarding the net!" ... Also causing inner-uterine irritation which may prevent implantation.
IUD's are hardly a reactionary measure. The real issue is that it isn't hobby lobby's money to exert moral authority over. It is compensation for service rendered. They shouldn't be able to extend their moral authority over their employee's use of compensation.
The fact that the new minimum required compensation includes services in addition to money should have no impact on the company's ability to regulate the use of those services.
Well the company could always choose not to pay. The employees would then get none of it and the government would fine the company directly and again the employees would get none of it. How is the employee's money again?
Three, a for-profit corporation shouldn't have religious rights at all.
Right, because once you start a company, all of your 1st amendment freedoms go out the window.
Well the company could always choose not to pay. The employees would then get none of it and the government would fine the company directly and again the employees would get none of it. How is the employee's money again?
Compensation is compensation. Yes the company could not pay, and on top of the fine the government would apply, the employees could sue and receive damages from their employer for not providing minimum compensation.
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Three, a for-profit corporation shouldn't have religious rights at all.Right, because once you start a company, all of your 1st amendment freedoms go out the window.
You are not your company.
Yeah, my thoughts exactly. We need to force Chick-Fil-A to work Sundays then....Three, a for-profit corporation shouldn't have religious rights at all.Right, because once you start a company, all of your 1st amendment freedoms go out the window.
Non sequitur.
I suppose I could debate that, but the SCotUS just decided my point was more valid.
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Well the company could always choose not to pay. The employees would then get none of it and the government would fine the company directly and again the employees would get none of it. How is the employee's money again?Compensation is compensation. Yes the company could not pay, and on top of the fine the government would apply, the employees could sue and receive damages from their employer for not providing minimum compensation.
Is that minimum compensation not met with 16 contraceptive measures that are covered for no out of pocket for the employee? They don't cover the Morning After pill, the Week After pill and 2 IUDs....It seems the minimum compensation is more than met, just not popular with those who dislike the idea of a company having religious freedoms....
Well the company could always choose not to pay. The employees would then get none of it and the government would fine the company directly and again the employees would get none of it. How is the employee's money again?Compensation is compensation. Yes the company could not pay, and on top of the fine the government would apply, the employees could sue and receive damages from their employer for not providing minimum compensation.
Pretty unlikely as there are already avenues (exchanges, medicaid, tax credits, etc) that people who don't get health care from their job already have. These employees would just fall into that group.
Let's be clear, the law doesn't require companies to give insurance. It doesn't give anyone a "right" to insurance. Instead it says the government will tax companies of certain sizes if they don't provide it. So giving insurance to their employees is a way to avoid a tax, not a right of the employees.
So it would be a little hard suing for not getting minimum compensation. That would be if they weren't paying overtime or paying minimum wage or something.
Is that minimum compensation not met with 16 contraceptive measures that are covered for no out of pocket for the employee? They don't cover the Morning After pill, the Week After pill and 2 IUDs....It seems the minimum compensation is more than met, just not popular with those who dislike the idea of a company having religious freedoms....Well the company could always choose not to pay. The employees would then get none of it and the government would fine the company directly and again the employees would get none of it. How is the employee's money again?Compensation is compensation. Yes the company could not pay, and on top of the fine the government would apply, the employees could sue and receive damages from their employer for not providing minimum compensation.
I do think it is laughable that a company (as a company) can have a religious belief. That does mean that the owners/operators of that company can't have religious beliefs, nor does it mean that they can't run the company in line with their beliefs. But the company itself is not an entity which should be given first amendment protections.
But my real issue is that companies shouldn't be able to dictate how I spend my compensation. It doesn't matter how many options I have. My employer shouldn't be in a position to remove ANY options from how I spend my compensation. Your employer can't tell you that you can't buy a 4 bedroom house, or Hershey's chocolate bars, or hookers and blow. It doesn't matter that there are all kinds of reasonable housing options that don't have 4 bedrooms, or other candy options, or other vices. It's my compensation, I worked for it, I earned it, I'll spend it as I choose.
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A company isn't a person. It isn't able to walk into a place of worship and offer thanks. It's an organization, composed of many people. The moment that line is crossed, the moment the world really starts to crumble.
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I do think it is laughable that a company (as a company) can have a religious belief. That does mean that the owners/operators of that company can't have religious beliefs, nor does it mean that they can't run the company in line with their beliefs. But the company itself is not an entity which should be given first amendment protections.But my real issue is that companies shouldn't be able to dictate how I spend my compensation. It doesn't matter how many options I have. My employer shouldn't be in a position to remove ANY options from how I spend my compensation. Your employer can't tell you that you can't buy a 4 bedroom house, or Hershey's chocolate bars, or hookers and blow. It doesn't matter that there are all kinds of reasonable housing options that don't have 4 bedrooms, or other candy options, or other vices. It's my compensation, I worked for it, I earned it, I'll spend it as I choose.
They never said their employees can't use any of the options, only that they will not pay for their employees to use Morning After, Week After pills and 2 IUDs. The employee can still choose to purchase whatever they wish. Use your compensation how you wish, the company however decides what you are being compensated. Your wages, how much coverage they provide, your co-pays, how much dental and eyecare....that is all determined by the company. Your only decision is whether you wish to work for them or not. They can even require you to sign morality clauses if you wish to work for them. The idea that you dictate what your employer owes you is laughable and points to how self-entitled we have become.
So how many stores do you have to own before you abdicate your morals to corporate sterility? Should corporations then be banned from donating to causes they morally agree with like gay rights?
Donation is the only thing I'm comfortable with, and even then only up to a point. No shell organizations or puppet groups fully funded by a company in private so that one can distance themselves from their beliefs.