1. The Senate Health Care Bill violates U.S. Constitution in that it blatantly violates the #9 Amendment, Rights Retained by the People
2. The Senate Health Care Bill violates U.S. Constitution in that it blatantly violates the #10 Amendment, Rights Retained by States.
3. The Senate Health Care Bill violates U.S. Constitution in that it blatantly violates the #14 Amendment, Civil Rights
4. The Senate Health Care Bill violates U.S. Constitution in that it blatantly violates the #16 Amendment, Income Taxes

Health Reform- What you need to know
The following considerations should be taken into account when deciding to move nearly 17% of the GDP ($2.23 Trillion) of the US into a government controlled program.

First, the US healthcare system is the envy of the world. America produces nearly 60% of miracle drugs and medical devices which save lives and costs of treating patients worldwide. Today, people take a pill on an outpatient basis when 25 years ago the same treatment would have required hospitalization, and invasive and risky surgery at considerable costs along with lost work and rehabilitation time. It is argued that some people are not covered by insurance and therefore have exposure to significant costs and reduced access to needed care. One figure used over the years is between 40 and 48 Million Americans have no health insurance. Few real studies have been conducted to verify this number. Let’s take a closer look at this.

So, who are these uninsured People?

1. There are 17.2 Million college students in America (according to the US census in 06). Many of these students do not have health insurance if their parent’s health policies drop them at a certain age or if they are not still living with the parents. But they do have an insurance plan covered under the University if they sign up for it. They do have basic coverage for routine medical problems and usually have a low utilization rate for hospitalization and advanced physician intervention given their youth and by definition general good health.

2. 15.9 Million of these uninsured are of predominantly Hispanic decent many of them illegal entrants to the US likely working for cash wages with no taxes taken out. They are living in Southwestern states as well as NY, NJ, etc. And millions more are still coming. The planned Universal healthcare solution appears to suggest that Medicare recipients who paid taxes their whole life are now going to have their benefits cut, in part, to pay for illegal entrants.

3. There are 21.2M white; 6.6 M Black and only 2.1 M Asian adults who have no health insurance. In a free country, there are young and healthy people who elect to not spend $400 per month on health insurance they don’t think they need and invest instead in a car payment.

Some of these 29 Million are simply people who lost or quit jobs. . It is also worth noting, that, 45 percent of uninsured people will be uninsured for less than four months according to the Congressional Budget Office. In other words they are uninsured for only a short time.

Accounting for all those factors, one prominent study places the total for the long-term uninsured as low as 8.2 million – a very different reality than the media and national health care advocate’s claim of 48 million.

But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326. Apparently, they choose not to be covered for medical care. America was built on Freedom to Choose.

Let’s also not forget that laws have been passed that require Hospitals to treat people regardless of their ability to pay. In effect, we already have universal free healthcare. Anyone can walk into an ER and demand treatment without an insurance card already.

Subtracting non-citizens and those who can afford their own insurance but choose not to purchase it, about 20 million people are left – less than 7 percent of the population.

So what is the true extent of the uninsured “crisis?” The Kaiser Family Foundation, a liberal non-profit organization frequently quoted by the media, puts the number of uninsured Americans who do not qualify for current government programs and make less than $50,000 a year between 8.2 million and 13.9 million. That is a much smaller figure than the number most often reported in the media. Lastly, Kaiser’s 8.2 million figure for the chronically uninsured only includes those uninsured for two years or more. Lastly, even Obama has revised his own estimates…”The Census report indicates that of the 46 million uninsured individuals, 34 million were native born and 2.8 million naturalized citizens. The report thus shows that there were 36.8 million uninsured U.S. citizens (native born and naturalized) in 2008.” But the census does not tell us how long these were uninsured or why.

The true number of uninsured in American is far below 36.1 million. The bottom line is why don’t we create medical savings account for each of these 36.8 million with access up to $ 2500 each from which to deduct payments for insurance and treatment for any pre existing condition. So why force all 300+ million Americans into a system the overwhelming majority of Americans don’t need or want to pay to help between 5 and 10 % of the population? Why spend $850 Billion. This has little to do with solving a small healthcare gap in coverage. The answer appears to be Votes and Power to socialize the country!

Other things you should know
The Government itself is a major cause of rising healthcare costs

1. In 1960 the healthcare bill in the US was only $5 Billion and 5.1% of the GDP and cost only $141 per person. Our parents paid nearly 60% of the healthcare bills out of pocket as many routine things were not covered only major expensive things were.

2. In 2007, the U.S. spent a projected $2.26 trillion on health care, or $7,439 per person. The government now pays 47% of the healthcare bills [4]. And together with Third party insurance companies Americans now only pay 17% of the bill out of pocket.

3. The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017. [2]

As the role of government in healthcare increased the costs went up astronomically. Health care costs have risen 454 times higher since 1965! When Medicare started in 1965, its budget was $1 Billion. In 2008, the Medicare costs were $454 billion accounted for 14 percent of the federal budget, and federal spending on Medicare is expected to grow to $524 billion by 2011. Medicaid was started in 1965 with a budget of $1 Billion the same as Medicare. Federal Medicaid expenditures were $180.6 billion in 2006, as compared to $181.7 billion in 2007. So, Medicaid has risen 181 times higher since 1965 while Medicare has risen an ASTOUNDING 454 TIMES. By comparison, Gas Prices have only risen about 8 times since 1965. Housing, food, recreation, etc are all less than ten times higher. The notion that the government can add millions to the rolls of the insured and somehow decrease costs is not mathematically possible. The only way any Universal Healthcare plan could expand access to millions of people and simultaneously REDUCE healthcare costs would be to deny care to millions of people. Or cutback on many of the non medically necessary services which were mandated as requirements for insurance companies and reintroduce some co payment and deductibles to replace first dollar coverage insurance plans thereby creating some sense of price competition between providers of care which is virtually nonexistent in healthcare outside managed care capitated contracts which were despised by many.

4. 15% of the people use 85% of the healthcare benefits. A portion of this group includes people with chronic conditions that demand a lot of medical care over a long time period. They also contain some elderly people who consume a large amount of healthcare benefits in the last 6 months of their lives. Also well represented in this high utilization group, are self inflicted maladies by people who do not practice healthy living habits. They are often people who consume alcohol, drugs and food to excess. They also have poor health habits and lifestyles which lead to repeated injury and care. And also immigrants who practice poor prenatal care can result in complicated premature births. Several women already bankrupted one re- insurance company in California with claims that exceeded $1 Million dollars each. Another similar case stayed in the hospital in Florida for over two years resulting in a multimillion dollar uncovered treatment bill. Americans have for years been paying extra for all these kinds of cases. People have not been dying in the streets or denied care for lack of money to pay.

4. Many, many things are now covered under insurance contracts that are not medically necessary and are not insurable events. Politicians lobbied and passed laws to cover virtually everything. Dental disease (everyone has it), sex change operations (really cosmetic and not medically necessary), etc. Insurance was meant to cover things that were catastrophic, happened infrequently and were very expensive. Car accidents, brain tumors, heart attacks. Today we cover everything as insurance. And with the UAW leading the way in the 50”s many have demanded first dollar coverage. In effect, many Americans already have a policy which covers all but a $15 co pay. 15% of patients seeing GPs have nothing wrong with them physically. They are worried well. Yet their visits are paid for. Many others are using drugs, drink a fifth of alcohol per day, have gained 100 pounds, or drive motorcycles recklessly without helmets and have multiple self inflicted healthcare expenses.

5. Another reason costs are rising is medical doctors insist on tests and doing procedures as a form of protection against lawsuits. And doctors and hospitals have a small army of people hired to deal with regulations, compliance and paperwork. Your healthcare bill contains about 25% extra for administrative and medical legal recordkeeping. That’s 25% of $2.26 TRILLION! Much of this expense is due to regulations or in record keeping along with defensive medicine required for medical liability issues. Note that no Health Reform bill has yet addressed this monstrous contributor to your healthcare bill. That is because the trial lawyers like John Edwards make billions off of hospitals and doctors suing them every year and contribute heavily to the Democratic party.

6. Your healthcare is often paid for by a third party. Neither the Dr nor you spend much time asking about costs because it’s “covered”. You are still paying this bill indirectly in the form of lost wages. Your employer could be giving you the money to buy your own plan perhaps with a high deductible like it used to be in the 60’s. 85% of Americans would save a lot of money by moving to this kind of system.

7. Healthcare costs are expensive because there is no free market competition between doctors and hospitals competing for your dollars. Healthcare costs have risen astronomically and quality has improved marginally in comparison. By comparison, you can buy a computer today for $500 that is twenty or more times more powerful and a tiny fraction of the cost of a computer in 1970? And the quality of that computer capability increased ASTRONOMICALLY at the same time the COST WENT DOWN. Airplane tickets generally the same thing. The quality of the planes went up and the costs remained relatively stable. The price of a transcontinental flight in 07 was similar to one in 1970. Airline tickets and computers were not paid for by the government or your employer. So, it should be vividly clear that once the government gets further involved in healthcare costs will go up ASTRONOMICALLY AND YOU WILL BE FORCED TO PAY THE BILL.

8. Under a Universal healthcare system, you can count on one other thing. Your life will be in danger. See the short film below—Brain Surgery Canada style. For decades, Canadians have had to cross the border into the US and pay cash to get care they needed and could not wait in line without risking deadly consequences. Also an estimated 25,000 people died in France several years ago in August when most doctors like everyone else were on Holiday. Don’t forget also that some of the best doctors left the practice of medicine in all countries where national healthcare went into effect. They came in large numbers to the US. In London, for example, some of the train bombers were doctors in the daytime. The same out migration of the most talented will likely happen in the US. People will be put in waiting lines like DMV. Some will die or be forced to pay separately to save their lives without the government program. You will be forced to pay for the public universal plan like you are forced to pay for public schools. If you want good care you will be forced to pay extra for the private plan. In Britain, private insurance was a big seller after the introduction of socialized medicine. The bottom line is many will be forced to pay for the public program and pay extra to be “covered” by some private option if they can afford it.

9. Insurance companies for decades have employed medical doctors, nurses, and allied health professionals to help deal with the complex decision making on claims submitted for payment. With the exception of the government push for HMOs this process has worked pretty well because of the decades of statistical utilization date and peer review guidelines developed by clinicians familiar with the complexities and subtleties of patient care. Literally decades of experience in managing millions of claims and billions of dollars of clinical decisions. How will such decisions be made under a Universal Healthcare System? Will it mimic the bureaucratic denials of needed care like the HMO movement? Paul Ellwood MD created the original Health Maintenance Organization which focused on getting help to those most in need and early. The purpose was to maintain and contain a serious health risk early in the disease progression. It was the government’s push later that morphed it into a Health Management Organization which focused more on cost containment. Bureaucratic bodies with little appreciation of the complexities of health treatment deciding who gets what kind of care or who waits in line is a decidedly Un- American approach.

10. Under Universal healthcare who will pay for research on new medical devices and lifesaving drugs? It costs about $800 Million and 13 years of research to get a drug through FDA and into your prescription. And only 1 in 500 compounds will make it to the market. People suggest we can buy drugs from Canada. These same people apparently don’t recognize that American private capital investors funded the development of over 50% of the drugs sold on Earth. Canada didn’t spend much of anything. And the Canadians get their drugs from the US. They can only sell them cheaper because they don’t have all of the costs and regulations to pay for when they fill a prescription on a drug whose patent has expired. Further, The National Institutes of Health have $30 Billion per year to research cancer, heart disease and others diseases. It was created by Roosevelt in the 1930’s. Nixon funded the National Cancer Institute in 1973. What have they accomplished so far with the many billions in taxes we paid? Heart Disease and Cancer are still the leading killers despite the many billions spent on research. Where will the money come from to conduct research on new lifesaving drugs and medical devices under a Universal Health Plan? Private Capital invested in companies with new technologies helped make America the greatest repository of lifesaving treatments in the world. Now what?

11. We have already tried to demonstrate the efficacy of Health Reform in two States Hawaii and Massachusetts. In both States the programs have Failed. In Hawaii, the program was terminated by the Governor in 7 months. Too many employees quit their health plan to go with the “free” plan and it sank the State Budget. In Massachusetts, the State is now $5 B in the hole.

Every member of Congress should be asked one simple question before voting on this bill. If we cannot make it work in a simple test in two small States how will it work in all 50 without more careful deliberation and testing before implementation?

Summary
There are not 48 Million people in the US without access to needed health care. We still have the best treatment system in the world. We have let politicians dictate what things must be covered by insurance that are by definition not insurable events and not medically necessary. Government involvement in healthcare since 1965 has led to GEOMETRICALLY ESCALATING COSTS like no other item in the average American family budget. It has increased 454 times compared to gas prices that has increased only 8 times. How will the same government that controls our education system, that manages DMV, AmTrak, the Post Office, Freddie and Fannie, that handled the Katrina hurricane, that has supervised our energy development, that manages our immigration system, that declared war on drugs, that launched a war on poverty in 1965 (the same exact 13% of Americans still live in poverty as in 1965), that created Head Start, etc. give you universal care THAT COVERS 30+ MILLION NEW PEOPLE WHILE SIMULATANEOUSLY DECREASES HEALTHCARE COSTS? Government programs have failed 85% of the time. And Based on 43 years of experience it is highly unlikely they can manage anything as complex as healthcare.

Is it not the case that most all of the socialist nations on the planet have one thing in common besides “free” healthcare? Don’t they all have humongous taxation and regulatory environments? France has had an out-migration of wealthy citizens for decades. Most French citizens cannot afford a home due to the taxes. And an estimated 25,000 people died in the heat several years ago during August when most of the doctors were on Holiday. The fastest selling product in Britain after its conversion to a Universal System was Private Insurance for those who did not trust the government with their very lives. And the Canadians virtually survived by driving or flying to the US for needed services for decades. See Brain Surgery: Canadian Style:

This film should be watched by all Americans. http://www.youtube.com/watch?v=bLJxmJZXgNI>

I have 5 children, all of whom I mostly as a single mother brought up and most lof them college educated without any help from their father or the government. I worked very hard to do this and yet I have NO debts. I thus do not have a lot of retirement money but lately fear I won't have enough to live on at the age of 76 due to high taxes and our "out-of-control government spending. Please do NOT ruin our country and our economy with your "out-of-control-spending" and start realizing that we, the people, came from our heritagewho built this country as a Christian nation with huge controls on spending!!! I am one of those "Sons & Daughters of the Revolutionary War" and my forefathers paid a huge price for our independence with their lives which our congress and senate in Washing DC is doing a GREAT job of shattering! STOP the insanity spending; give us our own insurance with court reform etc and stop the insanity of the bail-outs. Don't you know that we self employed people have no-one to bail us out and this is NOT fair to the largest portion of our citizens. I plead for you all to take note and realize your heritage. This USED to be the greatest nation on earth and in a short time you are making a mockery of it! Just stop the insanity and give us back our freedom!! Joanne (Bushnell) Wiley

There should be an amendment striking the Accountable Care Organization model for Medicare beneficiaries. see Sect. 3022 Medicare Shared Savings Program p. 739 - 751 of the latest Senate bill, The Patient Protection and Affordable Care Act. The ACO model encourages doctors and/or suppliers to group together and if their practice achieves savings for Medicare , i.e. comes in under a target benchmark goal set by the HHS Secretary for that year, then the group of doctors will receive a payment from the HHS Secretary for that year. This is shameful. It clearly is bribing doctors and/or suppliers to cut services for Medicare fee for service beneficiaries. Further, on p. 749, it states that there shall be no administrative or judicial review of the assessment of the quality of care furnished by the ACO as well as the establishment of performance standards of an ACO.

Section 5201, page 1317: The "sense of Congress" suggests that funds repaid under a loan program should not be put in the Treasury or "otherwise used for any other purpose other than to carry out this section." This is awfully vague terminology for how money repaid can be spent.

Sec. 5203, p. 1319: Government becomes too involved in the employment of doctors: "The Secretary shall establish and carry out a pediatric specialty loan repayment program under which the eligible individual agrees to be employed full-time for a specified period…."

Sec. 5203, p. 1321: This bill covers far more than health care: "Child and adolescent mental and behavioral health," which consists of psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work ... marriage and family therapy, etc. (This is under the heading of "Tomorrow's Pediatric Healthcare Workforce.")

Sec. 5203, p. 1321: "In entering into contracts under this subsection, the Secretary shall give priority to applicants who: have familiarity with evidence-based methods and cultural and linguistic competence health care services" (emphasis added). Culturally competent healthcare??!!

Sec. 5204, p. 1327: This bill converts doctors into the much-discredited indentured servant model of the Jamestown settlement 400 years ago: "Obligated service contracts-health workers contract to work with the government for a set time.”

Sec. 5207, p. 1333: We're going to have a "National Health Service Corps"! Like the disastrous British health system!

Sec. 5210, p. 1338: Look at all the public health worker positions being established by the bill. What’s wrong with just having doctors? "There shall be in the Service a commissioned Regular Corps and a Ready Reserve Corps for service in time of national emergency."

Sec. 5301, p. 1342: Health promotion … and perhaps gun control through "injury control"? "Grants and contracts ‘to plan, develop, and operate joint degree programs to provide interdisciplinary and interprofessional graduate training in public health and other health professions to provide training in environmental health, infectious disease control, disease prevention and health promotion, epidemiological studies and injury control.’"

Sec. 5301, p. 1344: More liberal claptrap, establishing grant priority given to applicants that "have a record of training individuals who are from underrepresented minority groups or from a rural or disadvantaged background" and who ‘‘provide training in the care of vulnerable populations such as children, older adults, homeless individuals, victims of abuse or trauma, individuals with mental health or substance-related disorders, individuals with HIV/ AIDS, and individuals with disabilities."

Dear Friends at TakeBackMedicine.com:

What an informative and awesome effort on tonight’s broadcast. I am so grateful for everyone who is involved all for your hard work and efforts to block the final death blow to health care in the United States.

ATTENTION: I need to apologize for an error I made on tonight’s broadcast and wish to make this correction: as heard on NBC Nightly News with Brian Williams, the amendment accepted into the heathcare reform bill today concerning breast cancer, cervical cancer and domestic violence screening will cost 940 MILLION not 940 billion dollars, please forgive the inaccuracy, I was unsuccessfully multi-tasking while preparing for the broadcast.

I have several points to make that should be valuable to all concerning: the dangers of electronic medical records; the disturbing sections of the bill that I read, pgs 415-465; and, today’s (12/3/09) amendment to the healthcare reform bill which I consider to be an assault on women between the ages of 40 and 50, at worst, a criminal extortion act or, at best, an act of coercion.

To get this out of the way, something I have never heard discussed in the argument against electronic medical records:. medical records can be inaccurate! I have proof that even simple family history details can be mis-documented. Has anyone ever heard of human error?

Further, I have evidence of healthcare providers, under direct threat from IPA’s and HMO’s, falsifying records and/or making false statements on medical records to prevent further diagnostics and care. I have evidence of healthcare providers falsifying information on medical records to pre-emptively protect themselves from mal-practice litigation. And, lastly, I have evidence of healthcare providers including false information in the medical records of patients with whom they were angry . I cannot imagine the ramifications for patients if these inaccuracies became the ABSOLUTE determining standard of their care.

THE BILL, pages 415-465: in summary, the most damning aspects discovered in this section were:

1. the arbitrary and destructive re-tooling of the Social Security Act;
2. the determining of “eligibility” for services by the Secretary of Health and Human Services, provider hospitals and random newly created agencies such as the “Express Lane Agency” (pg 422);
3. the granting of sweeping powers to these randomly created agencies
4. requiring “mandatory expanded enrollment” of all citizens of all U.S. territories and commonwealths,
5. to make “exceptions” for those who do not meet economic standards, ensuring that the government can foist enrollment on whomever they choose.;
6. Doublespeak throughout which could mean anything;
7. the unconstitutional mandatory funding of this program by individual states and the simultaneous de-funding of other existing programs by the Feds, i.e. Medicaid, CHIP;
8. the creation of “freestanding birthing centers”, which have no legal, safety and regulatory requirements as a newly created entity.

The following consists of direct quotes from pages 415-465 with commentary:

[ Overview: pg 415- 424: It appears through the jungle of legalese and superfluous verbiage that they are attempting to include individuals who would normally not qualify for the Federal medical program because of exceeding income limits by allowing them to be equated with those who receive SSI (an income well below the Federal Poverty Level) which determination can be made by either the Secretary of HHS or “an Express Lane agency”. This appears to be an attempt to force more individuals into their government run medical matrix. I perceive the intention to be bolster enrollment and include as many people as possible in this program by various arbitrary determinations by the Sect. of HHS and the new “Express Lane” Agency]

pg 415
AMDT. NO. 2786
1 (2) REPORTS TO CONGRESS.—Beginning April
2 2015, and annually thereafter, the Secretary of
3 Health and Human Services shall submit a report to
4 the appropriate committees of Congress on the total
5 enrollment and new enrollment in Medicaid for the
6 fiscal year ending on September 30 of the preceding
7 calendar year on a national and State-by-State
8 basis, and shall include in each such report such rec-
9 ommendations for administrative or legislative
10 changes to improve enrollment in the Medicaid pro-
11 gram as the Secretary determines appropriate.

Page 422

12 ‘‘(ii) EXPRESS LANE AGENCY FIND-
13 INGS.—In the case of a State that elects
14 the Express Lane option under paragraph
15 (13), notwithstanding subparagraphs (A),
16 (B), and (C), the State may rely on a find-
17 ing made by an Express Lane agency in
18 accordance with that paragraph relating to
19 the income of an individual for purposes of
20 determining the individual’s eligibility for
21 medical assistance under the State plan or
22 under a waiver of the plan.

[This following section appears to be verbiage describing the means that the Sect of HHS can pull a minor child into the program even if the parents make too much money to qualify for the program]
page 424:
‘‘(E) TRANSITION PLANNING AND OVER-
10 SIGHT.—Each State shall submit to the Sec-
11 retary for the Secretary’s approval the income
12 eligibility thresholds proposed to be established
13 using modified gross income and household in-
14 come, the methodologies and procedures to be
15 used to determine income eligibility using modi-
16 fied gross income and household income and, if
17 applicable, a State plan amendment establishing
18 an optional eligibility category under subsection
19 (a)(10)(A)(ii)(XX). To the extent practicable,
20 the State shall use the same methodologies and
21 procedures for purposes of making such deter-
22 minations as the State used on the date of en-
23 actment of the Patient Protection and Afford-
24 able Care Act. The Secretary shall ensure that
25 the income eligibility thresholds proposed to be
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Pg 425
AMDT. NO. 2786
1 established using modified gross income and
2 household income, including under the eligibility
3 category established under subsection
4 (a)(10)(A)(ii)(XX), and the methodologies and
5 procedures proposed to be used to determine in-
6 come eligibility, will not result in children who
7 would have been eligible for medical assistance
8 under the State plan or under a waiver of the
9 plan on the date of enactment of the Patient
10 Protection and Affordable Care Act no longer
11 being eligible for such assistance.
12 ‘‘(F) LIMITATION ON SECRETARIAL AU-
13 THORITY.—The Secretary shall not waive com
14 pliance with the requirements of this paragraph
15 except to the extent necessary to permit a State
16 to coordinate eligibility requirements for dual
17 eligible individuals (as defined in section
18 1915(h)(2)(B)) under the State plan or under
19 a waiver of the plan and under title XVIII and
20 individuals who require the level of care pro-
21 vided in a hospital, a nursing facility, or an in-
22 termediate care facility for the mentally re-
23 tarded.

pg 429
15 (b) OPTION TO PROVIDE PRESUMPTIVE ELIGI-
16 BILITY.—Section 1920(e) of such Act (42 U.S.C. 1396r–
17 1(e)), as added by section 2001(a)(4)(B) and amended by
18 section 2001(e)(2)(C), is amended by inserting ‘‘, clause
19 (i)(IX),’’ after ‘‘clause (i)(VIII)’’.

[Looks like inclusion for anyone whether they want it or not. ]

pg 431
3 (b) DISREGARD OF PAYMENTS FOR MANDATORY EX-
4 PANDED ENROLLMENT.—Section 1108(g)(4) of such Act
5 (42 U.S.C. 1308(g)(4)) is amended—
6 (1) by striking ‘‘to fiscal years beginning’’ and
7 inserting ‘‘to—
8 ‘‘(A) fiscal years beginning’’;
9 (2) by striking the period at the end and insert-
10 ing ‘‘; and’’; and
11 (3) by adding at the end the following:
12 ‘‘(B) fiscal years beginning with fiscal year
13 2014, payments made to Puerto Rico, the Vir-
14 gin Islands, Guam, the Northern Mariana Is-
15 lands, or American Samoa with respect to
16 amounts expended for medical assistance for
17 newly eligible (as defined in section 1905(y)(2))
18 nonpregnant childless adults who are eligible
19 under subclause (VIII) of section
20 1902(a)(10)(A)(i) and whose income (as deter-
21 mined under section 1902(e)(14)) does not ex-
22 ceed (in the case of each such commonwealth
23 and territory respectively) the income eligibility
24 level in effect for that population under title
25 XIX or under a waiver on the date of enact-
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432
AMDT. NO. 2786
1 ment of the Patient Protection and Affordable
2 Care Act, shall not be taken into account in ap-
3 plying subsection (f) (as increased in accord-
4 ance with paragraphs (1), (2), (3), and (5) of
5 this subsection) to such commonwealth or terri-
6 tory for such fiscal year.’’.

[I don’t like the sound of “Mandatory Expanded Enrollment”. It looks like the Commonwealths and Territories are going to be mandatorily enrolled.]

7 (c) INCREASED FMAP.—
8 (1) IN GENERAL.—The first sentence of section
9 1905(b) of the Social Security Act (42 U.S.C.
10 1396d(b)) is amended by striking ‘‘shall be 50 per
11 centum’’ and inserting ‘‘shall be 55 percent’’.
12 (2) EFFECTIVE DATE.—The amendment made
13 by paragraph (1) takes effect on January 1, 2011.
14 SEC. 2006. SPECIAL ADJUSTMENT TO FMAP DETERMINA-
15 TION FOR CERTAIN STATES RECOVERING
16 FROM A MAJOR DISASTER.
17 Section 1905 of the Social Security Act (42 U.S.C.
18 1396d), as amended by sections 2001(a)(3) and
19 2001(b)(2), is amended—
20 (1) in subsection (b), in the first sentence, by
21 striking ‘‘subsection (y)’’ and inserting ‘‘subsections
22 (y) and (aa)’’; and
23 (2) by adding at the end the following new sub-
24 section:
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pg 433
AMDT. NO. 2786
1 ‘‘(aa)(1) Notwithstanding subsection (b), beginning
2 January 1, 2011, the Federal medical assistance percent-
3 age for a fiscal year for a disaster-recovery FMAP adjust-
4 ment State shall be equal to the following:
5 ‘‘(A) In the case of the first fiscal year (or part
6 of a fiscal year) for which this subsection applies to
7 the State, the Federal medical assistance percentage
8 determined for the fiscal year without regard to this
9 subsection and subsection (y), increased by 50 per-
10 cent of the number of percentage points by which
11 the Federal medical assistance percentage deter-
12 mined for the State for the fiscal year without re-
13 gard to this subsection and subsection (y), is less
14 than the Federal medical assistance percentage de-
15 termined for the State for the preceding fiscal year
16 after the application of only subsection (a) of section
17 5001 of Public Law 111–5 (if applicable to the pre-
18 ceding fiscal year) and without regard to this sub-
19 section, subsection (y), and subsections (b) and (c)
20 of section 5001 of Public Law 111–5.
21 ‘‘(B) In the case of the second or any suc-
22 ceeding fiscal year for which this subsection applies
23 to the State, the Federal medical assistance percent-
24 age determined for the preceding fiscal year under
25 this subsection for the State, increased by 25 per-
(What???)
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pg434
AMDT. NO. 2786
1 cent of the number of percentage points by which
2 the Federal medical assistance percentage deter-
3 mined for the State for the fiscal year without re-
4 gard to this subsection and subsection (y), is less
5 than the Federal medical assistance percentage de-
6 termined for the State for the preceding fiscal year
7 under this subsection.
8 ‘‘(2) In this subsection, the term ‘disaster-recovery
9 FMAP adjustment State’ means a State that is one of
10 the 50 States or the District of Columbia, for which, at
11 any time during the preceding 7 fiscal years, the President
12 has declared a major disaster under section 401 of the
13 Robert T. Stafford Disaster Relief and Emergency Assist-
14 ance Act and determined as a result of such disaster that
15 every county or parish in the State warrant individual and
16 public assistance or public assistance from the Federal
17 Government under such Act and for which—
18 ‘‘(A) in the case of the first fiscal year (or part
19 of a fiscal year) for which this subsection applies to
20 the State, the Federal medical assistance percentage
21 determined for the State for the fiscal year without
22 regard to this subsection and subsection (y), is less
23 than the Federal medical assistance percentage de-
24 termined for the State for the preceding fiscal year
25 after the application of only subsection (a) of section
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Pg 435
AMDT. NO. 2786

1 5001 of Public Law 111–5 (if applicable to the pre2
ceding fiscal year) and without regard to this sub3
section, subsection (y), and subsections (b) and (c)
4 of section 5001 of Public Law 111–5, by at least 3
5 percentage points;

[This all meant what?]

Page 436
1 SEC. 2007. MEDICAID IMPROVEMENT FUND RESCISSION.
2 (a) RESCISSION.—Any amounts available to the Med-
3 icaid Improvement Fund established under section 1941
4 of the Social Security Act (42 U.S.C. 1396w–1) for any
5 of fiscal years 2014 through 2018 that are available for
6 expenditure from the Fund and that are not so obligated
7 as of the date of the enactment of this Act are rescinded.
8 (b) CONFORMING AMENDMENTS.—Section
9 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w–
10 1(b)(1)) is amended—
11 (1) in subparagraph (A), by striking
12 ‘‘$100,000,000’’ and inserting ‘‘$0’’; and [see comments below]
13 (2) in subparagraph (B), by striking
14 ‘‘$150,000,000’’ and inserting ‘‘$0’’. and [See how easy this new Federal math is? This is how this program won’t affect the deficit or raise any healthcare costs: just ask the dead people who will be denied care because of this kind of math! This section really speaks for itself, while simultaneously sucking every individual into this death-knoll Federal medical debacle they are simulataneously DEFUNDING IT…hmmm, I wonder what this will do to QUALITY of care. I know millions of doctors who want to work for free and zillions of hospitals who want to treat patients without being compensated: the words that come to mind are “Roman Coliseum” and “Lions”.]

Page 436:
15 Subtitle B—Enhanced Support for
16 the Children’s Health Insurance
17 Program
18 SEC. 2101. ADDITIONAL FEDERAL FINANCIAL PARTICIPA-
19 TION FOR CHIP.

[This one is classic “double speak”: while pretending to provide more funding to care for “the children”, in the end, they provide that the State will MAGICALLY have to find money to pay for these children in the following verbal gobbledygook.]

20 (a) IN GENERAL.—Section 2105(b) of the Social Se-
21 curity Act (42 U.S.C. 1397ee(b)) is amended by adding
22 at the end the following: ‘‘Notwithstanding the preceding
23 sentence, during the period that begins on October 1,
24 2013, and ends on September 30, 2019, the enhanced
25 FMAP determined for a State for a fiscal year (or for
26 any portion of a fiscal year occurring during such period)
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pg 437
AMDT. NO. 2786
1 shall be increased by 23 percentage points, but in no case
2 shall exceed 100 percent. The increase in the enhanced [in otherwords, not nearly enough to cover cost-of-living increasing, loss of income, recession and stagflation]
3 FMAP under the preceding sentence shall not apply with
4 respect to determining the payment to a State under sub-
5 section (a)(1) for expenditures described in subparagraph
6 (D)(iv), paragraphs (8), (9), (11) of subsection (c), or
7 clause (4) of the first sentence of section 1905(b).’’.
8 (b) MAINTENANCE OF EFFORT.—
9 (1) IN GENERAL.—Section 2105(d) of the So-
10 cial Security Act (42 U.S.C. 1397ee(d)) is amended
11 by adding at the end the following:
12 ‘‘(3) CONTINUATION OF ELIGIBILITY STAND
13 ARDS FOR CHILDREN UNTIL OCTOBER 1, 2019.—
14 ‘‘(A) IN GENERAL.—During the period
15 that begins on the date of enactment of the Pa-
16 tient Protection and Affordable Care Act and
17 ends on September 30, 2019, a State shall not
18 have in effect eligibility standards, methodolo-
19 gies, or procedures under its State child health
20 plan (including any waiver under such plan) for
21 children (including children provided medical
22 assistance for which payment is made under
23 section 2105(a)(1)(A)) that are more restrictive
24 than the eligibility standards, methodologies, or
25 procedures, respectively, under such plan (or
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pg438
AMDT. NO. 2786
1 waiver) as in effect on the date of enactment of
2 that Act. The preceding sentence shall not be
3 construed as preventing a State during such pe-
4 riod from—
5 ‘‘(i) applying eligibility standards,
6 methodologies, or procedures for children
7 under the State child health plan or under
8 any waiver of the plan that are less restric-
9 tive than the eligibility standards, meth-
10 odologies, or procedures, respectively, for
11 children under the plan or waiver that are
12 in effect on the date of enactment of such
13 Act; or
14 ‘‘(ii) imposing a limitation described
15 in section 2112(b)(7) for a fiscal year in
16 order to limit expenditures under the State
17 child health plan to those for which Fed-
18 eral financial participation is available
19 under this section for the fiscal year.
20 ‘‘(B) ASSURANCE OF EXCHANGE COV-
21 ERAGE FOR TARGETED LOW-INCOME CHILDREN
22 UNABLE TO BE PROVIDED CHILD HEALTH AS-
23 SISTANCE AS A RESULT OF FUNDING SHORT-
24 FALLS.—In the event that allotments provided
25 under section 2104 are insufficient to provide
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pg439
AMDT. NO. 2786
1 coverage to all children who are eligible to be
2 targeted low-income children under the State
3 child health plan under this title, a State shall
4 establish procedures to ensure that such chil-
5 dren are provided coverage through an Ex-
6 change established by the State under section
7 1311 of the Patient Protection and Affordable
8 Care Act.’’

[The underlined text: the State shall establish procedures to make money come out of thin air to pay for all of these children that have been ‘mandatorily’ forced into this heinous program!]

Page 439 contd.

15 (c) NO ENROLLMENT BONUS PAYMENTS FOR CHIL-
16 DREN ENROLLED AFTER FISCAL YEAR 2013.—Section
17 2105(a)(3)(F)(iii) of the Social Security Act (42 U.S.C.
18 1397ee(a)(3)(F)(iii)) is amended by inserting ‘‘or any chil-
19 dren enrolled on or after October 1, 2013’’ before the pe-
20 riod.

[Like we said, Plebians, make your own magic money!]

Pgs 439-441….[hmmmm, how do we put this to you? Everyone gets enrolled pay no attention to the crazy way we say it. We call this “Streamlined Enrollment”]

pg 441

4 (e) APPLICATION OF STREAMLINED ENROLLMENT
5 SYSTEM.—Section 2107(e)(1) of the Social Security Act
6 (42 U.S.C. 1397gg(e)(1)), as amended by subsection
7 (d)(2), is amended by adding at the end the following:
8 ‘‘(N) Section 1943(b) (relating to coordi-
9 nation with State Exchanges and the State
10 Medicaid agency).’’.
11 (f) CHIP ELIGIBILITY FOR CHILDREN INELIGIBLE
12 FOR MEDICAID AS A RESULT OF ELIMINATION OF DIS-
13 REGARDS.—Notwithstanding any other provision of law,
14 a State shall treat any child who is determined to be ineli-
15 gible for medical assistance under the State Medicaid plan
16 or under a waiver of the plan as a result of the elimination
17 of the application of an income disregard based on expense
18 or type of income, as required under section 1902(e)(14)
19 of the Social Security Act (as added by this Act), as a
20 targeted low-income child under section 2110(b) (unless
21 the child is excluded under paragraph (2) of that section)
22 and shall provide child health assistance to the child under
23 the State child health plan (whether implemented under
24 title XIX or XXI, or both, of the Social Security Act).

[pgs 441-445 is basically the Communist rewrite of the Social Security Act]

pg 445
Subtitle C—Medicaid and CHIP
2 Enrollment Simplification
3 SEC. 2201. ENROLLMENT SIMPLIFICATION AND COORDINA-
4 TION WITH STATE HEALTH INSURANCE EX
5 CHANGES.

[Okay, the word “simplification” means ‘complification’.]

[pgs 445-451 basically outlines a website to make the Hoover vacuum-like sucking of individuals into of this system even easier]

pgs 451-452
14 SEC. 2202. PERMITTING HOSPITALS TO MAKE PRESUMP-
15 TIVE ELIGIBILITY DETERMINATIONS FOR
16 ALL MEDICAID ELIGIBLE POPULATIONS.
17 (a) IN GENERAL.—Section 1902(a)(47) of the Social
18 Security Act (42 U.S.C. 1396a(a)(47)) is amended—
19 (1) by striking ‘‘at the option of the State, pro20
vide’’ and inserting ‘‘provide—
21 ‘‘(A) at the option of the State,’’;
22 (2) by inserting ‘‘and’’ after the semicolon; and
23 (3) by adding at the end the following:
24 ‘‘(B) that any hospital that is a partici25
pating provider under the State plan may elect
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pg452
AMDT. NO. 2786
1 to be a qualified entity for purposes of deter-
2 mining, on the basis of preliminary information,
3 whether any individual is eligible for medical as-
4 sistance under the State plan or under a waiver
5 of the plan for purposes of providing the indi-
6 vidual with medical assistance during a pre-
7 sumptive eligibility period, in the same manner,
8 and subject to the same requirements, as apply
9 to the State options with respect to populations
10 described in section 1920, 1920A, or 1920B
11 (but without regard to whether the State has
12 elected to provide for a presumptive eligibility
13 period under any such sections), subject to such
14 guidance as the Secretary shall establish;’’.

[Here they grant ‘a participating hospital’ the authority to determine eligibility of an individual for services… which means, if the hospital is not going to get paid for services, one will be considered “ineligible”. If the patient or the patient’s family disagrees with such a determination, they will have to make an “appeal” or sue the Federal government (this involves a 10-15 year time line) by which time the “eligible” person will be dead from lack of treatment: case closed.]

pg 453
6 Subtitle D—Improvements to
7 Medicaid Services
[Why do I have a sense that the word “improvement” stands for “destruction”?]

[pgs 453-455 describe the new way poor folks kids are going to be born for those who probably should have their baby in a hospital, these new “freestanding birthing centers” formerly known as “Howard Johnson’s” and/or “International House of Pancakes” may not provide suitable medical services for births with complications hereby guaranteeing higher infant mortality and possibly maternal mortality (call it a “two-fer”), thus lowering the population by yet another effective means. There are no legal safety regulations or standards of care in place for such facilities]

Pgs 455-465
[I was hoping I could catch something here about how they are going to mandate abortions since this section is about “family planning”, but I must honestly say that these ten pages say absolutely NOTHING. Call it circular language or worthless drivel, no matter, this section merely serves to continue to degrade the Social Security Act with strategic removals of “is” and “the” and replacing them with “might not be is” and “might not be the”. ]

Gigi Veguilla

As I understood it, the ratified amendment to the healthcare reform legislation passed on 12/3/09 provides that, starting at the age of 40, not 50, women will be able to receive “no cost” mammograms as a covered service of this proposed Big Brother healthcare reform. What a coincidence that the announcement by the U.S. Preventative Services Task Force that women should no longer be provided mammograms as a standard of care until the age of 50 should come only a few weeks before the ratification of a provision in the healthcare reform legislation that rolls the covered-service mammogram threshold age back to 40!

Personally, I don’t believe in coincidences. I find this ‘bribe’ to get women over the age of or approaching the age of 40 (and their loved ones) to support this horrific legislation in order to hope for a mammogram (which could potentially save their life) as a covered service by their health insurance provider more like extortion or a death threat, i.e.: “Support this legislation or we are going to let one of the top killers of women possibly end your or your loved-one’s life prematurely” and/or, “Cough up 3K every year for ten years to stay alive even though you’re already paying big bucks for healthcare” a.k.a. “We have ways of making you support this legislation!”

This goes way beyond the frog in the boiling water metaphor: it’s more like a metaphor involving a frog and a sledgehammer. If we are not outraged by blatant, big-government, strong-arm tactics like this, we are going to get the government we deserve and it isn’t going to be a representational democratic republic!

Let’s get real: this “coincidence” belies collusion at the U.S. Preventative Services Task Force with the Obama Administration in threats against the people for whom this government is supposed to exist. Climategate? Yes, that is an horrific perpetration, but this? We could call it ‘Genocidegate’ or ‘KillMomgate’!

I personally feel that the Task force should be immediately dissolved and replaced with people who have souls and consciences and do not stand to somehow benefit from despicable legislation such as the proposed healthcare reform legislation. Further, impeachment proceedings would not be unreasonable under the conflagration of so much malfeasance in so many sectors of the Administration.

I would also like to see every person involved in this whole healthcare reform travesty prosecuted under RICO, as they ought to be. Holding the women of this nation hostage in order to push through a fascist take-over of healthcare has gone too far and we need to let our leaders know that we are not going stand by while Rome burns and listen to their violin music. We are smarter than this and can solve our healthcare issues without applying fascism as the panacea.