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Sebelius gets one right on health exchange

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Wednesday, Nov. 6, 2013 10:57 PM

Health and Human Services Secretary Kathleen Sebelius said it's illegal for her to obtain insurance on the exchanges set up by the Affordable Care Act. Rep. Cory Gardner - a Colorado Republican who asked Sebelius why she isn't in the exchange - accused her of lying.

Turns out, she's right. Although she didn't explain it to Gardner, Sebelius is enrolled in Medicare and the Federal Employees Health Benefits program. Her office issued a statement that said: "Marketplace plans may not be sold to a Medicare enrollee, and the secretary is a Medicare enrollee." She can give up her Medicare coverage and purchase insurance on the exchanges, but it's complicated and costly.

If you renounce Medicare benefits, you also have to renounce your Social Security benefits and pay anything back that has been paid to you.

Factcheck has said for years that President Obama was over-simplifying and overpromising when he kept saying, "if you like your health-care plan, you can keep your health-care plan" under Obamacare.

The Congressional Budget Office projections 3 million people covered by employer-provided insurance plans under current law would not be offered coverage. The new law sets minimum standards for health insurance, requiring all health plans contain 10 essential benefits: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

Coverage also must be available to all regardless of pre-existing conditions. This outlaws many existing "bare bones" plans that were cheap, but didn't cover all (or any) of the required benefits available mainly to healthy people. Those plans are now outlawed, and not all who had them welcome better insurance at greater cost. The large majority of Americans are not affected by these changes, since they get their coverage through comprehensive employer plans or Medicare. But about 15 million Americans, or 5 percent of the population, currently purchase coverage on their own.

The law - starting in 2014 - will push premiums in the individual market up for some, down for others. The winners include older, less healthy persons. Those who were denied coverage before will now be able to obtain it. Those who had coverage, industry analysis say, may see premiums go down. But young, currently healthy persons are now seeing premiums go up, and experiencing the "sticker shock" that recent news reports highlight.

Sen. Mitch McConnell's Democratic opponent exaggerates when she claims McConnell "blocked the Senate over 400 times" since 2007. The Senate failed to approve cloture motions to end filibusters on 120 occasions - not "over 400 times" - since McConnell became minority leader seven years ago. Democrats have blocked six of the failed 120 cloture motions. Cloture is the only procedure by which the Senate can vote to place a time limit on consideration of a bill, thereby overcoming a filibuster.

A majority of voters actually prefer the blood-hungry creatures of The Walking Dead and Zombieland to the current Congress," state Rep. Ed Lindsey, R-Atlanta, wrote in a press release. "One poll earlier this month found that a plurality of registered voters prefer real zombies over the pseudo variety haunting Washington today. (Even mother-in-laws and the DMV also outpolled Congress.)" Public Policy Polling, asked the respondents "What do you have a higher opinion of: Congress or zombies? "Forty-three percent of the respondents said zombies, 37 percent said Congress. Nineteen percent said they weren't sure.

Chip Tuthill lives in Mancos. Website used: www.factcheck.org.

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