Minimum Essential Coverage

Yesterday I wrote about how military personnel and veterans were concerned about some of the language contained in the Shut Up and Die Already plan passed by the congress over the weekend. Well it seems that some of those fears may have been unwarranted, but by allaying those fears they have created a whole new set of issues. According to the language contained in a separate resolution, TRICARE, the health insurance plan for the military will be exempt from any of the rules contained in this legislation.

House lawmakers over the weekend voted to protect TRICARE and Defense non-appropriated fund health care beneficiaries from unintended consequences of national health reform.

The exemption (H.R. 4887) applies to the health care coverage provided by the Defense Department to military service members, retirees and their families. It clarifies the tax code to stipulate that coverage provided by Defense is treated as minimal essential coverage, ensuring that service members and their families will not need to purchase additional coverage to meet new health insurance requirements.

The legislation was introduced late Friday by Rep. Ike Skelton, D-Mo., chairman of the House Armed Services Committee. The full House approved it by a vote of 403-0 on Saturday afternoon.

Folks it is time to be very worried. I have Tricare. If Tricare is what the government considers as "minimal essential coverage" then their plan sucks.

I find it odd that in their legislation they want to cover things like sex change operations, which to the best of my knowledge Tricare doesn't and other such politically correct items. Tricare is definitely the definition of minimum coverage.

Let me be clear, I understand no insurance can cover everything, but my biggest issue with Tricare has been finding providers who will accept it. The reasons are varied. The low reimbursement rate, the special rules they have for filing claims, creating administrative headaches for the providers, and the generally slow processing of the claims. Providers have to quite often file the claims multiple times to get it through the system.

Other veterans in other parts of country no doubt have different experiences with the system, so my example can not be taken as the standard everywhere. Some veterans in different places may have excellent results with Tricare, but for me I had to go get additional private insurance simply to be able to find the providers.

Tricare has an excellent prescription drug program, but folks if my experiences with Tricare are a foreshadowing of what health care will be like under this reform plan, a whole lot of people are suddenly going to be very pissed off.

People will find themselves unable to find providers to accept the plan, providers who would rather not deal with it, slow reimbursements and reimbursements far lower then that offered by other insurers, and all kind of arcane rules that only the Imperial Federal Government can come up with.

Want to know why their is so much fraud, waste and abuse in the Medicare system? A provider almost can not file a claim without it being wrong in one way or another because of the volumes of rules and regulations, often contradictory and confusing that apply to Medicare claims. It is this very bureaucracy which makes Medicare such a juicy target for scammers. The same is true with Tricare.

Oh by the way the Tricare system in large parts of the country is administered by Humana. You know one of those big old bad private insurance companies. By administered, I mean Humana provides the infrastructure to process the claims which are then sent on to Tricare proper for disposition. Humana does not set the rates or rules simply the hardware and personnel to get the claims to them.

So while I am glad veterans got some sort of protection, you have to understand we have a much higher threshold for frustration then the average civilian, since our years of military service have conditioned us to such levels of bureaucracy and red tape, that I ain't too sure most folks will tolerate, although I could be wrong since everybody gripes about the DMV when it comes time to renew your drivers license, but nothing is ever done about it.

H/T to Crush over at Blackfive