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Tierney Provision in Health Care Law Holding Insurance Companies Accountable

In 2010, Congress passed the Affordable Care Act, which included many critical provisions for our families, students and seniors such as giving students the opportunity to stay on their parents insurance until age 26, ensuring men and women are not prevented from acquiring health insurance due to a pre-existing condition, and requiring more transparency and responsible spending from insurance companies.

One of the key aspects of the law that I fought to include is called the Medical Loss Ratio (MLR) or the “80/20” rule, which requires insurance companies to spend generally at least 80 cents of every dollar you pay in premiums on your health care versus CEO pay and other administrative costs. If the insurance company fails to meet this standard, in any year, they have to pay you a rebate. 

Late last week, the Administration announced the final rule directing insurance companies that did not meet the MLR to inform consumers and provide you with a rebate no later than Aug. 1 of this year.  According to early estimates from the Kaiser Family Foundation, insurance companies will reportedly provide 15.8 million Americans with as much as $1.3 billion in rebates in 2012!

This kind of transparency and accountability is critical to our efforts to protect consumers and keep health care costs down. There is no reason for your health care premiums to be spent on sky-high executive salaries or marketing materials. This rule empowers consumers with the knowledge of which companies are playing by the rules, and holds financially accountable those which aren’t. You’ll be able to see your plan’s medical loss ratio on HealthCare.gov starting this summer. 

More than one billion dollars in rebates and the transparency to know how insurance companies are spending your hard-earned money – it’s a step in the right direction.

Bryan McGonigle2

4:01 pm on Thursday, May 17, 2012

IMHO, this 80/20 rule is a form of government price fixing. I don't want my government involved in price fixing.

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Jackie Millinor

4:46 pm on Thursday, May 17, 2012

Thank you Rep Tierney for standng up for your constituents, working to ensure that we can afford good healthcare at reasonable costs. I personally do not believe or support for-profit hospitals, health insurance companies, or direct care. Just as I do not support for-profit education. Some parts of our society should never be subjected to a model that says that the bottom line is more important than the people it helps.

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Bob

8:30 am on Thursday, August 23, 2012

Jackie, then you really must not like or support the Affordable Care Act. One of it's provisions is to have a panel review your care as you get older and use a formula to decide whether an 80 year old should get a hip replacement or organ transplant or other life extending procedure. The panel is to decide based on cost, age of patient and life expectancy/productivity. In other words, they will decide if you at 80 are worth spending the money on.

Archie Bunker

5:35 pm on Thursday, May 17, 2012

The insurance industry is in favor of the ACA because they wrote it. Liz Fowler, a former vice president of WellPoint, wrote much of the Senate bill that became the ACA.
The insurance industry, captained by Karen Ignagni, the president and CEO of America's Health Insurance Plans (AHIP), understood that small changes to the market were unavoidable given the scale of the crisis and its impact on the economy. From the start of the health care reform debate, the industry won its most critical demand--the individual mandate that candidate Obama opposed, but President Obama fully supported.

James Morone, author of The Heart of Power: Health and Politics in the Oval Office, said of the ACA, "This is a bill that actually helps the insurance industry. It's like Franklin Roosevelt saving the banks. It's like lots of other examples in American history where the industry is actually helped and protected from some of the more outraged critics--in this case, people demanding single payer." (The ACA is not your friend).
http://socialistworker.org/2012/04/05/against-the-health-care-mandate

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Joe Veno

7:01 pm on Thursday, May 17, 2012

Tierney will be gone after the next election. And he can take his Obama healthcare that he voted for with him !!!

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Steph

5:15 am on Friday, May 18, 2012

But you live in Massachusetts, Joe, so besides the Federal addition that you cannot be denied coverage for a pre-existing condition and keeping kids on your plan a little longer if you choose, any repeal of the Obama health plan isn't really going to affect you. We already live with it here. Your statement doesn't really make any sense.

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mary p. ayer

11:55 am on Saturday, July 28, 2012

HOORAY!! OBAMA WILL BE OUT TOO! TIERNEY, WARREN AND OBAMA----GONE WITH THE WIND!

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Steve

1:39 pm on Wednesday, August 22, 2012

Steph - Joe is avoiding the mistake you are making. He speaks for the good of the country, not for individual personal gain. Say NO to Tierney - he is helping to destroy what made this country great.

Joe Veno

5:55 am on Friday, May 18, 2012

Steph, After making that statment it shows you do not know what is in Obamas health bil. Read it.

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Jackie Millinor

10:56 am on Tuesday, May 29, 2012

The ACA is basically RomneyCare - minus the coverage for abortions and a few other changes. And not to worry, the Supremes are going to kill the entire bill anyway, leaving us back where we were before. They're not interested in anything but adhering to their pro-corporation, anti-individual agenda.

It is imperative that we do something about the health care system in this country. The ACA is not perfect, and neither is RomneyCare, but it's a start. It is my hope, that like Canada, (and it appears that this is alrleady beginning to happen) that states will begin to opt for single-payer systems for their citizens. In order to get the middle class back on track, we must address this massive anvil haning over our heads.

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mary p. ayer

11:59 am on Saturday, July 28, 2012

You are right Joe--but--- Palosi said it had to pass and then read!! Did that make any sense? WE-- the tax payers-- pay for those who don't.

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Barry

3:39 pm on Wednesday, August 22, 2012

Joe, can you honestly tell anyone with a straight face that you have read a single word of the Affordable Health Care Act? (And I'm not talking about reading campaign literature or other propaganda and misinformation provided you by the Tisei, Brown or Romney campaigns, nor am I talking about reading the chryons you see when your eyes are glued to Fox News).

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KlassySalem

9:29 am on Friday, May 18, 2012

You'll also note, of course, that with our version, we have some of the very highest healthcare costs in the country. So much for the "savings."

This is of course to say nothing of the vastly different roles of the state vs. federal govts, which make one law constitutional, and the other in question.

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Bob

8:36 am on Thursday, August 23, 2012

One HUGE difference... Romneycare is STATE mandated solution. Obamacare is a Federal overreach that is usurping the power of the states. There is a reason many of our founding fathers fought for the 10th amendment.

hammergjh

7:52 am on Friday, May 18, 2012

The MLR rule is another example of gov't regulation that works. It forces the insurance companies to spend policy holder's premiums on, oh my god, medical expenses and not administrative costs! The bits and pieces of the ACA work. Give it a chance.

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Bryan McGonigle2

9:35 am on Friday, May 18, 2012

The MLR rule is price fixing and it has unintended consequences.

All those health care law waivers given by the federal government is another example of government regulation causing more harm than good.

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Jim Cyrier

7:26 am on Sunday, May 20, 2012

Rep Tieney, you are correct, there are a few things in Obamacare that have some merit. However, most of the law is a HUGH over reach by the Federal Government. Tort reform is not one of them.

I can not believe that you people in Washington are operating without a BUDGET. According to the White House Budget Office's budget, if we shut down the federal government completely and did not pay for defense, or any other departments then we would have just enough money to pay for Entitlements and the interest on our debt as of today. That means that this portion of our spending is $2.3 Trilion dollars. We are borrowing and printing dollars to cover the other $1.3 Trillion for defense, and all the other WASTEFUL agencies and empty buildings in Washington.

To get ourselves out of the mess you help put us in, we have to reform entitlements, reduce spending and stimulate the economy with fewer regulations and rewrite the tax code.

I do not see the leadership in Washington to accomplish this.

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Don

8:03 am on Monday, May 21, 2012

Tierney is going to be gone because his wife got caught being a crook and spent time in jail.

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gene

12:32 pm on Monday, May 21, 2012

What an intelligent comment. Surely written by a third grader.

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Don

1:48 pm on Monday, May 21, 2012

Dats rite, I we vote 2.

Olaf Faeskorn

3:15 pm on Monday, May 21, 2012

Did I just read the words "Tierney", "transparency" and "accountable" in one sentence??

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E

1:11 pm on Tuesday, May 29, 2012

After a wonderful Memorial Day weekend lets reignite this debate.

1. Jackie....you appear to be a socialist or maybe someone with socialist ideals that just benefits from the fruits of our capitalist society.
2. American businesses have been subsidizing the bloated health care system for generations creating too many hospitals, too many tests, too many administrators and zero competition for your health care dollar.
3. Back in the day...1970's...My father (small business owner) spent his hard earned money on a Blue Cross and Blue Shield policy protecting our family. This policy saved the lives of my father, brother, sister and mother over the years. How many families today could afford $15,000 for a comprehensive policy? Guess what? It should still be the responsibility of the family to provide coverage not the federal government or the employer for that matter.
4. I recently had the pleasure of spending an overnight stay in a hospital for a minor non surgical ailment. Total billed to my insurance $6,000. Huge rip off and the food sucked.
5. If more people had skin in the game...imagine how competitive health care would become.
6. The big problem is that most Americans don't have sufficient savings to pay their medical bills....So....lets ask the federal government to bail them out? Single payer is the wrong solution!!!

E

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Archie Bunker

2:03 am on Sunday, July 29, 2012

VABO = Vote Against Barack Obama...

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gene

8:45 am on Friday, August 24, 2012

You really didn't come up with that all by yourself did you? Glad to see you've gotten through to the end of the alphabet

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peter lucci

1:11 pm on Thursday, August 23, 2012

Wow Joe, you read the entire Health Care Act cover to cover??!!! Very impressive but obviously just another big lie from Joe the Fraud. Keep it up Joe, you're more entertaining by the day!!!

Steve

9:42 pm on Wednesday, August 22, 2012

Anything that takes over 2700 pages to explain is wrong - You can become an expert in Complex Variables in about 600 pages. Obamacare is a sham filled with deals that are not related to Health Care. The very nature of its obsequiesness (spelling?) makes it impossible to read completely. That's why most of us take the word of people we trust who have found really bad things in the bill and point those out to us, citing the text straight from the bill.

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Ashley Troutman

10:14 pm on Thursday, August 23, 2012

Just a reminder to please be civil when commenting.

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Bob Samson

11:31 pm on Thursday, August 23, 2012

ObamaCare takes 716 Billion from MediCare to fund ObamaCare. Don't tell the Elderly about that.

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Jim Class

8:16 am on Friday, August 24, 2012

Ha Joe, Peter, and Barry. It's people like you that have turned this forum ugly. Go find a hobby or another blog to hijack. The people in NR and Reading are sick of seeing your childish and unprofessional comments on every damn article Patch posts.

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Joe Veno

8:07 pm on Friday, August 24, 2012

Jim, I agree but please note I am not theone who starts it.

Archie Bunker

11:17 am on Friday, August 24, 2012

Most of us seem to be on the same track here. The ACA is a misnomer, it is anything but affordable! Those who think it is like Romneycare ignore the fact that Romney care is administered on the state level which allows for greater accountability and it is designed to address ONLY the needs of the 8% uninsured, whereas Obama care is administered by Czars from a labyrinthine bureaucracy in Washington and encompasses everyone! What could go wrong?

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becky

11:25 am on Friday, August 24, 2012

For those of you spouting the right wing party line were you to actually check sites like factcheck.org you would find that far more outlandish assertions by the right are considered outright lies than those from the Obama administration. Part of the reason the ACA is so unwieldy is because Obama and the Democrats tried to be inclusive to actually get an act passed that the republicans are opposed to now that it comes from a democrat as opposed to when it was proposed by a republican (Romney). Alot of you sound like teaparty types who if you were holding up a sign it would likely misspell something about keeping government out of your medicare, not recognizing for a second that medicare is a government program. Or for that matter a red state person who doesn't recognize that those states that generally benefit most from all sorts of government programs live in a red state rather than a blue.

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Steve

11:50 am on Friday, August 24, 2012

Becky Becky Becky - calm down. both sides spout stupid stuff and it's not only the right that has spelling or grammar problems - it's true that some right wing spellings are more hilarious, but some left wing viewpoints are just as moonbattishly amusing. And for the record, you may think right wing lies are more prominent and outlandish than left wing lies, but that is only because leftists are better at obfuscating their lies. And Obamacare is unweildy not because of what had to be added to assuage jerks like Nelson and Stupak, it is because we continue to elect lawyers as opposed to regular people, say, like engineers who can write documents that are succinct, to the point and actually address the issues that need to be addressed.

Archie Bunker

11:28 am on Friday, August 24, 2012

Becky, you mean the Medicare Obama is gutting to pay for Obama care?

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Archie Bunker

11:29 am on Friday, August 24, 2012

I live in the bluest of states, that doesn't mean I cannot read or cognate!

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Bryan McGonigle2

12:03 pm on Friday, August 24, 2012

I'd like to second and third what Steve has to say.

I'd like to add a point on ObamaCare. The President isn't much of a leader. He left the details to hundreds of Democratic lawmakers - who knew he'd sign anything they'd pass. And the Democratic lawmakers should be ashamed at what they passed.

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pk

12:17 pm on Friday, August 24, 2012

The main parts of the Affordable Care Act were proposed by Conservatives over the past twenty years and are consistent with conservative principles. The act mandates that those with the means to do so must insure themselves. This prevents people from becoming a burden on society should they become ill. Before, we were made to care for uninsured people at public expense. Government health care for the indigent was mandated by the courts decades ago. Conservative opposition to this provision is a nonsensical knee-jerk reaction to something they should welcome, i.e., personal responsibility.

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Bryan McGonigle2

1:15 pm on Friday, August 24, 2012

A limited number of conservatives proposing an idea 20 years ago - doesn't make it a good idea. Since when do liberals jump on a conservative ideas? Why don't you guys jump on what they propose now - repeal?

Can you name a conservative who is supporting the Affordable Care Act today? I can't name a single conservative who voted for it.

Forcing certain young, healthy, and/or financially responsible people to purchase over-priced health insurance to subsidize everyone else is not my definition of personal responsibility. Where's the affordable health care policies for the young and healthy (who can afford to pay)?

Now that we have ObamaCare, some people are trying to fight obesity by banning unhealthy food. After all, your unhealthy lifestyle choice is costing us all money! I might want to make you ineligible for ObamaCare if you do drugs, commit a crime, do other dangerous things (sky dive or MMA) or are in this country illegally - all in the name of keeping health care affordable. Let's lower the speed limit to reduce accidents that cause emergency room visits. Since young males are terrible drivers, lets increase the driving age and not allow them to drive at night - until their no longer on their parents health insurance. Let's ban all contact sports and make yoga mandatory.

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Steve

2:17 pm on Friday, August 24, 2012

The act mandates MUCH more than what you are stating here. The act does nothing to ameliorate the costs incurred by the legal taxpayer...in fact it adds more cost (I have seen this first hand already), will lead to an elimination of choices that an employer is willing to offer (I have seen this first hand already), impedes the flow of the health care process and makes health care professionals consider getting out of the system. I have no doubt that future prospective employees will be presented with only one choice for health care....sorry, the company does not offer health care anymore - ask your government official. Do you like the RMV? You are going to LOVE health care in the future, unless we act now to elect knowledgable honest people....that is....not Tierney or Warren types.

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pk

3:05 pm on Sunday, August 26, 2012

Mitt Romney on Fox News:
Just two weeks after a Romney spokesperson faced a barrage of conservative criticism for highlighting the success of the governor’s Massachusetts health care law, Romney himself bragged that the measure has expanded access to women’s health care services, including contraception. During an interview with Fox News on Sunday, Romney said he was “very proud” of Romneycare — which includes an individual mandate — for providing coverage to all women and men:
ROMNEY: With regards to women’s health care, look, I’m the guy that was about to get health care for all of the women and men in my state. They’re talking about it on the federal level, we actually did something. [...]
CHRIS WALLACE (HOST): So you’re saying, look at Romneycare?
ROMNEY: Well, absolutely. I am very proud of what we did, and the fact that we helped women and men and children in our state… And then with regard to contraceptives, of course Republicans, myself in particular, recognize that women have a right to use contraceptives. There is absolutely no validity whatsoever to the Obama effort to try and bring that up.
http://thinkprogress.org/health/2012/08/26/745521/romney-touts-romneycare-im-the-guy-that-got-healthcare-for-all-the-women-and-men-in-my-state/

Ellen G

1:07 pm on Friday, August 24, 2012

I wish the Patch would block articels of sensitive political nature from being commented on. I am sick and tired of coming onto the Patch to see ignorant rants from the right and insults from the left.

Lets all agree to disagree and using your power of the vote in the voting box, not on this forum. The opinions of Joe, Steve, Mary, Archie et. al. are not going to changes the minds of Barry, Gene, Peter et. al.

Throughout this country the hate and anger being spouted by opposing people of view points is what is keeping our country from growing and healing. It is not the politics of Tierney, Obama, Warren, Tsei, or Brown that is ruining this country, It is an unwillingness to compromise and understand the otherside that is our downfall.

In the US people are entitled to differing opinions, please lets all be civil in our political discussions and make the world a happier place, not a place full of hate.

It is time to move forward and learn how to work with others, not reduce everything to name calling

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Bryan McGonigle2

1:38 pm on Friday, August 24, 2012

If we had the civil Patch message boards and diversity training during the American Revolution, we'd might get along better but we might still be part of the British Empire.

They say you shouldn't discuss politics and religion in polite company. I don't like hateful, rude, unthoughtful, and dumb posts like everyone else (except for my own). But what I think Ellen G is essentially proposing is to eliminate political and religious topics from the Patch - so we'd all get along. I'm willing to live with some hate and anger in order to express my opinion.

I'm doing my best to promote my opinion is a civil fashion with a dash of sarcasm. An to tell others where I disagree without personally attacking.

BTW, I think Mitt Romney would do a better job of bringing the country together than the current President - since I think he's a little closer to the center. And Mr. Tisei is much closer to the center than Congressman Tierney.

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Steve

2:10 pm on Friday, August 24, 2012

Way to go Ellen G. Can't even take the time to look up articels or proof your post at all. And yes, please take away my right to free speech because you haven't got the energy to fast forward through comments and articels (sic) you don't like. I beg to differ with you that it is not the politics of those elected that is ruining this country. It is EXACTLY that, and the people who choose to elect them without researching the consequenses. Do you think it was any different in Jefferson's time? Do some reading, see what history was like. If you don't like it, then you may find the way it happens in other countries more appealing (Venezuela, Cuba come to mind). If people are civil with me, I am civil with them. And your post indicates that you want to censor, not contribute. Have a wonderful day and please contribute to the discussion when you have something meaningful to say.

mary p. ayer

1:35 pm on Friday, August 24, 2012

Ellen, Unfortunetly the very ones you say don't matter, OBAMA,BIDEN,TIERNEY AND OBAMA'S STAFF OF DANGEROUS MEN, ETC. are the ones that have been "elected" to lead and make decisions for this country and if they continue to make such BAD and socialist decisions we are headed for a HITLER type country. Get rid of thes terrible people who are running this wonderful free country. We DO have the right to voice our opinions and we do not have to lay back and just play dumb---like you would have us do. It is the Constituion that rules this land of ours.

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