Hearing no objection, the amendment is adopted.
Should we clarify the language on funding, or are we ready to take this to a vote?
From my perspective, the bill seems ready, but Yankee may have something more to say about funding? I assume the funding question arises with respect to hiring nurses.
So I wrote up eight paragraphs at one in the morning responding to this (six of which can be viewed below) to only to reread clause 2 and realize it was not as big of an issue as I first thought, though it was more so on previous bills.
For some reason I thought that the gov't was hiring these nurses and then paying them through Atlascare, which would be rather roundabout way of doing it obviously. However, as structured it is workable as a coverage mandate.
It is not my desire to long delay this bill over this matter above as it is a mistake made in numerous bills up to this point, of basically applying costs to the wrong federal agencies.
Theoretically Atlascare could be authorized to cover in home assistance for certain groups maybe the elderly, but they aren't paying and recruiting the nurses. A health care provider or office or network of providers/offices would and then they would bill Atlascare, which is how I think it works with Medicare IRL but I am not 100% sure on that. Maybe Scott would know more about that aspect.
The say I see it and the way the law is structured, various gov't agencies pay Atlascare to cover healthcare expenses, which they then turn around and use their vast size to leverage lower prices for said expenses (Think Medicare negotiating drug prices, but across the board). Its administration is an agency within HHS, but Atlascare itself functions more as a GSE (Government Sponsored Entity) allowing it to compete on the individual market place as a public option and once again obtain more leverage to reduce costs, while also being able to function as a successor to most all previous gov't health care programs.
On the exchanges, it competes for the general population as well as the same people that would have been in either Obamacare or Medicaid or lets be frank completely on their own or dying in the street, but are now covered by the Healthcare Subsidy. If these people are in Atlascare as most of these people are, the Healthcare Subsidy Office (HSO) pays Atlascare in accordance with the formula to cover these people (I know its 100% of all out of pocket costs and premiums for former Medicaid recipients or equivalent income levels and is so above those income levels for a good bit then tapers off, the slope is bit steeper than I would have liked around the mid five digit incomes but hey, "math's hard yall").
It also absorbs the coverage aspects of Medicare, CHIP, Tricare and the VA, but it is paid to do these things via a relevant agency in the government (For ex. DoD would pay Atlascare to cover active duty military or veterans health care costs), and do so in accordance with the expectations or mandates of the previous program.
Atlascare does cover preventative care and vaccinations and has for quite a while. There were improvements made in this regards early this year (or maybe last year) as well as beefing up some of the laws on the exchanges.
