The People's House (/Senate)

[Startraveler]

One of the refrains we've been hearing this summer from certain political activists is "read the bill!" Another is "1,000 pages is too long for a bill." There was even a thread on here at one point where people discussed whether a thousand page bill is indeed too long. One person compared the length to a Harry Potter book and someone else countered with the fact that a thousand pages of legislative language is a much harder slog than a Harry Potter book. It's true that the House health care bill is a pretty long and sometimes difficult read.

There is one committee that has the unique habit of not initially writing its bills in dense, legalistic terminology. This is the Senate Finance Committee, the committee that's currently wrangling over its own health care bill. The Finance Committee writes its bill in conceptual language, which was explained by a member of the committee today like this:

What is conceptual language? It's plain English. Plain English. I'm not a lawyer. We write our bills in plain English so the members can understand them, and so the public can understand them. Conceptual language is much more transparent. To most people, legislative language is gobbledy-gook.

Part of the question seems to be "who is legislation aimed at?" Granted, I'm sure plain English makes it easier for Senators to quickly understand and discuss proposals but it also seems like adopting a plain English approach is designed, at least in part, to make legislation more accessible to ordinary voters. That's an interesting philosophy, particularly since I think it's unusual for most people to really care what's going on in a Senate committee. Still, it's an unusual tradition and I'm wondering if people think it's a good idea that should be implemented more widely or if they generally think it's unnecessary.

I'm going to take a quick example of a relatively simple proposal to show how this is communicated differently under different approaches. The health care reform proposals put regulations on the practices of insurance companies but they have a grandfather clause that allows existing insurance policies to continue to exist after the reforms go into effect.

In a speech it comes across as something like "if you like your heath insurance, you can keep it."

In the Finance Committee's "conceptual language" it sounds like this:

Individuals and groups who wish to renew coverage in an existing policy would be permitted to do so. Plans could continue to offer coverage in a grandfathered policy, but only to those who were currently enrolled, dependents, or in the case of an employer, to new employees and their dependents. No tax credits would be offered for grandfathered plans.

Beginning January 1, 2013, Federal rating rules would be phased in for grandfathered policies in the small group market, over a period of up to five years, as determined by the state with approval from the Secretary. These plans could continue to exist after the transition period, but would be subject to the new rating rules.

And in the House bill's "legislative language":

(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘grandfathered health insurance coverage’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT-

(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

(B ) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.

(B ) Grace Period for Current Employment-based Health Plans-

(1) GRACE PERIOD-

(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.

(B ) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:

(i) Any coverage described in section 3001(a)(1)(B )(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).

(ii) Excepted benefits (as defined in section 733(c ) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.

(iii) Such other limited benefits as the Commissioner may specify.

In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division

You can see why the House bill is a thousand pages and the Finance Committee bill is only 200-odd pages. Once the Finance bill is translated into legislative language it'll be pretty long, too.

Edited September 23, 2009 by Startraveler