Americans For Truth » Health Care

LISTEN: AFTAH Interview with Former Transsexual Walt Heyer – Part Two

Peterlab — Tue, 26 Jul 2011 19:27:36 +0000

Walt Heyer once lived as "Laura" in his futile quest to become a woman.

Here is Part Two of my interview with Walt Heyer, a former transsexual who lived as “Laura” after leaving his wife to undergo radical “Gender Reassignment Surgery” (commonly referred to as a “sex-change” operation, although Walt correctly asserts that one can change his or her sex). In this interview, which aired July 23, 2011, Heyer discusses the regret and persistent unhappiness that many “post-op” transsexuals have — which he says is rarely discussed in pro-”transgender” circles. Heyer’s websites are www.tradingmysorrows.com, www.sexchangeregret.com and www.sexchangeinfo.com. For Part One of the interview, go HERE.

HOW TO LISTEN: This is an mp3 file, supported in most operating systems by Windows Media Player, Quick Time and/or I-Tunes. Do not use Real Player. It is not supported and there may be difficulty when listening with it. Left click once on the link below to play. (Please be patient, depending upon the speed of your internet connection it may take a moment or two to load.) OR right click the link then “save target as” to download the whole show.

7-23-11, Walt Heyer, Part Two

Dude, Obama: Here are Some Less Hip Questions We Wish Jon Stewart Had Asked You on the Daily Show

Peterlab — Fri, 29 Oct 2010 17:34:51 +0000

President Obama degraded the Office with liberal Stewart’s help

Barack Obama may be setting new highs when it comes to presidential appointments of People Practicing Homosexuality (PPH) in his administration — already more than 150, according to AP – but he’s setting new lows everywhere else. Yesterday, leftie Comedy Central “anchor” Jon Stewart referred to the Commander-in-Chief as “dude” in the course of his half-hour interview with Obama. (Obama is the first president to appear on the show.)

Read liberal Washington Post writer Dana Milbank’s slam on Obama and his appearance (“On Comedy Central, the joke was on President Obama Wednesday night”) HERE, and watch the “dude” reference in context starting at about 1:45 on Part 3 of the videos of the Daily Show interview HERE.

I agree with this comment responding to a YouTube critical of Obama’s Daily Show disaster: “Obama has diminished himself so many times enough already that even liberals don’t treat him with presidential respect.” We at AFTAH are not nearly as cool as Jon Stewart, and don’t have anything approaching his cultural sway (especially with young people), but here are some questions and comments we wish he would have delivered to the Dude-in-Chief:

Dude, stop undermining our military by using illegal means to homosexualize it (under the existing law that only Congress can change, homosexuals are barred from serving in the Armed Forces; see www.cmrlink.org);
Dude, abortion is the murder of an innocent life; stop promoting it and don’t make taxpayers subsidize it;
Dude, aren’t you trashing the Defense of Marriage Act and the Constitution by granting via Executive Order marriage-type benefits to homosexual “spouses“?;
On the same point: dude, you really pulled the wool over America’s eyes (and Rick Warren’s…) with all that talk in the 2008 campaign about how you believe marriage should be preserved as between a man and a woman. If that were true, why didn’t you use your Bully Pulpit to criticize the homosexual activist judge who recently single-handedly overturned California’s Proposition 8 — even though this marriage-defense amendment had passed in a statewide referendum?

Dude, homosexuality is a sin, according to the Big Guy Upstairs (the real Annointed One) who created the world, so could you stop celebrating homosexual “pride” and stop promoting “gay” identities to impressionable young people?
Speaking of which: dude, do you get to change God’s transcendent moral code just because you’re the coolest cat who ever sat in the Oval Office (the pro-homosexuality-obsessed Jon Stewart also might ask that of himself…);
Dude, fire Kevin Jennings. He hates Bible-believing Christians (at least those who object to his homosexual lifestyle) — and the organization he founded, GLSEN (Gay, Lesbian, Straight Education Network), promotes reckless sexual behavior and gender confusion to minors; what message are you sending by stubbornly keeping this bigoted extremist on the Obama Team?
Dude, stop making a sham of your public profession to be a Christian by using your tremendous executive powers to distort historic Christian teachings – and promoting sexual immorality as a “right” and abortion-on-demand as a “choice”;
Dude, before you made that YouTube video about bullied gay youth, shouldn’t you at least have looked into the massive health risks linked to gay sex? Is the proper response to bullying to promote dangerous lifestyles and identities based on unnatural and unhealthy behaviors?
Dude, we get it: you respect Muslims, but enough with the “America is not a Christian nation” comments already;
Dude, since you respect Muslims so much, why not learn from their strong moral disapproval of homosexuality and abortion?
Dude, a federal bill granting “civil rights” based on homosexuality and gender confusion (ENDA, the Employmen Non-Discrimination Act) will be used to take away the rights of other citizens who disagree with homosexuality. What about their “civil rights”?; in fact, the woman you appointed to the E.E.O.C., Chai Feldblum, has essentially affirmed that the courts will grant superior rights to homosexuals at the expense of Americans’ religious liberties; “Gays win, Christians lose,” she says; is that fair in a nation founded on religious liberty?
Dude, why don’t you expand your vision by “vetoing” Political Correctness and inviting some EX-”gays” to the White House? Wouldn’t that be consistent with your commitment to “diversity”?
Dude, why did one of your “gay” appointees urge his fellow homosexual activists visiting the White House to lobby for coverage of transsexual “sex-change” operations under Obama-care? I feel sorry for these terribly confused people, but should Americans be forced to pay for their grotesque, body-disfiguring operations with their hard-earned tax dollars?….

We could go on and on, but there is too much work to be done to spend time pondering the degree to which Obama has degraded the Office of the Presidency, and harmed the United States of America with his left-wing agenda (after running for office posturing as a moderate). There’s a big election Tuesday. Change is coming. Yes, we can, dude — er … Mr. President. Yes, we can. — Peter LaBarbera, www.aftah.org

Battle Over the Blood — FDA Upholds Ban on Homosexual Male Blood Donations

Peterlab — Wed, 16 Jun 2010 13:34:20 +0000

“In this battle, if the gays win, you lose,” says Kincaid

[NOTE: Corrected contact info for American Red Cross below]

“Detection of HIV infection is particularly challenging when very low levels of virus are present in the blood for example during the so-called ‘window period.’ The ‘window period’ is the time between being infected with HIV and the ability of an HIV test to detect HIV in an infected person….FDA’s MSM policy reduces the likelihood that a person would unknowingly donate blood during the ‘window period’ of infection. This is important because the rate of new infections in MSM is higher than in the general population and current blood donors.” – Food and Drug Administration (FDA)

In the book And the Band Played On: Politics, People and the AIDS Epidemic, homosexual journalist Randy Shilts documents how homosexual activists originally fought the effort to ban "gay" male blood donations, saying it was discriminatory. This caused a delay in starting the ban, which led to the needless deaths of many innocent people. Shilts himself died of AIDS.

Folks, thankfully, sanity has prevailed and the political attempt to weaken the FDA ban on blood donations from “men who have had sex with men” (MSM) failed in a 6-9 vote Friday by the FDA committee mentioned in Cliff Kincaid’s article below. (Note the American Red Cross’ condemnation of the vote, along with “gay” activist organizations; contact the Red Cross HERE.) I only wish the homosexual activists and their liberal allies (most importantly the CDC) would redirect their energies toward shutting down homosexual bathhouses and sex clubs — i.e., the venues that encourage the anonymous hyper-promiscuity that facilitates the spread of sexually-transmitted diseases. (See our story: “CDC: Gay Men’s HIV Rate 44 Times that of Other Men; Syphilis Rate 46 Times Higher.”) But this would run contrary to the history of homosexual activism, which elevates deviant sex and “rights” based on same above the public health and other interests of the public. TAKE ACTION: Contact the Food and Drug Administration HERE; Contact the Red Cross HERE; and you can reach Congress at 202-224-3121. – Peter LaBarbera, www.aftah.org,

____________________________________

The Battle Over Blood

By Cliff Kincaid, Reprinted with permission of Accuracy in Media, www.aim.org | June 9, 2010

With the public focused on the calamity of the Gulf oil spill, another disaster that could affect millions of lives is in the making. The federal Advisory Committee on Blood Safety and Availability (ACBSA) is holding meetings on June 10 and June 11 to consider lifting the ban on gay blood.

In this battle, if the gays win, you lose.

Gay activists, who are expected to dominate the proceedings and intimidate federal policy makers, insist that the ban is discriminatory and homophobic and are demanding the “right” to donate blood. The lifting of the ban on gay blood is seen as a necessary prerequisite to lifting the ban on open gays in the military. After all, how can gays be on the battlefield, where they could be called upon to provide a blood transfusion to a fellow soldier, if they cannot legally donate blood?

What this means, if politics is played with the blood supply, is that that the five million Americans a year who receive blood transfusions, in addition to soldiers on the battlefield, could be exposed to the AIDS virus or other infections in the diseased blood of sexually active homosexuals.

Tragically, despite the life and death nature of this issue, news organizations are spreading deliberate lies.

For example, The Desert Sun of Palm Springs, California, reports that “Gay advocates in the Coachella Valley say now is the time to change the ban they consider discriminatory.” It then quoted David Brinkman, executive director of Desert AIDS Project in Palm Springs, as saying, “There is no scientific or medical evidence that supports the need for the ban anymore. All blood is tested twice and there’s 100 percent accuracy to insure no HIV gets into the blood supply.”

I informed Nicole Brambila, the author of the story, that the claim she featured in her story was absolutely false. But she refuses to correct the record.

In fact, the Food and Drug Administration (FDA), with jurisdiction over the blood supply, says, “Blood donor testing using current advanced technologies has greatly reduced the risk of HIV transmission but cannot yet detect all infected donors or prevent all transmission by transfusions. While today’s highly sensitive tests fail to detect less than one in a million HIV infected donors, it is important to remember that in the US there are over 20 million transfusions of blood, red cell concentrates, plasma or platelets every year. Therefore, even a failure rate of 1 in a million can be significant if there is an increased risk of undetected HIV in the blood donor population.”

This is one reason why gay males, or men who have sex with men (MSM), are prohibited from donating blood.

The FDA also says, “Detection of HIV infection is particularly challenging when very low levels of virus are present in the blood for example during the so-called ‘window period.’ The ‘window period’ is the time between being infected with HIV and the ability of an HIV test to detect HIV in an infected person….FDA’s MSM policy reduces the likelihood that a person would unknowingly donate blood during the ‘window period’ of infection. This is important because the rate of new infections in MSM is higher than in the general population and current blood donors.”

These critical facts are being carefully omitted from media coverage of the pending change. And because the major media are influenced or intimidated by such groups as the National Lesbian and Gay Journalists Association and the gay-run Media Matters organization, reporters can find themselves targeted as “haters” and “homophobes” if they tell the truth about the gay lifestyle. As a result, many writers and commentators decide to avoid the topic.

The truth is so sensitive that when the Obama Administration tapped a Washington University professor by the name of Jonathan I. Katz to serve on a scientific panel to review the handling of the oil spill in the Gulf of Mexico, he was immediately attacked because of his article, “In Defense of Homophobia,” on the dangers of homosexual behavior.

As a result of the outcry from the homosexual lobby, Katz was dropped from the panel, even though the article had nothing to do with the Gulf matter. This is how they operate—protest and intimidation. As we recently saw with George Will’s capitulation to the gay lobby, very few conservatives have the intestinal fortitude to go up against them.

Despite the controversial title, the Katz article is well-researched and touches on the gay blood problem, noting that the homosexual activists have been campaigning for a lifting of the ban for several years and that their position is that “In order to satisfy their demand for full acceptance by society, the homosexual movement demands to kill some transfusion recipients by infecting them with AIDS…”

Do you or your loved ones want to die in order to advance the gay rights agenda?

In advance of the Thursday and Friday meetings on blood safety, a federal notice has reiterated that male homosexuals “have an increased incidence and prevalence of several currently recognized transfusion-transmitted diseases”—Hepatitis B virus, HIV, syphilis, and cytomegalovirus.

It also says, “There is a theoretical concern that MSM populations may also be at increased risk for other unrecognized transfusion-transmitted agents.” That means another infectious agent could be lurking in the blood that they want to have the “right” to donate to the nation’s blood supply.

The move to lift the ban is being spearheaded by the Human Rights Campaign, a gay rights lobby which contributes to the campaigns of liberal Congressional candidates. It reports “progress” in this effort, based on the fact that Senators John Kerry and Al Franken have done the organization’s bidding and pressured the federal government to hold the June 10 and 11 meetings to consider lifting the ban on gay blood. The FDA commissioner, Dr. Margaret Hamburg, is a political appointee of the Obama Administration.

The pressure campaign has already forced the American Red Cross and two other blood groups to previously argue for lifting the ban. But the FDA, after reviewing the policy in 2006, reiterated the prohibition, which has been in effect since 1983 and applies to MSM since 1977, the beginning of the AIDS epidemic.

Randy Shilts’ book, And the Band Played On, and the movie by the same name that was based on it, documents how gays at that time of the discovery of AIDS and the virus causing it, HIV, were even then arguing that a ban on gay blood was discriminatory. The blood industry was then resisting the testing of the blood, mainly because of the cost.

The result was an unconscionable delay in banning gay blood and the unnecessary deaths of many people.

The gays even objected to the original name for AIDS as GRID, standing for gay-related immune deficiency. Another name for Acquired Immune Deficiency Syndrome, the “gay cancer,” was also jettisoned because of its obvious association with the gay lifestyle.

Upset at the delay in responding to the dangers to the blood supply, one official of the Centers for Disease Control, reported Shilts, attended a meeting on blood safety and pounded his table with his fist, shouting, “How many people have to die? How many deaths do you need?”

A representative of hemophiliacs, dependent on blood transfusions for their day-to-day survival, objected to all of the talk at the time about the rights of gays not to be discriminated against, asking, “What about our right to live?”

Once again, as we have seen in the gays in the military debate, the gays are constantly screaming about their rights, oblivious to the point of madness about the rights of others. In this case, it’s our right to be free of infected blood when our loved ones get a blood transfusion.

But unless the public quickly offers its comments and raises an outcry with the federal authorities coming under the influence and intimidation of the gay rights lobby, the “right” to donate blood could soon be extended to a politically-connected special interest group that has a demonstrated propensity to acquire life-threatening and deadly diseases.

* CONTACT: Jerry A. Holmberg, Ph.D., Executive Secretary, Advisory Committee on Blood Safety and Availability, Office of Public Health and Science, Department of Health and Human Services, 1101 Wootton Parkway, Suite 250, Rockville, MD 20852, (240) 453-8803, FAX (240) 453-8456, e-mail ACBSA@hhs.gov; Contact the Red Cross HERE and the the FDA HERE. Call Congress at 202-224-3121 or 202-225-3121 or go to www.congress.org.

Additional Red Cross information:

American Red Cross National Headquarters
2025 E Street, NW
Washington, DC 20006

Phone: (202) 303-5000

General Red Cross Contact Page: http://www.redcross.org/contactus

Cliff Kincaid is the Editor of the AIM Report and can be reached at cliff.kincaid@aim.org

Part Two of AFTAH Interview with Matt Barber

Peterlab — Mon, 14 Jun 2010 14:36:18 +0000

Boxer-turned culture warrior assails homosexual lobby’s selfish attempt to lift blood-donation restrictions

Matt Barber's unapologetic approach toward the Culture War over homosexuality is the answer to wimpy evangelicals who seem to have forgotten that they are defending God's clearly-revealed Truth on this moral issue.

Here is Part Two of AFTAH’s June 12, 2010 interview with Matt Barber (CLICK HERE). (Listen to Part One HERE, or any other past interview HERE.) Barber is the Director of Cultural Affairs for the Liberty Counsel and an Associate Dean at Liberty University’s School of Law — where he will be teaching a course on “Sexual Behavior and the Law” this Fall. Barber and AFTAH’s Peter LaBarbera discussed the upcoming Americans For Truth Academy and the hysterical opposition to it by homosexual radicals like Joe Jervis (who claims the Academy will “foster violence” against homosexuals). At the Truth Academy, to be held outside Chicago Aug 5-7, Barber will be lecturing on, among other things, a “Non-defensive approach to the issue of homosexuality.” Speaking of which, the two discuss the current malaise of evangelicals on the homosexuality issue — including Andy Marin’s preposterous call for a “moratorium” in churches on preaching against the sin of homosexuality.

Toward the end of the interview, Barber, author of the “The Right Hook: From the Ring to the Culture War,” discusses the homosexual activist movement (failed) attempt to open up blood donations to homosexual men — despite the well-documented linkage between male-on-male sex and various sexually transmitted diseases including HIV. You will want to pass this interview on to your friends!

HOW TO LISTEN: This is an mp3 file. Left click on the link below to play. (Please be patient, depending upon the speed of your internet connection it may take a moment to load.) OR right click the link then “save target as” to download the whole show.

6-12-10, Matt Barber, All

Don’t Ask, Don’t Bleed – Health Risks and ‘Gays’ in the Military

Peterlab — Fri, 05 Mar 2010 02:51:46 +0000

“Men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors (American Red Cross).” –FDA (U.S. Food & Drug Administration), “Blood Donations from Men Who Have Sex with Other Men - Questions and Answers”

War is bloody, yet men who have practiced homosexuality cannot give blood. Writes Barber: "If 'gays' are allowed to serve openly ... how much more would soldiers in the field – where battlefield blood transfusions and frequent exposure to biohazards are commonplace – face pointless peril?"

Another informative piece by Matt Barber, AFTAH Board Member and Director of Cultural Studies at the Liberty Counsel. To read about the current FDA policy banning blood donations from MSM (“men who have had sex with men”) — and women who have had sex with MSM — go HERE. Homosexuality is not about “human rights,” but rather (changeable) human wrongs — and human wrongs often have public health consequences. — Peter LaBarbera, www.AmericansForTruth.org; write us at americansfortruth@comcast.net.

TAKE ACTION: Call and write your U.S. Congressman and Senators (202-224-3121; www.congress.org) and urge them to oppose ALL efforts to force open homosexuality on the military. Oppose S. 3065 in the Senate and HR 1283 in the House — bills that would homosexualize our Armed Services and force our nation’s conservative military culture to become one that celebrates homosexual “pride.”

______________________________

Don’t Ask, Don’t Bleed

By J. Matt Barber

The U.S. military has always discriminated. There are a host of malignant behaviors such as illicit drug use or habitual criminality that can render a person ineligible to serve. As my father-in-law learned, there are also benign maladies such as vision impairment or flat feet that can bar an otherwise eligible applicant. Any number of behaviors or conditions with varying degrees of severity can dash one’s hope of donning the uniform.

This is discrimination only insofar as “discriminating minds” with expertise in these matters have found that such restrictions are necessary to maintain excellence in our historically unparalleled fighting force.

In formal recognition of the long-established finding that “homosexuality is incompatible with military service,” federal law – Section 654, Title 10 – objectively prescribes the following:

The primary purpose of the armed forces is to prepare for and to prevail in combat should the need arise;
Success in combat requires military units that are characterized by high morale, good order and discipline, and unit cohesion;
The prohibition against homosexual conduct is a long-standing element of military law that continues to be necessary in the unique circumstances of military service;
The presence in the armed forces of persons who demonstrate a propensity or intent to engage in homosexual acts would create an unacceptable risk to the high standards of morale, good order and discipline, and unit cohesion that are the essence of military capability; and
There is no constitutional right to serve in the armed forces.

Indeed, federal courts have ruled over and again that a prohibition against homosexual conduct within the ranks of the military is both constitutional and justified.

So now that Barack Obama is president, what has changed? Is there something about “out and proud” homosexuality, hitherto absent or unseen, that suddenly makes it compatible with military service? Is there something about our military that has, for the first time in history, made it compatible with this particular lifestyle?

The answer to both is no.

The fact that “homosexual acts would create an unacceptable risk to the high standards of morale, good order and discipline” has not changed. Proponents of military homosexualization offer scant evidence to the contrary. In truth, the only thing that has changed is politics.

Reasons for incompatibility are manifold. They are firmly rooted in both common sense and in the “settled” anthropological, sociopolitical and medical sciences, as well as the theological arena. Taken alone, each provides ample justification for maintaining the status quo. Combined, they prove the case. For now – in the interest of brevity – we’ll focus on but one: medical science.

Consider that current U.S. health regulations prohibit men who have sex with men (MSM – aka “gays”) from donating blood. Studies conducted by the Centers for Disease Control and Prevention and the Food and Drug Administration categorically confirm that if MSM were permitted to give blood, the general population would be placed at risk.

According to the FDA: “['Gay' men] have an HIV prevalence 60 times higher than the general population, 800 times higher than first-time blood donors and 8,000 times higher than repeat blood donors.”

The FDA further warns: “['Gay' men] also have an increased risk of having other infections that can be transmitted to others by blood transfusion. For example, infection with the Hepatitis B virus is about 5-6 times more common, and Hepatitis C virus infections are about 2 times more common in ['gay' men] than in the general population.”

A 2007 CDC study further rocked the homosexual activist community, finding that, although “gay” men comprise only 1-to-2 percent of the population, they account for an epidemic 64 percent of all syphilis cases.

Do the math: If “gays” are allowed to serve openly – as to appease leftists’ euphemistic demands for “tolerance” and “diversity” – how much more would soldiers in the field – where battlefield blood transfusions and frequent exposure to biohazards are commonplace – face pointless peril?

All things considered (and we’ve only scratched the surface), is it any wonder that, according to a 2008 Military Times survey, almost 10 percent of currently enlisted personnel say that should “gays” be allowed to serve openly: “I would not re-enlist or extend my service.” Furthermore, 14 percent warn: “I would consider not re-enlisting or extending my service.” The potential exodus of up to 14 percent of military personnel from our all-volunteer services would be devastating.

When we apply these uncompromising medical and administrative realities to the “gays in the military” debate, we find that, objectively, and based solely upon medical science and the imperative to maintain good order and unit cohesion, homosexual behavior and military service remain today as oil and water.

Yet, inexplicably we see reckless movement from this administration, liberals in Congress and even a handful of high-ranking military commanders toward military homosexualization. This type of San Francisco-style social experimentation within the ranks of the armed services would demonstrably weaken, not strengthen, our military, jeopardizing national security.

In a purely civilian world perhaps we can afford to grant liberal social engineers a manageable level of latitude to play fast and loose with wistful “gay rights” rhetoric. However, it’s an entirely different proposition when bad behaviors place others – particularly those who’ve already waged life and limb for country – at both an unnecessary and avoidable level of risk.

For these reasons (and many more) allowing practitioners of the homosexual lifestyle to serve openly in our armed services should not and must not be “tolerated.”

Mr. President, it’s your sworn duty to place national security above misguided ideology and extreme special interests. It’s high time you begin to take your job seriously.

_______________________________

Matt Barber is an attorney concentrating in constitutional law. He is author of the book “The Right Hook – From the Ring to the Culture War” and serves as Director of Cultural Affairs with Liberty Counsel. Send comments to Matt at jmattbarber@comcast.net. Barber is a Board Member of Americans For Truth About Homosexuality. (This information is provided for identification purposes only.)

Table of Contents of Senate Majority Leader Reid’s Health Care Bill, HR 3590

Peterlab — Fri, 20 Nov 2009 20:13:34 +0000

SENATE HEALTHCARE BILL — H.R. 3590

“Patient Protection and Affordable Care Act”

November 18, 2009

http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf

(The version of the Senate Bill on Senator Reid’s website does not include page numbers on the Table of Contents. This document — created by a private citizen who laboriously entered the page numbers on the attached Table of Contents — was provided by Texas education advocate Donna Warner. We apologize that the Page Numbers on the right side are not flush with the right side of the page.)

TAKE ACTION: Call 202-224-3121 or 202-225-3121 and click here to reach your U.S. Senators and Congressman: www.congress.org

Page #

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Patient Protection and Affordable Care Act’’.

6 (b) TABLE OF CONTENTS.—The table of contents of

7 this Act is as follows:

Sec. 1. Short title; table of contents.

2

TITLE I—QUALITY, AFFORDABLE HEALTH CARE FOR ALL

AMERICANS

Subtitle A—Immediate Improvements in Health Care Coverage for All 15

Americans

Sec. 1001. Amendments to the Public Health Service Act. 15

‘‘PART A—INDIVIDUAL AND GROUP MARKET REFORMS 15

‘‘SUBPART II—IMPROVING COVERAGE 16

‘‘Sec. 2711. No lifetime or annual limits 16

‘‘Sec. 2712. Prohibition on rescissions. 16

‘‘Sec. 2713. Coverage of preventive health services. 17

‘‘Sec. 2714. Extension of dependent coverage. 18

‘‘Sec. 2715. Development and utilization of uniform explanation of coverage 19

documents and standardized definitions.

‘‘Sec. 2716. Prohibition of discrimination based on salary. 26

‘‘Sec. 2717. Ensuring the quality of care. 26

‘‘Sec. 2718. Bringing down the cost of health care coverage. 30

‘‘Sec. 2719. Appeals process. 33

Sec. 1002. Health insurance consumer information. 34

Sec. 1003. Ensuring that consumers get value for their dollars. 37

Sec. 1004. Effective dates. 40

Subtitle B—Immediate Actions to Preserve and Expand Coverage 41

Sec. 1101. Immediate access to insurance for uninsured individuals with a preexisting 41

condition.

Sec. 1102. Reinsurance for early retirees. 48

Sec. 1103. Immediate information that allows consumers to identify affordable 54

coverage options.

Sec. 1104. Administrative simplification. 57

Sec. 1105. Effective Date 77

Subtitle C—Quality Health Insurance Coverage for All Americans 78

PART I—HEALTH INSURANCE MARKET REFORMS 78

Sec. 1201. Amendment to the Public Health Service Act. 78

‘‘SUBPART I—GENERAL REFORM 78

‘‘Sec. 2701. Fair health insurance premiums. 80

‘‘Sec. 2702. Guaranteed availability of coverage. 82

‘‘Sec. 2703. Guaranteed renewability of coverage. 83

‘‘Sec. 2704. Prohibition of preexisting condition exclusions or other discrimination 78

based on health status.

‘‘Sec. 2705. Prohibiting discrimination against individual participants and 83

beneficiaries based on health status.

‘‘Sec. 2706. Non-discrimination in health care. 95

‘‘Sec. 2707. Comprehensive health insurance coverage. 96

‘‘Sec. 2708. Prohibition on excessive waiting periods. 97

PART II—OTHER PROVISIONS 97

Sec. 1251. Preservation of right to maintain existing coverage. 97

3

Sec. 1252. Rating reforms must apply uniformly to all health insurance issuers 99

and group health plans.

Sec. 1253. Effective dates. 99

Subtitle D—Available Coverage Choices for All Americans 100

PART I—ESTABLISHMENT OF QUALIFIED HEALTH PLANS 100

Sec. 1301. Qualified health plan defined. 100

Sec. 1302. Essential health benefits requirements. 102

Sec. 1303. Special rules. 116

Sec. 1304. Related definitions. 124

PART II—CONSUMER CHOICES AND INSURANCE COMPETITION THROUGH 128

HEALTH BENEFIT EXCHANGES

Sec. 1311. Affordable choices of health benefit plans. 128

Sec. 1312. Consumer choice. 153

Sec. 1313. Financial integrity. 160

PART III—STATE FLEXIBILITY RELATING TO EXCHANGES 164

Sec. 1321. State flexibility in operation and enforcement of Exchanges and related 164

requirements.

Sec. 1322. Federal program to assist establishment and operation of nonprofit, 168

member-run health insurance issuers.

Sec. 1323. Community health insurance option. 182

Sec. 1324. Level playing field. 200

PART IV—STATE FLEXIBILITY TO ESTABLISH ALTERNATIVE PROGRAMS 201

Sec. 1331. State flexibility to establish basic health programs for low-income individuals 201

not eligible for Medicaid.

Sec. 1332. Waiver for State innovation. 212

Sec. 1333. Provisions relating to offering of plans in more than one State. 219

PART V—REINSURANCE AND RISK ADJUSTMENT 226

Sec. 1341. Transitional reinsurance program for individual and small group 226

markets in each State.

Sec. 1342. Establishment of risk corridors for plans in individual and small 233

group markets.

Sec. 1343. Risk adjustment. 236

Subtitle E—Affordable Coverage Choices for All Americans 238

PART I—PREMIUM TAX CREDITS AND COST-SHARING REDUCTIONS 238

SUBPART A—PREMIUM TAX CREDITS AND COST-SHARING REDUCTIONS 238

Sec. 1401. Refundable tax credit providing premium assistance for coverage 238

under a qualified health plan.

Sec. 1402. Reduced cost-sharing for individuals enrolling in qualified health 259

plans.

SUBPART B—ELIGIBILITY DETERMINATIONS 269

4

Sec. 1411. Procedures for determining eligibility for Exchange participation, 269

premium tax credits and reduced cost-sharing , and individual

responsibility exemptions.

Sec. 1412. Advance determination and payment of premium tax credits and 290

cost-sharing reductions.

Sec. 1413. Streamlining of procedures for enrollment through an exchange and 295

State Medicaid, CHIP, and health subsidy programs.

Sec. 1414. Disclosures to carry out eligibility requirements for certain programs. 302

Sec. 1415. Premium tax credit and cost-sharing reduction payments disregarded 306

for Federal and Federally-assisted programs.

PART II—SMALL BUSINESS TAX CREDIT 307

Sec. 1421. Credit for employee health insurance expenses of small businesses. 307

Subtitle F—Shared Responsibility for Health Care 320

PART I—INDIVIDUAL RESPONSIBILITY 320

Sec. 1501. Requirement to maintain minimum essential coverage. 320

Sec. 1502. Reporting of health insurance coverage. 340

PART II—EMPLOYER RESPONSIBILITIES 346

Sec. 1511. Automatic enrollment for employees of large employers. 346

Sec. 1512. Employer requirement to inform employees of coverage options. 347

Sec. 1513. Shared responsibility for employers. 348

Sec. 1514. Reporting of employer health insurance coverage. 357

Sec. 1515. Offering of Exchange-participating qualified health plans through 362

cafeteria plans.

Subtitle G—Miscellaneous Provisions 364

Sec. 1551. Definitions. 364

Sec. 1552. Transparency in government. 364

Sec. 1553. Prohibition against discrimination on assisted suicide. 364

Sec. 1554. Access to therapies. 366

Sec. 1555. Freedom not to participate in Federal health insurance programs. 367

Sec. 1556. Equity for certain eligible survivors. 367

Sec. 1557. Nondiscrimination. 368

Sec. 1558. Protections for employees. 369

Sec. 1559. Oversight. 371

Sec. 1560. Rules of construction. 371

Sec. 1561. Health information technology enrollment standards and protocols. 373

Sec. 1562. Conforming amendments. 377

TITLE II—ROLE OF PUBLIC PROGRAMS 396

Subtitle A—Improved Access to Medicaid 396

Sec. 2001. Medicaid coverage for the lowest income populations. 396

Sec. 2002. Income eligibility for nonelderly determined using modified gross income. 418

Sec. 2003. Requirement to offer premium assistance for employer-sponsored insurance. 427

Sec. 2004. Medicaid coverage for former foster care children. 428

Sec. 2005. Payments to territories. 430

5

Sec. 2006. Special adjustment to FMAP determination for certain States recovering 432

from a major disaster.

Sec. 2007. Medicaid Improvement Fund rescission. 436

Subtitle B—Enhanced Support for the Children’s Health Insurance Program 436

Sec. 2101. Additional federal financial participation for CHIP. 436

Sec. 2102. Technical corrections. 442

Subtitle C—Medicaid and CHIP Enrollment Simplification 445

Sec. 2201. Enrollment Simplification and coordination with State Health Insurance 445

Exchanges.

Sec. 2202. Permitting hospitals to make presumptive eligibility determinations 451

for all Medicaid eligible populations.

Subtitle D—Improvements to Medicaid Services 453

Sec. 2301. Coverage for freestanding birth center services. 453

Sec. 2302. Concurrent care for children. 456

Sec. 2303. State eligibility option for family planning services. 457

Sec. 2304. Clarification of definition of medical assistance. 466

Subtitle E—New Options for States to Provide Long-Term Services and

Supports 466

Sec. 2401. Community First Choice Option. 466

Sec. 2402. Removal of barriers to providing home and community-based services. 479

Sec. 2403. Money Follows the Person Rebalancing Demonstration. 488

Sec. 2404. Protection for recipients of home and community-based services 489

against spousal impoverishment.

Sec. 2405. Funding to expand State Aging and Disability Resource Centers. 490

Sec. 2406. Sense of the Senate regarding long-term care. 490

Subtitle F—Medicaid Prescription Drug Coverage 492

Sec. 2501. Prescription drug rebates. 492

Sec. 2502. Elimination of exclusion of coverage of certain drugs. 502

Sec. 2503. Providing adequate pharmacy reimbursement. 503

Subtitle G—Medicaid Disproportionate Share Hospital (DSH) Payments 510

Sec. 2551. Disproportionate share hospital payments. 510

Subtitle H—Improved Coordination for Dual Eligible Beneficiaries 515

Sec. 2601. 5-year period for demonstration projects. 515

Sec. 2602. Providing Federal coverage and payment coordination for dual eligible 517

beneficiaries.

Subtitle I—Improving the Quality of Medicaid for Patients and Providers 522

Sec. 2701. Adult health quality measures. 522

Sec. 2702. Payment Adjustment for Health Care-Acquired Conditions. 526

Sec. 2703. State option to provide health homes for enrollees with chronic conditions. 528

Sec. 2704. Demonstration project to evaluate integrated care around a hospitalization. 538

6

Sec. 2705. Medicaid Global Payment System Demonstration Project. 542

Sec. 2706. Pediatric Accountable Care Organization Demonstration Project. 544

Sec. 2707. Medicaid emergency psychiatric demonstration project. 547

Subtitle J—Improvements to the Medicaid and CHIP Payment and Access 553

Commission (MACPAC)

Sec. 2801. MACPAC assessment of policies affecting all Medicaid beneficiaries. 553

Subtitle K—Protections for American Indians and Alaska Natives 565

Sec. 2901. Special rules relating to Indians. 565

Sec. 2902. Elimination of sunset for reimbursement for all medicare part B 567

services furnished by certain indian hospitals and clinics.

Subtitle L—Maternal and Child Health Services 568

Sec. 2951. Maternal, infant, and early childhood home visiting programs. 568

Sec. 2952. Support, education, and research for postpartum depression. 595

Sec. 2953. Personal responsibility education. 604

Sec. 2954. Restoration of funding for abstinence education. 618

Sec. 2955. Inclusion of information about the importance of having a health 619

care power of attorney in transition planning for children aging

out of foster care and independent living programs.

TITLE III—IMPROVING THE QUALITY AND EFFICIENCY OF

HEALTH CARE 621

Subtitle A—Transforming the Health Care Delivery System 621

PART I—LINKING PAYMENT TO QUALITY OUTCOMES UNDER THE

MEDICARE PROGRAM 621

Sec. 3001. Hospital Value-Based purchasing program. 622

Sec. 3002. Improvements to the physician quality reporting system. 652

Sec. 3003. Improvements to the physician feedback program. 658

Sec. 3004. Quality reporting for long-term care hospitals, inpatient rehabilitation

hospitals, and hospice programs. 663

Sec. 3005. Quality reporting for PPS-exempt cancer hospitals. 673

Sec. 3006. Plans for a Value-Based purchasing program for skilled nursing facilities

and home health agencies. 676

Sec. 3007. Value-based payment modifier under the physician fee schedule. 680

Sec. 3008. Payment adjustment for conditions acquired in hospitals. 687

PART II—NATIONAL STRATEGY TO IMPROVE HEALTH CARE QUALITY 692

Sec. 3011. National strategy. 692

Sec. 3012. Interagency Working Group on Health Care Quality. 699

Sec. 3013. Quality measure development. 702

Sec. 3014. Quality measurement. 709

Sec. 3015. Data collection; public reporting. 717

PART III—ENCOURAGING DEVELOPMENT OF NEW PATIENT CARE MODELS 723

Sec. 3021. Establishment of Center for Medicare and Medicaid Innovation

within CMS. 723

Sec. 3022. Medicare shared savings program. 739

Sec. 3023. National pilot program on payment bundling. 751

7

Sec. 3024. Independence at home demonstration program. 764

Sec. 3025. Hospital readmissions reduction program. 775

Sec. 3026. Community-Based Care Transitions Program. 789

Sec. 3027. Extension of gainsharing demonstration. 795

Subtitle B—Improving Medicare for Patients and Providers 796

PART I—ENSURING BENEFICIARY ACCESS TO PHYSICIAN CARE AND OTHER

SERVICES 796

Sec. 3101. Increase in the physician payment update. 796

Sec. 3102. Extension of the work geographic index floor and revisions to the 797

practice expense geographic adjustment under the Medicare

physician fee schedule.

Sec. 3103. Extension of exceptions process for Medicare therapy caps. 801

Sec. 3104. Extension of payment for technical component of certain physician 801

pathology services.

Sec. 3105. Extension of ambulance add-ons. 802

Sec. 3106. Extension of certain payment rules for long-term care hospital services 803

and of moratorium on the establishment of certain hospitals

and facilities.

Sec. 3107. Extension of physician fee schedule mental health add-on. 803

Sec. 3108. Permitting physician assistants to order post-Hospital extended care 803

services.

Sec. 3109. Exemption of certain pharmacies from accreditation requirements. 804

Sec. 3110. Part B special enrollment period for disabled TRICARE beneficiaries. 808

Sec. 3111. Payment for bone density tests. 810

Sec. 3112. Revision to the Medicare Improvement Fund. 813

Sec. 3113. Treatment of certain complex diagnostic laboratory tests. 813

Sec. 3114. Improved access for certified nurse-midwife services. 816

PART II—RURAL PROTECTIONS 817

Sec. 3121. Extension of outpatient hold harmless provision. 817

Sec. 3122. Extension of Medicare reasonable costs payments for certain clinical 818

diagnostic laboratory tests furnished to hospital patients in certain

rural areas.

Sec. 3123. Extension of the Rural Community Hospital Demonstration Program. 818

Sec. 3124. Extension of the Medicare-dependent hospital (MDH) program. 821

Sec. 3125. Temporary improvements to the Medicare inpatient hospital payment 822

adjustment for low-volume hospitals.

Sec. 3126. Improvements to the demonstration project on community health integration 824

models in certain rural counties.

Sec. 3127. MedPAC study on adequacy of Medicare payments for health care 825

providers serving in rural areas.

Sec. 3128. Technical correction related to critical access hospital services. 826

Sec. 3129. Extension of and revisions to Medicare rural hospital flexibility program. 826

PART III—IMPROVING PAYMENT ACCURACY 828

Sec. 3131. Payment adjustments for home health care. 828

Sec. 3132. Hospice reform. 836

Sec. 3133. Improvement to medicare disproportionate share hospital (DSH) 842

payments.

8

Sec. 3134. Misvalued codes under the physician fee schedule. 846

Sec. 3135. Modification of equipment utilization factor for advanced imaging 852

services.

Sec. 3136. Revision of payment for power-driven wheelchairs. 857

Sec. 3137. Hospital wage index improvement. 858

Sec. 3138. Treatment of certain cancer hospitals. 861

Sec. 3139. Payment for biosimilar biological products. 863

Sec. 3140. Medicare hospice concurrent care demonstration program. 865

Sec. 3141. Application of budget neutrality on a national basis in the calculation 867

of the Medicare hospital wage index floor.

Sec. 3142. HHS study on urban Medicare-dependent hospitals. 867

Subtitle C—Provisions Relating to Part C 869

Sec. 3201. Medicare Advantage payment. 869

Sec. 3202. Benefit protection and simplification. 903

Sec. 3203. Application of coding intensity adjustment during MA payment 908

transition.

Sec. 3204. Simplification of annual beneficiary election periods. 909

Sec. 3205. Extension for specialized MA plans for special needs individuals. 911

Sec. 3206. Extension of reasonable cost contracts. 918

Sec. 3207. Technical correction to MA private fee-for-service plans. 918

Sec. 3208. Making senior housing facility demonstration permanent. 919

Sec. 3209. Authority to deny plan bids. 920

Sec. 3210. Development of new standards for certain Medigap plans. 921

Subtitle D—Medicare Part D Improvements for Prescription Drug

Plans and MA–PD Plans 923

Sec. 3301. Medicare coverage gap discount program. 923

Sec. 3302. Improvement in determination of Medicare part D low-income 943

benchmark premium.

Sec. 3303. Voluntary de minimis policy for subsidy eligible individuals under 943

prescription drug plans and MA–PD plans.

Sec. 3304. Special rule for widows and widowers regarding eligibility for low income 945

assistance.

Sec. 3305. Improved information for subsidy eligible individuals reassigned to 946

prescription drug plans and MA–PD plans.

Sec. 3306. Funding outreach and assistance for low-income programs. 947

Sec. 3307. Improving formulary requirements for prescription drug plans and 950

MA–PD plans with respect to certain categories or classes of drugs.

Sec. 3308. Reducing part D premium subsidy for high-income beneficiaries. 952

Sec. 3309. Elimination of cost sharing for certain dual eligible individuals. 961

Sec. 3310. Reducing wasteful dispensing of outpatient prescription drugs in 962

long-term care facilities under prescription drug plans and

MA–PD plans.

Sec. 3311. Improved Medicare prescription drug plan and MA–PD plan complaint 963

system.

Sec. 3312. Uniform exceptions and appeals process for prescription drug plans 964

and MA–PD plans.

Sec. 3313. Office of the Inspector General studies and reports. 965

Sec. 3314. Including costs incurred by AIDS drug assistance programs and Indian 970

Health Service in providing prescription drugs toward the

annual out-of-pocket threshold under part D.

Sec. 3315. Immediate reduction in coverage gap in 2010. 972

9

Subtitle E—Ensuring Medicare Sustainability 974

Sec. 3401. Revision of certain market basket updates and incorporation of productivity 974

improvements into market basket updates that do not

already incorporate such improvements.

Sec. 3402. Temporary adjustment to the calculation of part B premiums. 999

Sec. 3403. Independent Medicare Advisory Board. 1,000

Subtitle F—Health Care Quality Improvements 1,053

Sec. 3501. Health care delivery system research; Quality improvement technical 1,053

assistance.

Sec. 3502. Establishing community health teams to support the patient-centered 1,067

medical home.

Sec. 3503. Medication management services in treatment of chronic disease. 1,075

Sec. 3504. Design and implementation of regionalized systems for emergency 1,081

care.

Sec. 3505. Trauma care centers and service availability. 1,091

Sec. 3506. Program to facilitate shared decision making. 1,105

Sec. 3507. Presentation of prescription drug benefit and risk information. 1,113

Sec. 3508. Demonstration program to integrate quality improvement and patient 1,115

safety training into clinical education of health professionals.

Sec. 3509. Improving women’s health. 1,118

Sec. 3510. Patient navigator program. 1,132

Sec. 3511. Authorization of appropriations. 1,133

TITLE IV—PREVENTION OF CHRONIC DISEASE AND IMPROVING 1,134

PUBLIC HEALTH

Subtitle A—Modernizing Disease Prevention and Public Health Systems 1,134

Sec. 4001. National Prevention, Health Promotion and Public Health Council. 1,134

Sec. 4002. Prevention and Public Health Fund. 1,141

Sec. 4003. Clinical and community preventive services. 1,142

Sec. 4004. Education and outreach campaign regarding preventive benefits. 1,150

Subtitle B—Increasing Access to Clinical Preventive Services 1,156

Sec. 4101. School-based health centers. 1,156

Sec. 4102. Oral healthcare prevention activities. 1,167

Sec. 4103. Medicare coverage of annual wellness visit providing a personalized 1,174

prevention plan.

Sec. 4104. Removal of barriers to preventive services in Medicare. 1,184

Sec. 4105. Evidence-based coverage of preventive services in Medicare. 1,189

Sec. 4106. Improving access to preventive services for eligible adults in Medicaid. 1,190

Sec. 4107. Coverage of comprehensive tobacco cessation services for pregnant 1,192

women in Medicaid.

Sec. 4108. Incentives for prevention of chronic diseases in Medicaid. 1,195

Subtitle C—Creating Healthier Communities 1,203

Sec. 4201. Community transformation grants. 1,203

Sec. 4202. Healthy aging, living well; evaluation of community-based prevention 1,209

and wellness programs for Medicare beneficiaries.

10

Sec. 4203. Removing barriers and improving access to wellness for individuals 1,220

with disabilities.

Sec. 4204. Immunizations. 1,221

Sec. 4205. Nutrition labeling of standard menu items at chain restaurants. 1,228

Sec. 4206. Demonstration project concerning individualized wellness plan. 1,237

Sec. 4207. Reasonable break time for nursing mothers. 1,239

Subtitle D—Support for Prevention and Public Health Innovation 1,240

Sec. 4301. Research on optimizing the delivery of public health services. 1,240

Sec. 4302. Understanding health disparities: data collection and analysis. 1,241

Sec. 4303. CDC and employer-based wellness programs. 1,252

Sec. 4304. Epidemiology-Laboratory Capacity Grants. 1,255

Sec. 4305. Advancing research and treatment for pain care management. 1,257

Sec. 4306. Funding for Childhood Obesity Demonstration Project. 1,265

Subtitle E—Miscellaneous Provisions 1,265

Sec. 4401. Sense of the Senate concerning CBO scoring. 1,265

Sec. 4402. Effectiveness of Federal health and wellness initiatives. 1,265

TITLE V—HEALTH CARE WORKFORCE 1,266

Subtitle A—Purpose and Definitions 1,266

Sec. 5001. Purpose. 1,266

Sec. 5002. Definitions. 1,267

Subtitle B—Innovations in the Health Care Workforce 1,278

Sec. 5101. National health care workforce commission. 1,278

Sec. 5102. State health care workforce development grants. 1,297

Sec. 5103. Health care workforce assessment. 1,309

Subtitle C—Increasing the Supply of the Health Care Workforce 1,316

Sec. 5201. Federally supported student loan funds. 1,316

Sec. 5202. Nursing student loan program. 1,318

Sec. 5203. Health care workforce loan repayment programs. 1,319

Sec. 5204. Public health workforce recruitment and retention programs. 1,324

Sec. 5205. Allied health workforce recruitment and retention programs. 1,329

Sec. 5206. Grants for State and local programs. 1,331

Sec. 5207. Funding for National Health Service Corps. 1,333

Sec. 5208. Nurse-managed health clinics. 1,334

Sec. 5209. Elimination of cap on commissioned Corps. 1,336

Sec. 5210. Establishing a Ready Reserve Corps. 1,336

Subtitle D—Enhancing Health Care Workforce Education and Training 1,339

Sec. 5301. Training in family medicine, general internal medicine,

general pediatrics, and physician assistantship. 1,339

Sec. 5302. Training opportunities for direct care workers. 1,346

Sec. 5303. Training in general, pediatric, and public health dentistry. 1,349

Sec. 5304. Alternative dental health care providers demonstration project. 1,355

Sec. 5305. Geriatric education and training; career awards;

comprehensive geriatric education. 1,359

Sec. 5306. Mental and behavioral health education and training grants. 1,368

11

Sec. 5307. Cultural competency, prevention, and public health and individuals 1,374

with disabilities training.

Sec. 5308. Advanced nursing education grants. 1,377

Sec. 5309. Nurse education, practice, and retention grants. 1,378

Sec. 5310. Loan repayment and scholarship program. 1,382

Sec. 5311. Nurse faculty loan program. 1,384

Sec. 5312. Authorization of appropriations for parts B through D of Title VIII. 1,389

Sec. 5313. Grants to promote the community health workforce. 1,389

Sec. 5314. Fellowship training in public health. 1,395

Sec. 5315. United States Public Health Sciences Track. 1,397

Subtitle E—Supporting the Existing Health Care Workforce 1,411

Sec. 5401. Centers of excellence. 1,411

Sec. 5402. Health care professionals training for diversity. 1,416

Sec. 5403. Interdisciplinary, community-based linkages. 1,417

Sec. 5404. Workforce diversity grants. 1,430

Sec. 5405. Primary care extension program. 1,431

Subtitle F—Strengthening Primary Care and Other Workforce Improvements 1,440

Sec. 5501. Expanding access to primary care services and general surgery services. 1,440

Sec. 5502. Medicare Federally qualified health center improvements. 1,446

Sec. 5503. Distribution of additional residency positions. 1,449

Sec. 5504. Counting resident time in outpatient settings and allowing flexibility 1,458

for jointly operated residency training programs.

Sec. 5505. Rules for counting resident time for didactic and scholarly activities 1,461

and other activities.

Sec. 5506. Preservation of resident cap positions from closed hospitals. 1,465

Sec. 5507. Demonstration projects To address health professions workforce 1,469

needs; extension of family-to-family health information centers.

Sec. 5508. Increasing teaching capacity. 1,485

Sec. 5509. Graduate nurse education demonstration. 1,500

Subtitle G—Improving Access to Health Care Services 1,508

Sec. 5601. Spending for Federally Qualified Health Centers (FQHCs). 1,508

Sec. 5602. Negotiated rulemaking for development of methodology and criteria 1,510

for designating medically underserved populations and health

professions shortage areas.

Sec. 5603. Reauthorization of the Wakefield Emergency Medical Services for 1,514

Children Program.

Sec. 5604. Co-locating primary and specialty care in community-based mental 1,515

health settings.

Sec. 5605. Key National indicators. 1,518

Subtitle H—General Provisions 1,528

Sec. 5701. Reports. 1,528

TITLE VI—TRANSPARENCY AND PROGRAM INTEGRITY 1,529

Subtitle A—Physician Ownership and Other Transparency 1,529

Sec. 6001. Limitation on Medicare exception to the prohibition

on certain physician referrals for hospitals. 1,529

12

Sec. 6002. Transparency reports and reporting of physician 1,542

ownership or investment interests.

Sec. 6003. Disclosure requirements for in-office ancillary services exception to 1,564

the prohibition on physician self-referral for certain imaging services.

Sec. 6004. Prescription drug sample transparency. 1,564

Sec. 6005. Pharmacy benefit managers transparency requirements. 1,567

Subtitle B—Nursing Home Transparency and Improvement 1,571

PART I—IMPROVING TRANSPARENCY OF INFORMATION 1,571

Sec. 6101. Required disclosure of ownership and additional disclosable parties 1,571

information.

Sec. 6102. Accountability requirements for skilled nursing facilities and nursing 1,579

facilities.

Sec. 6103. Nursing home compare Medicare website. 1,585

Sec. 6104. Reporting of expenditures. 1,603

Sec. 6105. Standardized complaint form. 1,605

Sec. 6106. Ensuring staffing accountability. 1,607

Sec. 6107. GAO study and report on Five-Star Quality Rating System. 1,609

PART II—TARGETING ENFORCEMENT 1610

Sec. 6111. Civil money penalties. 1,610

Sec. 6112. National independent monitor demonstration project. 1,619

Sec. 6113. Notification of facility closure. 1,625

Sec. 6114. National demonstration projects on culture change and use of information 1,628

technology in nursing homes.

PART III—IMPROVING STAFF TRAINING 1,630

Sec. 6121. Dementia and abuse prevention training. 1,630

Subtitle C—Nationwide Program for National and State Background Checks 1,632

on Direct Patient Access Employees of Long-term Care Facilities and Providers

Sec. 6201. Nationwide program for National and State background checks on 1,632

direct patient access employees of long-term care facilities and

providers.

Subtitle D—Patient-Centered Outcomes Research 1,648

Sec. 6301. Patient-Centered Outcomes Research. 1,648

Sec. 6302. Federal coordinating council for comparative effectiveness research. 1,702

Subtitle E—Medicare, Medicaid, and CHIP Program Integrity Provisions 1,703

Sec. 6401. Provider screening and other enrollment requirements under Medicare, 1,703

Medicaid, and CHIP.

Sec. 6402. Enhanced Medicare and Medicaid program integrity provisions. 1,720

Sec. 6403. Elimination of duplication between the Healthcare Integrity and 1,747

Protection Data Bank and the National Practitioner Data

Bank.

Sec. 6404. Maximum period for submission of Medicare claims reduced to not 1,760

more than 12 months.

13

Sec. 6405. Physicians who order items or services required to be Medicare enrolled 1,762

physicians or eligible professionals.

Sec. 6406. Requirement for physicians to provide documentation on referrals to 1,764

programs at high risk of waste and abuse.

Sec. 6407. Face to face encounter with patient required before physicians may 1,765

certify eligibility for home health services or durable medical

equipment under Medicare.

Sec. 6408. Enhanced penalties. 1,768

Sec. 6409. Medicare self-referral disclosure protocol. 1,773

Sec. 6410. Adjustments to the Medicare durable medical equipment, prosthetics, 1,775

orthotics, and supplies competitive acquisition program.

Sec. 6411. Expansion of the Recovery Audit Contractor (RAC) program. 1,777

Subtitle F—Additional Medicaid Program Integrity Provisions 1,778

Sec. 6501. Termination of provider participation under Medicaid if terminated 1,783

under Medicare or other State plan.

Sec. 6502. Medicaid exclusion from participation relating to certain ownership, 1,783

control, and management affiliations.

Sec. 6503. Billing agents, clearinghouses, or other alternate payees required to 1,784

Sec. 6504. Requirement to report expanded set of data elements under MMIS 1,785

to detect fraud and abuse.

Sec. 6505. Prohibition on payments to institutions or entities located outside of 1,786

the United States.

Sec. 6506. Overpayments. 1,786

Sec. 6507. Mandatory State use of national correct coding initiative. 1,788

Sec. 6508. General effective date. 1,790

Subtitle G—Additional Program Integrity Provisions 1,791

Sec. 6601. Prohibition on false statements and representations. 1,791

Sec. 6602. Clarifying definition. 1,793

Sec. 6603. Development of model uniform report form. 1,793

Sec. 6604. Applicability of State law to combat fraud and abuse. 1,794

Sec. 6605. Enabling the Department of Labor to issue administrative summary 1,795

cease and desist orders and summary seizures orders against

plans that are in financially hazardous condition.

Sec. 6606. MEWA plan registration with Department of Labor. 1,797

Sec. 6607. Permitting evidentiary privilege and confidential communications. 1,797

Subtitle H—Elder Justice Act 1,798

Sec. 6701. Short title of subtitle. 1,798

Sec. 6702. Definitions. 1,799

Sec. 6703. Elder Justice. 1,799

Subtitle I—Sense of the Senate Regarding Medical Malpractice 1,858

Sec. 6801. Sense of the Senate regarding medical malpractice. 1,858

TITLE VII—IMPROVING ACCESS TO INNOVATIVE MEDICAL 1,859

THERAPIES

Subtitle A—Biologics Price Competition and Innovation 1,859

Sec. 7001. Short title. 1,859

Sec. 7002. Approval pathway for biosimilar biological products. 1,859

14

Sec. 7003. Savings. 1,906

Subtitle B—More Affordable Medicines for Children and Underserved 1,906

Communities

Sec. 7101. Expanded participation in 340B program. 1,906

Sec. 7102. Improvements to 340B program integrity. 1,913

Sec. 7103. GAO study to make recommendations on improving the 340B program. 1,924

TITLE VIII—CLASS ACT 1,925

Sec. 8001. Short title of title. 1,925

Sec. 8002. Establishment of national voluntary insurance program for purchasing 1,925

community living assistance services and support.

TITLE IX—REVENUE PROVISIONS 1,979

Subtitle A—Revenue Offset Provisions 1,979

Sec. 9001. Excise tax on high cost employer-sponsored health coverage. 1,979

Sec. 9002. Inclusion of cost of employer-sponsored health coverage on W–2. 1,996

Sec. 9003. Distributions for medicine qualified only if for prescribed drug or insulin. 1,997

Sec. 9004. Increase in additional tax on distributions from HSAs and Archer 1,998

MSAs not used for qualified medical expenses.

Sec. 9005. Limitation on health flexible spending arrangements under cafeteria 1,999

plans.

Sec. 9006. Expansion of information reporting requirements. 1,999

Sec. 9007. Additional requirements for charitable hospitals. 2,001

Sec. 9008. Imposition of annual fee on branded prescription pharmaceutical 2,010

manufacturers and importers.

Sec. 9009. Imposition of annual fee on medical device manufacturers and importers. 2,020

Sec. 9010. Imposition of annual fee on health insurance providers. 2,026

Sec. 9011. Study and report of effect on veterans health care. 2,033

Sec. 9012. Elimination of deduction for expenses allocable to Medicare Part D 2,034

subsidy.

Sec. 9013. Modification of itemized deduction for medical expenses. 2,034

Sec. 9014. Limitation on excessive remuneration paid by certain health insurance 2,035

providers.

Sec. 9015. Additional hospital insurance tax on high-income taxpayers. 2,040

Sec. 9016. Modification of section 833 treatment of certain health organizations. 2,044

Sec. 9017. Excise tax on elective cosmetic medical procedures. 2,045

Subtitle B—Other Provisions 2,047

Sec. 9021. Exclusion of health benefits provided by Indian tribal governments. 2,047

Sec. 9022. Establishment of simple cafeteria plans for small businesses. 2,050

Sec. 9023. Qualifying therapeutic discovery project credit 2,057

(Note – Page 2074 is the last page of the document.)

(11/19/09)

_____________________________

Text of HR 3590: http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf

Researcher: 74 Percent of Bisexuals Experienced Child Sex Abuse

Peterlab — Fri, 21 Aug 2009 15:52:27 +0000

Health risks, self-harm far greater among bisexuals compared to straights

From the Bi Health Summit’s website’s report on its conference in Chicago Friday, Aug. 14 (emphasis added):

Research presented by Cheryl Dobinson, MA, and Stewart Landers, JD, MCP, from their two separate studies was remarkably similar. Bisexuals reported suffering from depression and anxiety in higher rates than heterosexuals or lesbians and gay men. In terms of attempting or thinking of attempting suicide, bisexual men were 7 times higher, while gay men were 4 times higher, than straight men; bisexual women were 6 times higher, while lesbian women were 4 times higher, than straight women. An Australian study revealed that middle-aged bi women were 24 times more likely to engage in self harm, like cutting, than straight women, as a coping mechanism.

Dobinson’s research revealed that only 26% of bisexuals did not experience child sexual abuse. I’ll be getting more information on violence, domestic violence, and physical or sexual abuse, since she whizzed through a lot of that information and I don’t wish to misquote her findings.

I would also like to speak more with Cheryl Dobinson regarding her findings in anal sex for bi women and men. Her research shows that bi men have fewer male partners than gay men and engage in anal sex less with men, but are more likely to have unprotected anal sex with men; while bi women have higher rates of anal sex with men than straight women and are more likely to report being HIV+. … I would really like to discuss the 2005 CDC study with her that showed 44% of straight men and 35% of straight women engaged in anal sex.

Stewart Landers’ information from the 2001-2006 Massachusetts’ Behavioral Risk Factor Surveillance System Survey — which is just the kind of huge population study bi researchers are looking for — revealed similar levels of depression, anxiety, suicidality, self-harm, and suffering from violence. Bisexual adults report poorer health and greater risks across a whole spectrum of health factors, including alcohol, substance abuse, and tobacco use. Heart disease seems to be up 3 times higher than straight people, asthma rates reported higher than straight people but fairly equal to lesbians and gay men.

Landers’ study showed a surprising finding that people 18-24 were the largest group identifying as bisexual.

See also a related report from the Bi Health Summit: “Half of Homosexuals are Bisexual: Homosexual Newspaper.”

Maddow Stumbles on Obama-Care and Transsexual ‘Sex-Change’ Surgeries: Barber

Peterlab — Thu, 06 Aug 2009 14:13:04 +0000

Maddow Misinformation: MSNBC’s resident lesbian activist Rachel Maddow (left) lied about Matt Barber’s press statement regarding the potential of Obama-Care to become “Tranny-Care” by mandating coverage for body-disfiguring transsexual “sex change” operations.

Folks, we hope that Rachel Maddow (left) — the lesbian MSNBC talker who is as “out” in her homosexuality promotion as in her left-wing activism — takes up the offer of my good friend Matt Barber and lets him appear as a guest on her show. That seems only fair after Maddow lied about Barber’s statement on Obama-care and “sex-change” operations.

We understand that liberals don’t want to talk (rationally, anyway) about Obama-care covering abortions and grotesque transsexual “sex-change” procedures as “health care.” That is why we must discuss these awful possibilities. (By the way, even before Barber’s column, below, the conservative Heritage Foundation’s blog noted that President Obama’s favorite think tank, the liberal-left Center for American Progress, was beating the drums for adding “sex change operations to the list of medical procedures that all health insurance policies in the nation must cover.”) — Peter LaBarbera, www.americansfortruth.com

BANQUET REMINDER: Culture warrior and former professional boxer Matt Barber (right) is coming to Chicago on Saturday, Oct. 24 to keynote the AFTAH fundraising banquet. The dinner is being held at the Christian Liberty Academy in Arlington Heights, IL, and tickets are $50 per person. You can prepay online (just note “AFTAH banquet” in the Paypal or Credit Card form) or mail your check (designate it “AFTAH Banquet”) to: Americans For Truth, PO Box 5522, Naperville, IL 60567-5522. Please spread the word and make plans to come! E-mail aftahangela@gmail.com or americansfortruth@comcast.net for more information.

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Matt Barber writes:

Sex-Change-apalooza: ObamaCare Likely to Mandate Free ‘Sex-Change’ Surgeries

By Matt Barber, August 5, 2009

I got a call a couple days ago from a producer with MSNBC. He wanted a hard copy of a press release I sent out entitled: “ObamaCare Likely to Mandate Free ‘Sex-Change’ Surgeries.” In the release I addressed the likelihood that, under Obama’s monolithic socialized healthcare scheme, taxpayers may well end up funding elective and entirely cosmetic “gender reassignment” surgeries. I was happy to oblige and asked which program he produced. “Rachel Maddow,” he reluctantly divulged. I chuckled and joked, “Oh, I’m sure Rachel will give me a glowing review.”

I then suggested that it would be better still if Rachel actually had me on the show to defend and debate the substance of my release. He declined. Understandable, though. Ms. Maddow—a hard-left lesbian activist who plays a pseudo-journalist on TV—certainly wouldn’t want me confusing all 242 of her wide-eyed, spoon-fed, Kool-Aid swilling viewers with the facts. (By the way, Rachel, sweetheart, if you have the guts, the offer still stands.)

In what was apparently an awkward attempt at ridicule, Maddow then focused like a laser on the title of my release. True to form, she twisted and spun like the Michelle Kwan of yellow journalism. I was disappointed. Not because she transparently distorted my words. I counted on that. I was disappointed because I actually expected the allegedly clever, Oxford educated talking-head to pull it off with some degree of satirical dexterity.

She did not.

Did Maddow mock me for suggesting that ObamCare might provide taxpayer funded “sex-change” operations? No. Did she deride me for mean-spiritedness, insensitivity and “transphobia”? No. Instead, she just lied. She dishonestly suggested that I claimed the government was going to “mandate sex-change operations.” Get it? That, if ObamaCare becomes reality, healthcare officials will knock down your door, drag you away and force you to undergo a “gender reassignment” surgery. I know—Silly.

Still, what Maddow didn’t say speaks volumes. She didn’t refute any of the substance of my release. She didn’t deny the real likelihood that such cosmetic procedures will be covered at taxpayer expense. And she certainly didn’t give me the opportunity to respond to her propagandist obfuscation.

But it didn’t stop with Maddow. Those adorable, patchouli soaked little left-wing lemmings at the Daily Kos, Wonkette and elsewhere also picked up on my release. I was surprised to see that many of them, in fact, agreed with the substance of my argument. Quite a few opined that “sex-change” surgeries should be covered at taxpayer expense and a number of them conceded that they almost certainly will.

So what prompted me to break this story in the first place? Well, when Sen. Orin Hatch (R-UT) asked Sen. Barbara Mikulski (D-MD) whether President Obama’s proposed socialized healthcare plan will mandate taxpayer funded abortion, she admitted that it will require “any service deemed medically necessary or medically appropriate.” It now appears that the plan’s “medically appropriate” umbrella is far more expansive than most Americans could have imagined.

In addition to abortion on demand, the weight of the evidence indicates that, in fact, cosmetic “gender reassignment” surgeries for both U.S. citizens and illegal immigrants who suffer from APA recognized “Gender Identity Disorder” (GID) may indeed be provided—free of charge—courtesy of the U.S. taxpayer. The current price tag for such a procedure can exceed $50,000.

Page 972 of the House version of the bill (H.R. 3200) provides for “standards, as appropriate, for the collection of accurate data on health and health care” based on “sex, sexual orientation [and] gender identity.” [Click HERE to read Peter Fleckenstein analysis of HR 3200 posted by Liberty Counsel.] The Senate draft indicates that the government will “detect and monitor trends in health disparities,” requiring the Department of Health and Human Services to “develop standards for the measurement of¬†gender.” (i.e., officially recognize subjectively self-determined “transgender” or “transsexual” gender identities). It further mandates “participation in the institutions’ programs of individuals and groups from…different genders and sexual orientations.”

So, does ObamaCare expressly stipulate that taxpayer funded “sex-change” operations will be provided? No, but neither does it explicitly require coverage for heart bypass surgery. Don’t forget; we’re talking about what’s “medically appropriate” here, and look who gets to make that subjective determination: Your doctor? No, it’s “Rachel Maddow-minded” bureaucrats within the Democratic Party. It’s a liberal-Democrat appointed government “Health Benefits Advisory Committee.” And if you think they’re not itching to pay back the homosexual, transgender and pro-abortion pressure groups that helped get them elected, I’ve got a house at 1600 Pennsylvania I want to sell you.

Still, there’s a gulf of difference between what Obama and liberals in Congress, and the American people deem “medically appropriate;” especially when it’s “we the people” footing the bill. It’s unconscionable to force Americans, against their conscience, to fund abortion on demand and to facilitate gender confusion by subsidizing the elective practice of genital “sex-change” mutilation.

But don’t just take my word for it. After hearing Sen. Mikulski’s “any service deemed…medically appropriate” admission, I was prompted to dig a little deeper. I contacted the offices of Sen. Harry Reid, Rep. Charlie Rangel, Rep. Barney Frank and the House Subcommittee on Health. I asked, very simply, for “an assurance that the proposed healthcare plan will not allow taxpayer funded ‘gender reassignment’ surgeries or hormone therapies.” When faced with the bill’s relevant language, every staffer I spoke with either declined to answer or would neither confirm nor deny that such procedures would be covered.

Indeed it’s no wonder that—as Americans find out what’s hidden within this socialized ObamaCare monstrosity—support for the plan is plummeting faster than MSNBC’s ratings.

It’s time for the mainstream press—yes you too Rachel Maddow—to do its job and demand straight answers. Instead of prancing around like little ObamaCare cheerleaders, journalists need to ask the same questions I did and refuse to take “no answer” for an answer.

But don’t hold your breath.

Thankfully, we don’t have to. Wanna have a little fun? Contact your Congressional representative (202-224-3121; 202-225-3121; www.congress.org) and ask the following question: “Will you personally guarantee that, under this plan, no taxpayer dollars will go to fund abortion or ‘sex-change’ operations?’”

Then sit back and watch them squirm.

Matt Barber is a Board Member of Americans for Truth About Homosexuality (AFTAH), and an attorney concentrating in constitutional law. He serves as Director of Cultural Affairs with both Liberty Counsel and Liberty Alliance Action. Click HERE for information on Barber’s appearance as keynote speaker at AFTAH’s fund-raising banquet on Saturday, Oct. 24. Send comments to Matt at: jmattbarber@comcast.net .

Taxpayer-Funded Tranny-Care? ObamaCare Could Mandate Free ‘Sex-Change’ Surgeries

Peterlab — Wed, 05 Aug 2009 09:07:05 +0000

Say NO to Tax-Funded ‘Tranny-Care’: Transsexual activists like Autumn Sandeen (at left; that’s his “female” name — adopted after leaving his traditional role as husband and father) are caught up in gender confusion. For some, this culminates in body-disfiguring operations to “change” into the opposite sex. No American should be forced to pay for these nature-rejecting procedures with his or her tax dollars. Homosexual groups like Human Rights Campaign boast of their support for taxpayer-funded “sex-change” operations in cities like San Francisco. Click on photo to enlarge.

Folks, you don’t have to be very politically sophisticated to predict that GLBT (gay, lesbian, bisexual, transgender) activists and their liberal allies are going to demand “Tranny-Care” under a federal health insurance system, in the name of “fairness” and “inclusion” — even if it’s not passed initially as a “benefit.” And yes, the idea of subsidizing body-disfiguring “operations” surely would be considered “queer” by the average tax-paying American. Already, trans activists are strategizing on the best ways to get taxpayers to pay for their ~~gender-confused mutilations~~ “sex change” procedures — and Human Rights Campaign and other homosexual lobby groups boast of their support for same in cities like San Francisco. — Peter LaBarbera, www.aftah.com

P.S. Go HERE to read Liberty Counsel’s posting of Peter Fleckenstein’s report exposing what is actually inside HR 3200, Obama’s Health Care Plan under consideration in the House of Representatives.

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Matt Barber Statement, August 4, 2009; contact: jmattbarber@comcast.net

ObamaCare Likely to Mandate Free “Sex-Change” Surgeries

Washington, DC – When asked by Senator Orin Hatch (R-UT) whether President Obama’s proposed socialized healthcare plan will mandate taxpayer funded abortion, Senator Barbara Mikulski (D-MD) admitted that it will require “any service deemed medically necessary or medically appropriate.” It now appears that the plan’s “medically appropriate” umbrella is far more expansive than most Americans could have imagined.

In addition to abortion on demand, the weight of the evidence indicates that cosmetic “gender reassignment” surgeries for both U.S. citizens and illegal immigrants who suffer from APA recognized “Gender Identity Disorder” (GID) may also be provided – free of charge – courtesy of the U.S. taxpayer. The current price tag for such a procedure can exceed $50,000.

Page 972 of the House version of the bill (H.R. 3200) provides for “standards, as appropriate, for the collection of accurate data on health and health care” based on “sex, sexual orientation [and] gender identity.” The Senate draft indicates that the government will “detect and monitor trends in health disparities,” requiring the Department of Health and Human Services to “develop standards for the measurement of gender.” (i.e., officially recognize subjectively self-determined “transgender” or “transsexual” gender identities). It further mandates ‘‘participation in the institutions’ programs of individuals and groups from…different genders and sexual orientations.”

Matt Barber, Director of Cultural Affairs with both Liberty Counsel and Liberty Alliance Action commented: “There’s a gulf of difference between what Obama and liberals in Congress, and the American people deem ‘medically appropriate;’ especially when it’s ‘we the people’ footing the bill. To force Americans, against their conscience, to fund abortion on demand and to facilitate gender confusion by subsidizing the elective practice of genital ‘sex-change’ mutilation is unconscionable.

“After hearing Sen. Mikulski’s ‘any service deemed…medically appropriate’ admission, I was prompted to dig a little deeper. I contacted the offices of Sen. Harry Reid, Rep. Charlie Rangel, Rep. Barney Frank and the House Subcommittee on Health. I asked, very simply, for ‘an assurance that the proposed healthcare plan will not allow taxpayer funded gender reassignment surgeries or hormone therapies.’ When faced with the bill’s relevant language, every staffer I spoke with either declined to answer or would neither confirm nor deny that such procedures would be covered.

“It’s time for the mainstream media to do its job and demand straight answers on this government healthcare scheme. Instead of acting as ObamaCare cheerleaders, journalists need to ask the same questions I did and refuse to take ‘no answer’ for an answer. I also call on the American people to ask their Congressional representatives the following question: ‘Will you pledge to oppose this legislation unless taxpayer funding for both abortion and sex change surgeries are expressly excluded?’

“It’s no wonder that, as Americans find out what’s hidden within this socialized ObamaCare monstrosity, furious opposition to it continues to skyrocket.”