Health Choices Commissioner does not decide your health benefits

It may be the longest chain e-mail we've ever received. A page-by-page analysis of the House health care bill argues that reform will end the health care system as we know it: "Page 29: Admission: your health care will be rationed! ... Page 42: The 'Health Choices Commissioner' will decide health benefits for you. You will have no choice. None. ... Page 50: All non-US citizens, illegal or not, will be provided with free health care services."

Most of the e-mail's claims are wrong, and you can read our extended analysis to find out why.

One of the claims that is just plain wrong says this: "Page 42: The 'Health Choices Commissioner' will decide health benefits for you. You will have no choice. None."

To explain this one, we will start with an explanation of the overall bill, which was unveiled July 14, 2009. The bill envisions that everyone will be required to have health insurance. People who get health insurance through work satisfy this requirement right off the bat.

People who don't get insurance through work or another group will go to the health care exchange; it's designed to help people who have to go off on their own to buy health insurance, and for small businesses with few employees. The reason for the exchange is that the government wants to regulate insurers to make sure that health plans clearly explain what they offer, can't refuse people for pre-existing conditions, and must offer basic levels of service.

"This is designed to protect consumers from plans that have outrageous cost-sharing or really limited benefits," said Jennifer Tolbert, an independent health care analyst at the Kaiser Family Foundation, a nonpartisan foundation that studies health care reform.

Tolbert has read and analyzed all the major health proposals, including those of the Republicans, and the foundation provides point-by-point analyses of the plans on its Web site.

The exchange is meant to ensure that people are "actually getting coverage and not a junk policy," Tolbert added.

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A key point here is that employer-provided insurance is already subject to this kind of regulation. Employer-provided insurance has to meet certain requirements to win its tax-exempt status.

That's why, if you get insurance through work, you're not asked about pre-existing conditions, and you pay the same rate as all of your co-workers.

The bill says that a Health Choices commissioner will run the exchange, and that he or she will make sure that insurers are offering basic benefits and adhering to the regulations. Individuals then choose their own plan from offerings on the exchange. The health commissioner does not "decide health benefits for you." To the extent that insurance plans have to meet basic requirements, those instructions are ultimately coming from Congress. The commissioner executes the rules.

The chain e-mail mentions page 42, which is part of Section 142. That section outlines the duties of the Health Choices commissioner and explains that the commissioner should seek insurers to offer different types of insurance, including basic, enhanced and premium. Again, individuals will be able to choose among competing insurers that are regulated via the exchange.

The e-mail is adamant that the Health Choices commissioner "will decide health benefits for you. You will have no choice. None." That is not what the bill says. The bill envisions an exchange with several different plans, and people choosing their own plan. We rate this claim Pants on Fire!