Sun Apr 1, 2012, 04:38 PM
LAGC (5,265 posts)
You Know, Maybe "ObamaCare" Isn't All that Bad...
I was just reading up on the Wiki for the PPACA (Patient Protection and Affordable Care Act) and was kind of surprised by what I found:
Effective by January 1, 2014
- Insurers are prohibited from discriminating against or charging higher rates for any individuals based on pre-existing medical conditions.
- Impose an annual penalty of $95, or up to 1% of income, whichever is greater, on individuals who do not secure insurance; this will rise to $695, or 2.5% of income, by 2016. This is an individual limit; families have a limit of $2,085. Exemptions to the fine in cases of financial hardship or religious beliefs are permitted.
- Insurers are prohibited from establishing annual spending caps.
- Expand Medicaid eligibility; all individuals with income up to 133% of the poverty line qualify for coverage, including adults without dependent children.
- Two years of tax credits will be offered to qualified small businesses. In order to receive the full benefit of a 50% premium subsidy, the small business must have an average payroll per full time equivalent ("FTE") employee, excluding the owner of the business, of less than $25,000 and have fewer than 11 FTEs. The subsidy is reduced by 6.7% per additional employee and 4% per additional $1,000 of average compensation. As an example, a 16 FTE firm with a $35,000 average salary would be entitled to a 10% premium subsidy.
- Impose a $2,000 per employee tax penalty on employers with more than 50 employees who do not offer health insurance to their full-time workers (as amended by the reconciliation bill).
- Set a maximum of $2,000 annual deductible for a plan covering a single individual or $4,000 annual deductible for any other plan (see 111HR3590ENR, section 1302). These limits can be increased under rules set in section 1302.
- The CLASS Act provision would have created a voluntary long-term care insurance program, but in October 2011 the Department of Health and Human Services announced that the provision was unworkable and would be dropped, although an Obama administration official later said the President does not support repealing this provision.
- Pay for new spending, in part, through spending and coverage cuts in Medicare Advantage, slowing the growth of Medicare provider payments (in part through the creation of a new Independent Payment Advisory Board), reducing Medicare and Medicaid drug reimbursement rate, cutting other Medicare and Medicaid spending.
- Revenue increases from a new $2,500 limit on tax-free contributions to flexible spending accounts (FSAs), which allow for payment of health costs.
- Establish health insurance exchanges, and subsidization of insurance premiums for individuals with income up to 400% of the poverty line, as well as single adults. Section 1401(36B) of PPACA explains that the subsidy will be provided as an advanceable, refundable tax credit and gives a formula for its calculation. Refundable tax credit is a way to provide government benefit to people even with no tax liability (example: Earned Income Credit). The formula was changed in the amendments (HR 4872) passed March 23, 2010, in section 1001. According to DHHS and CRS, in 2014 the income-based premium caps for a "silver" healthcare plan for family of four would be the following:
- Members of Congress and their staff will only be offered health care plans through the exchange or plans otherwise established by the bill (instead of the Federal Employees Health Benefits Program that they currently use).
- A new excise tax goes into effect that is applicable to pharmaceutical companies and is based on the market share of the company; it is expected to create $2.5 billion in annual revenue.
- Most medical devices become subject to a 2.3% excise tax collected at the time of purchase. (Reduced by the reconciliation act to 2.3% from 2.6%)
- Health insurance companies become subject to a new excise tax based on their market share; the rate gradually raises between 2014 and 2018 and thereafter increases at the rate of inflation. The tax is expected to yield up to $14.3 billion in annual revenue.
- The qualifying medical expenses deduction for Schedule A tax filings increases from 7.5% to 10% of earned income.
While its far from perfect, I'm starting to think that it might actually be a step in the right direction, better than the status quo of currently skyrocketing premiums at the very least.
I'd qualify for Medicaid, which while not as good as Medicare, would still be better than nothing. And even for well-off workers, insurance premiums would be capped at 9.5% of income. A lot less than many folks are paying for insurance now.
Best of all, it gets rid of the "Cadillac" insurance plans that Congress gets for free, and forces all Congresscritters to buy into the same plans as the rest of us. No wonder the Republicans don't want this to go into effect. They'll lose out on their sweet "superior healthcare for me, but not for thee" situation that exists today.
Too bad we have to wait until June to find out whether the SCOTUS strikes it down or not. Chief Justice John Roberts has said that he doesn't like the idea of an "activist court" going against what Congress passes for law, so maybe he'll side with Kennedy and let it stand.
Because truth is, if ObamaCare is struck down, it will probably be another generation until health care reform is attempted again. But if it passes, we may actually see Medicare for all in our lifetimes, a single-payer plan like other civilized Western countries, once people get tired of private insurance companies profiting off of human misery.
Have any of you guys done the math? How much do you pay for health insurance now, compared to how much it will be capped at once ObamaCare goes into full effect in 2014?
4 replies, 2997 views
You Know, Maybe "ObamaCare" Isn't All that Bad... (Original post)
Response to LAGC (Original post)
Sun Apr 1, 2012, 04:40 PM
pnwmom (80,291 posts)
1. An expansion of Medicaid was also part of the bill, which the Rethugs didn't want, either.
It's too bad the bill has gotten so much bad press because I think you're right. It's a solid beginning, even for those who would prefer Medicare for all.
Response to LAGC (Original post)
Sun Apr 1, 2012, 04:47 PM
TheKentuckian (23,947 posts)
2. What insurance Congress has means little to nothing for the bill.
That proves nothing other than that those with money can get a level of care that they are accustomed.
A millionaire congressman just takes the platinum and gets great coverage, "small people" get what we used to call junk.
Response to LAGC (Original post)
Sun Apr 1, 2012, 04:48 PM
canoeist52 (2,282 posts)
3. How about NO deductibles at all.
"- Set a maximum of $2,000 annual deductible for a plan covering a single individual or $4,000 annual deductible for any other plan (see 111HR3590ENR, section 1302). These limits can be increased under rules set in section 1302. "
Where the hell do I come up with an extra $4000. dollars per year before getting any care on our family's $35,000. per year salary!
Response to canoeist52 (Reply #3)
Sun Apr 1, 2012, 06:20 PM
subterranean (2,497 posts)
In most countries with insurance-based universal healthcare, there are no deductibles. Some have modest co-payments, but the insurance covers you from the start. You don't have to spend thousands of dollars out of pocket before you can use it.