What is in the health care bill that just passed

Source: The Wall Street Journal


“¢ The proposal will cost $940 billion over a decade and reduce the deficit by $138 billion in the first 10 years, according to a CBO estimate.

New price tags, taxes
“¢ A new excise tax on high-premium insurance plans, equal to 40% of premiums paid on plans costing more than $27,500 annually for a family, starting in 2018
“¢ An increase in Medicare payroll taxes on couples with income of more than $250,000 a year.
“¢ Customers of indoor tanning salons would pay a 10% tax
“¢ Fees on insurance companies, pharmaceutical companies and medical device manufacturers, including $33 billion over ten years on fees on drug makers
“¢ A tax on individuals without qualifying coverage, maximum penalty set at 2.5% of income Requirements
“¢ Requires U.S. citizens and legal residents to have qualifying health coverage
“¢ Individuals without qualifying coverage could face a penalty up to 2.5% of income
“¢ Exemptions for economic hardship, religious objections, American Indians, those without coverage for less than three months, undocumented immigrants, incarcerated individuals
“¢ Employers of 50 or more full-time workers that do not offer coverage would pay a fee as high as $2,000 per worker if the government ends up subsidizing employees’ coverage

“¢ Tax credits for individuals and families likely making up to 400% of the federal poverty level, or $88,000 for a family of four to purchase insurance through the Exchanges
“¢ Tax credits to buy health coverage available to small employers with up to 25 workers and average wage of $40,000 or less
“¢ Ensure that federal premium or cost-sharing subsidies are not used to purchase coverage for abortion if coverage extends beyond saving the life of the woman or in cases of rape or incest

“¢ All plans sold to individuals and small businesses would have to cover at least 60% of an essential set of benefits, limits annual cost-sharing
“¢ Prohibit abortion coverage from being required as part of the essential health-benefits package

Government run-plan
“¢ A new public plan would be run by nonprofit entities set up by the private sector and would be available to the public on new insurance exchanges

How you choose your plan
“¢ Self-employed people and small businesses could pick a plan offered through new state-based purchasing pools
“¢ Employees would be generally allowed to keep their work-provided coverage

Medicaid changes
“¢ Expand Medicaid to all individuals under 65 with income eligibility levels likely to be standardized to 133% of poverty ($29,327 a year for a family of four)

Private Insurance changes
“¢ Establish a temporary national high-risk pool to provide health coverage to individuals with pre-existing medical conditions
“¢ Require health plans to report the proportion of premium dollars spent on clinical services, quality, and other costs and provide rebates to consumers
“¢ Adopt standards for financial and administrative transactions to promote administrative simplification
“¢ Develop standards for insurers to use in providing information on benefits and coverage
“¢ Limit deductibles for health plans in the small group market to $2,000 for individuals and $4,000 for families
“¢ Create a new federal body that would have power to block insurers from raising rates
“¢ Limit any waiting periods for coverage to 90 days.
“¢ Grandfather existing individual and group plans with respect to new benefit standards, but require these plans to extend dependent coverage to age 26 and prohibit rescissions of coverage. Require grandfathered plans to eliminate lifetime limits on coverage and annual limits on coverage. Require grandfathered plans to eliminate pre-existing condition exclusions.

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Posted by at 08:39 | Posted in Measure 37 | 13 Comments |Email This Post Email This Post |Print This Post Print This Post
  • Rupert in Springfield

    I wonder if anyone has any research on when the temporary high risk pool for pre existing conditions is expanded to be both permanent and equal to the entire population of the country.

    If things remain the same, obviously in short order the entire population will be in such a pool. With fines for not having coverage set at 2.5% and pre existing coverage provided for there is no financial reason whatsoever to carry insurance on oneself.

    This is especially so since my insurance rates will double (at least that’s how much I recall the premium being when I inquired about changing my deductibility from the current $5,000 to the now required $2,000, this is probably the most financially punitive portion of the bill for me. The premium difference was more that the deductable difference $3000 so basically BO just doubled my rates with no real benifit ).

    • valley p

      Rupert, its so hard to know when you just make things up. But since the purchasing pools are phased in over several years, and the requirements to meet minimum standards are only within those pools, no one has doubled anything yet. On top of that, your insurance has probably already increased substantially in cost well before BO got involved. And lastly, once the pool is ready, there will be competition, so you can shop around to your hearts content.

      In other words, chill out.

      • Rupert in Springfield

        Look, if you cant address the argument, then please don’t comment.

        Since I made nothing up,. and merely asked if anyone had worked out the logical consequence of some aspects of the bill it would be nice if you could address that.

        If all you have are your usual childish insults because you cannot address the point it would be nice if you would not waste everyone’s time.

        • valley p

          “Look, if you cant address the argument, then please don’t comment.”

          What argument was that exactly?

          “Since I made nothing up”

          You started with a phony premise and then expanded that into a nonsensical claim that BO just doubled your insurance rates. Knowing that reality has no purchase with you, what do you expect? I’m supposed to try and convince you of actual facts? I gave up on that.

          “it would be nice if you would not waste everyone’s time. ”

          Its only a waste of time for you if you read and respond to my comments. You are a free person. Try ignoring me.

          • Rupert in Springfield

            >What argument was that exactly?

            Re read first sentence of what you were replying to. I simply cannot cut and paste because you are too lazy to scroll up and read.

            Indicating after a rebuttal that you had no idea what you were replying to doesn’t do wonders for your case.

            >You started with a phony premise

            I stated the facts of the bill and the logical consequence of it. If you are unfamiliar with those facts, then obviously you should have read the article posted here, then my response, then come up with why it was a phony premise.

            The fact is, for most, the fine for not having insurance is less than the cost of insurance. The fact is, if you cover pre existing conditions there is no reason to ever buy insurance before one has a condition.

            Those are the facts, the premise is iron clad,

            You have no argument, Just assertion. While that does establish your incompetence, it does not dislodge my point.

            >then expanded that into a nonsensical claim that BO just doubled your insurance rates.

            Well, if you want to argue how cutting my deductibility more than in half will not double my rates, when that’s what the insurance company quoted me several years ago be my guest.

            Id like to know your reasoning though.

            And no, simply asserting it is nonsensical is not much of an argument. Again it just reinforces that you haven’t thought out your position.

            So let’s hear it.

            Tell me why my logic, based upon what is required in the bill, and what my insurance company told me long before BO was ever elected is faulty.

            Show us all your reasoning as to why my conclusion is nonsensical.

            I don’t think you can offer any argument because I don’t think you have one. I think you simply said what you did because you really have nothing to offer other than insults when you feel threatened. I think this is why you react in such an insecure manner whenever anyone asks you to stay on topic and argue your position.

            You come up with your position based on two criteria – your emotions ( you wish something were so, you desire it) and partisanship (if a Democrats is for it or does it, you support it or it is right)

            You want to be an intellectual, but cannot admit that you simply don’t have that capacity in every area.

            No one does, but most have the security to admit so, You can’t.

            If you don’t know something, you have to mock someone who does. Thus your mocking of me every time the Supreme Court comes up because you cant stand that you made the assertion that illegal aliens had no standing in the Supreme Court and I proved you wrong, or ignorance that Nuclear Weapons were not protected in an individual interpretation of the second amendment because that had already been addressed by the Supreme Court under Miller.

            This is also why you cant stand that you missed a basic literary reference to a common book, Animal Farm, and had to mock it as elitist of me to make it.

            It is what you are doing here. Someone points out the logical consequences of BO care and you realize that those consequences hadn’t occurred to you. You hate that you missed an obvious consequence of your position, so you have to call it nonsensical, or phony.

            We all know you don’t have an argument against these things. That much is as obvious.

            There is one thing you do prove here virtually every day, and on a consistently effective basis. Your character.

            You cant admit you are wrong, You feel threatened that someone you disagree with or don’t like might know more about something than you.

          • valley p

            Someone needs a hug.

          • valley p

            “Re read first sentence of what you were replying to.”

            I did. it said you wondered something rather ridiculous. Wondering something ridiculous is not an expression of an argument.

            “I stated the facts of the bill and the logical consequence of it”

            You stated what amounts to a partial fact (2.5% of what?) and then drew a conclusion based on a previous conversation you had with an insurance agent (years ago) who is not offering policies within the framework of a competitive exchange.

            “The fact is, for most, the fine for not having insurance is less than the cost of insurance. The fact is, if you cover pre existing conditions there is no reason to ever buy insurance before one has a condition.”

            The fact is that the CBO took this into account when estimating the number of people who would become insured. And the number they came up with, 32 million, negates your entire premise. And the Mass. experience already shows that small fines are sufficient to get people to enroll.

            “Well, if you want to argue how cutting my deductibility more than in half will not double my rates, when that’s what the insurance company quoted me several years ago be my guest.”

            Several years ago? That is the basis for your argument? Let me ask you this. How much has your insurance gone up over the past 5 years? And how many of those 5 years were pre Obamacare?

            “I don’t think you can offer any argument because I don’t think you have one. ”

            The argument is…and pay attention now:
            1) The CBO factored in the fine rate. They concluded 32 million would either take insurance or enroll in expanded Medicaid. Your fears are for naught.
            2) A 5 year old insurance quote has no relavence to what a quote might be 3 or 4 years hence when the exchanges are operational. But here again, the CBO has estimated that your insurance cost will be lower, apples to apples.

            As for the rest, get some oxygen. You seem to be hyperventilating.

          • Rupert in Springfield

            >You stated what amounts to a partial fact (2.5% of what?)

            So not only can you not be bothered to read what you are responding to, my comment about the article, you don’t even know what is in the article itself.

            Scroll up, the 2.5% figure is there.

            You are simply being as inane at this point. You now clearly didn’t read the article, clearly didn’t me my response to it that you were replying to, and are only flailing around because you feel a need to insult someone who may know more about something than you do, or who may have thought of something you hadn’t.

            In other words this a perfect illustration of your insecurity I was pointing out.

            You hate someone knowing more about something than you do, so you have to either be insulting, or call them an elitist (sorry, a reference to Animal Farm is not elitist, its a common book for most).

            Who knows, maybe you will move on to the racial ugliness you have a propensity for displaying every few months (don’t think your claim that you can tall what a person does by where they live and how they look has been forgotten).

            Next time if you cant be bothered to read my response to an article before you start this little display, at least read the article itself. If you cant do that, its simply hard to take you with any intellectual credibility about anything.

          • valley p

            Boy….you really DO need a hug. You had a really no good horrible bad day yesterday Rupert. Now you are taking it out on poor wittle ole me today.

            On behalf of liberals everywhere, I apologize for helping to elect Democrats who passed comprehensive health care reform.

            All better now?

  • Divert US from MARXing to Pretoria

    May the first three “bull shove it” snake oil posters be booked by Dano and accorded a Hawaii Five O farewell over Jack Lord’s grave situation near Kahala.

    As for the titanic mistake of passing H.R. 3200, the House of misRepresentatives should be directed to Hang Ten of the Dem Kakahuna Kool-Aid pissoirs out to dry on the steppes outside Lenin’s tomb and the remainder aborted from toking any more from Chairman Maobama’s little dread book.

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