What is in the health care bill that just passed

Source: The Wall Street Journal

Cost

“¢ 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

Subsidies
“¢ 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

Benefits
“¢ 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.