This might help break some of the bill down for people... it reads as pretty non-partisan (as in there's no YAY OBAMA or SCREW OBAMA tones to it), so take it as you will, and if you find any more info (hopefully of the neutral toned kind, lol), please feel free to add it to this thread.
As all the world knows, the House voted Sunday in favor of a modified version of the Senate health care reform bill and-assuming the Senate agrees and the President signs-it’s all over but the head scratching. What’s this tremendously complex new law mean for you exactly, and how is it going to change your life? There will be reams written on the topic over the years. But for now, here are some answers about a historic bill that, love it or hate it, may affect your financial welfare more deeply than anything to come out of Congress in a long, long time.
Will the bill change my current coverage?
If you now get coverage through your employer, probably not. That’s because existing plans are exempt from adopting the benefits levels dictated for other plans. There are just a couple of exceptions: Starting in six months, for example, a plan can’t exclude children for pre-existing conditions (adults theoretically can be excluded until 2014), and it will have to cover your dependents up to age 26.
Will I have to get insurance if I don’t already have it?
Yes, but not until 2014, when most of the plan’s signature provisions kick in. If you don’t, you could face a fine of up to $2,085, or 2.5% of income. But you’ll be able to buy the insurance from a newly created American Health Benefit Exchange in your state, for a premium cost that can’t exceed 8% of your income.
Will there be a public option?
No. The Republicans won that one.
How will the bill affect Medicare?
There will be a number of changes, including higher Part A premiums for high-income people and new rules for Medicare Advantage plans. But easily the most popular change is likely to be the gradual phasing out of the annoying “doughnut hole” in Part D, the prescription drug plan. The gap will close entirely by 2020; in the meantime you’ll get a partial rebate for money you spend to cover the hole.
How am I going to pay for it?
The bill comes with a variety of new fees and taxes. After all, it’s going to cost $940 billion over 10 years, according to the Congressional Budget Office. Among the taxes you’ll see:
- Fees on drug companies and insurers
- An excise tax of 10% on overly generous health plans
- A 2.9% tax on the sale of medical devices
- A hike in your Medicare payroll taxes, if you make more than $250,000 and you’re married, plus a 3.8% excise tax on interest, dividends and other unearned income.
Should I be happy about this or furious?
Both Republicans and Democrats agree that it never made any sense for health insurance to be tied solely to employment. That link, a historical accident, discourages entrepreneurship, makes employees reluctant to leave a job for a new opportunity, and it can turn a job loss into a financial catastrophe. The bill corrects that situation. But even if the bill becomes law, it won’t in itself slow the rise in health care costs, and it’s not clear that the program’s massive costs-including subsidies for households with incomes as high as four times the poverty level-will remain under control. Remember Medicare? Health care costs have a way of escaping politicians’ control.
More on CBS MoneyWatch.com
This is what I found about Medicaid... looks like you'll be fine, and more people will be covered under Medicaid:
More lower-income individuals under the age of 65 would be covered by Medicaid. Under the new rules, households with income up to 133 percent of the federal poverty level, or about $29,327 for a family of four, would be eligible.
Quoting NatesMommy118:So I have a question. I get MediCADE for my son and I because I don't have a job. So in 2014 if I still am on Medicade, will it still be free?
The uninsured are clearly the biggest beneficiaries of the historic legislation, which would extend the health care safety net for the lowest-income Americans. The legislation is also meant to provide coverage for as many as 32 million people who have been shut out of the market -- whether because insurers deem them too sick or because they cannot afford ever-rising insurance premiums.
For people already covered by a large employer -- most Americans, in other words -- the effect will not be as significant. And yet, just about everyone might benefit from tighter insurance regulations.
"We think it's a big step forward," said Bill Vaughan, a policy analyst at Consumers Union. "It's going to provide a peace of mind that many Americans who really want or need health insurance will always be able to get a quality product at a reasonable price regardless of their health or financial situation."
There will be costs to consumers, too. Affluent families will be required to pay additional taxes. Most Americans would be required to have health insurance and face federal penalties if they do not buy it. And it is still unclear what effect, if any, the legislation would have on rising out-of-pocket medical costs and premiums.
But there is no question that the legislation should benefit consumers in various ways. Beginning in 2014, for example, many employers -- those with 50 or more workers -- could face federal fines for not providing insurance coverage. Several of the other changes would take effect much sooner.
Six months after the legislation is enacted, many plans would be prohibited from placing lifetime limits on medical coverage, and they could not retroactively cancel policies on people who fall ill. Children with pre-existing conditions could not be denied coverage.
And dependent children up to age 26 would be eligible for coverage under their parents' plans -- instead of the current state-by-state rules that often cut off coverage for children at 18 or 19.
And within three months of the law's taking effect, people who have been locked out of the insurance market because of a pre-existing condition would be eligible for subsidized coverage through a new high-risk insurance program.
That special coverage will continue until the legislation's engine kicks into a higher gear in 2014, when coverage would be extended to a wider portion of the population through Medicaid and new state-run insurance exchanges.
Those exchanges, or marketplaces, are meant to provide much more competitive, consumer-friendly online shopping centers of private insurance for people who are not able to obtain coverage through an employer.
In 2014, people with pre-existing conditions could no longer be denied insurance, all lifetime and annual limits on coverage would be eliminated, and new policies would be required to meet higher benefit standards.
Even sooner, in 2013, affluent families with annual income above $250,000 would be required to pay an additional 3.8 percent tax on their investment income, while contributing more to the Medicare program from their payroll taxes. And eventually, the most expensive insurance policies will be subject to a new tax.
Here is a look at some of the main ways the health care overhaul might affect household budgets:
Although most Americans who do not obtain health insurance would face a federal penalty starting in 2014, many experts question how strict the enforcement of that penalty will actually be.
The first year, consumers who did not have insurance would owe $95, or 1 percent of income, whichever is greater. But the penalty would subsequently rise, reaching $695, or 2 percent of income.
Families who fall below the income-tax filing thresholds would not owe anything. Nor would people who cannot find a policy that costs less than 8 percent of their income, said Sara R. Collins, a vice president at the Commonwealth Fund, an independent nonprofit research group.
More lower-income individuals under the age of 65 would be covered by Medicaid. Under the new rules, households with income up to 133 percent of the federal poverty level, or about $29,327 for a family of four, would be eligible.
Most other uninsured people would be required to buy insurance through one of the new state-run insurance exchanges. People with incomes of more than 133 percent of the poverty level but less than 400 percent (that's $29,327 to $88,200 for a family of four) would be eligible for premium subsidies through the exchanges.
Premiums would also be capped at a percentage of income, ranging from 3 percent of income to as much as 9.5 percent.
The exchanges would also help people who lose their jobs, quit or decide to start their own businesses.
"If you lose your employer-related insurance, you will be able to move seamlessly into the exchange," said Timothy Stoltzfus Jost, a professor at the Washington and Lee University School of Law.
Moreover, people of any age who cannot find a plan that costs less than 8 percent of their income would be allowed to buy a catastrophic policy that will be available for people under age 30.
People who receive coverage through large employers are unlikely to see any dramatic changes, nor should premiums or coverage be affected. But almost everyone would benefit from new regulations, like the ban on pre-existing conditions that would apply to all policies come 2014.
There may even be cases where people would be eligible to buy insurance through an exchange instead of through their employer, Mr. Jost said: those who must pay more than 9.5 percent of their income for premiums, or those whose plans do not cover more than 60 percent of the cost their benefits.
One of the biggest changes involves the Medicare prescription drug program. Its unpopular "doughnut hole" -- a big, expensive gap in coverage that affects millions -- would be eliminated by 2020. Starting immediately, consumers who hit the gap would receive a $250 rebate. In 2011, they would receive a 50 percent discount on brand-name drugs.
Starting in 2018, employers that offer workers pricier plans -- or those with total premiums of $10,200 or more for singles and $27,500 for families -- would be subject to a 40 percent tax on the excess premium, said C. Clinton Stretch, managing principal of tax policy at Deloitte. Retirees and workers in high-risk professions like firefighting would have higher thresholds ($11,850 singles, or $30,950 for families), pegged to inflation.
Although the taxes would be levied on the insurer, experts expect the assessment to be passed on to the consumer in the form of higher premiums or reduced benefits.
Read more: http://www.post-gazette.com/pg/10081/1044744-84.stm#ixzz0iu2vlZvr
Haha, I try to stay as simple as possible.
Quoting mamapaparazzi:
Well, that's helpful, thanks, LOL ;).
Quoting Elyce225:
A two word term for the new health care:
WE'RE FUCKED!
Quoting mamapaparazzi:Will the bill change my current coverage?
If you now get coverage through your employer, probably not. That’s because existing plans are exempt from adopting the benefits levels dictated for other plans. There are just a couple of exceptions: Starting in six months, for example, a plan can’t exclude children for pre-existing conditions (adults theoretically can be excluded until 2014), and it will have to cover your dependents up to age 26.
So, we have private insurance that we pay for ourselves that isn't through our employer. Would we have to change?
Our kids have PeachCare, which is something like non-medicaid state insurance that's at a lower cost, that we pay for. Will that change?
damn we make too much for that
Quoting mamapaparazzi:This is what I found about Medicaid... looks like you'll be fine, and more people will be covered under Medicaid:
More lower-income individuals under the age of 65 would be covered by Medicaid. Under the new rules, households with income up to 133 percent of the federal poverty level, or about $29,327 for a family of four, would be eligible.
Quoting NatesMommy118:So I have a question. I get MediCADE for my son and I because I don't have a job. So in 2014 if I still am on Medicade, will it still be free?
I'm not an expert - I have the same access to search engines as you do, lol. Do a search for "how the health care bill affects pre-existing insurance coverage" and see what comes up. If you find some answers, please share the info, I'm sure there's a lot of people with that question.
Quoting jillbailey26:
Quoting mamapaparazzi:Will the bill change my current coverage?
If you now get coverage through your employer, probably not. That’s because existing plans are exempt from adopting the benefits levels dictated for other plans. There are just a couple of exceptions: Starting in six months, for example, a plan can’t exclude children for pre-existing conditions (adults theoretically can be excluded until 2014), and it will have to cover your dependents up to age 26.
So, we have private insurance that we pay for ourselves that isn't through our employer. Would we have to change?
Our kids have PeachCare, which is something like non-medicaid state insurance that's at a lower cost, that we pay for. Will that change?
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- mamapaparazzi
on Mar. 22, 2010 at 6:51 AM