Per a reader’s personal request, I will try to map out the pros and cons of the healthcare reform that passed 219-212 in the House last night. This is major and amazing legislation that is sure to help the people of this country in the long run. Obviously you may not all agree with what I see as pros and cons, but alas it’s my opinion so please argue against me if you wish. I look forward to our discussion.
1. The new bill will reduce the deficit by $130-143 billion over the next ten years. In the second ten years of existence, it will reduce the deficit by $1.2 billion. (Estimates provided by the Congressional Budget Office).
2. Expands coverage to 32 million Americans who are currently uninsured!
3. The uninsured and self-employed would be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level. **Federal Poverty Level for a family of four is $22,050** An exchange is a group that coordinates the purchase of health insurance, determines which plans can be offered and allows consumers to compare options on prices and other factors. Small business would have separate exchanges to purchase coverage — effective 2014.
4. Individuals and families who make between 100 percent – 400 percent of the Federal Poverty Level and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale. **Federal Poverty Level for a family of four is $22,050**
5. Excise Tax — Beginning in 2018, insurance companies will pay a 40% excise tax on high-end insurance plans worth over $27,500 for families ($10,200 for individuals). Dental and vision plans are exempt and will not be counted in the total cost of a family’s plan. – This will help to fund over ¼ of the new health reform.
6. Tanning Tax — 10 percent excise tax on indoor tanning services. – This is essentially a vanity tax on those who want to look orange and give themselves skin cancer, it is estimated that it will generate $2.7 billion to help pay for the new plan.
7. The Medicare prescription drug “donut hole” in Plan D will be closed by 2020. Until then, seniors who hit the donut hole by 2010 will receive a $250 rebate. – The rebate should be more, but helping those who are on Medicare afford name brand prescription is good.
8. Expands Medicaid to include 133 percent of federal poverty level which is $29,327 for a family of four.
9. Illegal immigrants are not eligible for Medicaid.
10. Six months from enactment, insurance companies can no longer deny children coverage based on a preexisting condition.
11. Insurance companies cannot deny coverage to anyone with preexisting conditions, starting in 2014 – Wish this one started in 6 months as well.
12. Insurance companies must allow children to stay on their parent’s insurance plans through age 26. – Great thing to have in this economy where it is hard to find a job.
13. Companies with more than 50 employees must provide health insurance, if they don’t they must pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance. – Without employees companies wouldn’t have profits, therefore employees should be taken care of. I’m not sure fines are the appropriate punishment, but how else do you ensure businesses comply and make sure employees are taken care of.
1. Costs $940 billion over 10 years – I question how this is payable in the current economic situation and current debt.
2. Funding available to states to establish exchanges within one year of enactment and until January 1, 2015 – I believe funding should be until the end of 2015.
3. Abortions will not be covered by federal money; private insurance premium funds and taxpayer funds are separated. Individuals would have to pay for abortion coverage, but federal funds can cover cases of abortion in rape, incest and when the pregnancy poses a threat to the mother. – I wish I could quote Bob Dylan and say “the times are a changing’” but I guess not yet.
4. Even if illegal immigrants want to purchase insurance with their own money, they will not be allowed to buy health insurance in the exchanges. – This is not fair because without illegal immigrants, much of our economy would suffer and some sectors would collapse. I have no problem with not allowing tax money to pay for their coverage, but they should be able to buy coverage with their own money.
1. Medicare Payroll tax on investment income — Starting in 2012, the Medicare Payroll Tax will be expanded to include unearned income (stocks, etc.). This translates into a 3.8 percent tax on investment income for families making more than $250,000 per year ($200,000 for individuals). – I think this tax should be extended to families making over $175,000 and individuals making $100,000, but Obama promised not to raise taxes on families making less than $250,000. Either way, I’m not sure this is a good environment to announce tax increases.
2. Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade. – The prescription part is fine, but Medicare shouldn’t be cut, but then again coverage is now universal so there will be other means.
3. In 2014, everyone must purchase health insurance, if not they have to pay a $695 annual fine. There are some exceptions for low-income people. – Not sure that people should be punished for their stupidity of not buying very affordable health insurance, let’s hope they don’t get sick and need a hospital visit (I once had to pay $200 for anti-bacteria ointment and a band-aid from the ER).