H.R. 3962, called the "Affordable Health Care for America Act," was passed by the House by a 220 to 215 vote on November 8, 2009. People with employer-provided health insurance should not see major changes. The legislation would create a federally regulated marketplace where some 30 million people who have no employer coverage can buy it on their own, some with the help of government subsidies.
Some provisions in this bill:
- The majority of people with employer-provided health insurance would not see changes. The main beneficiaries would be some 30 million people who have no coverage at work or have to buy it on their own. The legislation would create a federally regulated marketplace where they could shop for coverage.
- Creates a public health insurance option and a national exchange of private insurance plans for uninsured individuals and small businesses to purchase health insurance. The Secretary of Health and Human Services negotiates rates with doctors and hospitals to set reimbursement rates. This is in contrast to Medicare, which, by law, must receive the cheapest rates of any insurance plan.
- Mandates that individuals must purchase health insurance and businesses must provide health insurance or pay a fine, 2.5% of gross income or 8% of payroll. Businesses with payrolls less than $500,000 are exempt.
- Prohibits insurance companies from denying coverage based on pre-existing conditions. Caps deductibles. Out of pocket spending is capped at $5000 per year.
- Eliminates the Medicare doughnut hole for prescription drug coverage over ten years. After Medicare beneficiaries exceed a certain limit, they currently pay for the entire cost of prescription drugs until the expense reaches the catastrophic threshold. Then Medicare payments kick in once more.
- Allows individuals up to 27 years to remain on their parent’s health insurance, whether or not they are students.
- Expands Medicaid from 100% to 150% of the Federal Poverty Level.
- Provides tax subsidies for individuals on a sliding scale between 150% and 400% of the Federal Poverty Level. Small businesses also may receive tax subsidies.
- As amended, it prohibits the public option and any insurance plans in the national exchange from covering abortions. Even if consumers pay 100% for these plans without a government subsidy, abortion cannot be covered. Women need to purchase separate riders if they want abortion coverage.
- Raises money to cover the plan with a 5.4% tax on individuals making more than $500,000 and $1 million for couples.
- Achieves Medicare savings by reducing overpayments to doctors who treat Medicare Advantage patients (Medicare HMO plan). It is estimated they are paid 14% more than doctors who treat Medicare patients. Cost savings also occur by abolishing the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices and by cracking down on Medicare fraud.
How aware of the specifics of the bill were you?Reference: Jill Jackson, CBS News Blogs
Comments (63)
I wish I could rec' this more than once. : D
It's a sane recap of the healthcare bill, no "they're tryin' to kill grandma and make her a commie!" nonsense.
I didn't know about the mandating of insurance purchasing.
Here are the major differences between the House and Senate bills:
1. The House would require employers to provide coverage; the Senate does not.
2. The House would pay for the coverage expansion by raising taxes on upper-income earners; the Senate uses a variety of taxes and fees, including a levy on high-cost insurance plans.
3. The House plan costs about $1.2 trillion over 10 years; the Senate version is under $900 billion.
4. The House bill tacked on an abortion amendment, which prevents the public option and insurance plans in the exchange from offering abortion coverage, even if the consumer pays 100% for the policy without government financial assistance. Before this amendment, the bill prevented any government subsidy payments to be used to fund abortion.
@AlterEgo909@xanga - If you want to prohibit insurance companies from denying coverage based on pre-existing conditions, you have to mandate universal care. Otherwise, people would wait to buy health insurance until they get sick. This would be like buying life insurance when you know you are dying. It is not an economic model that will work for either a public option or for insurance companies.
Thanks for the information. I admit I don't know enough about what's going on.
@redhairedgrrl@xanga - Makes sense.
@agnophilo@xanga - I second your sentiments!
It's good to see this posted.
People definitely need to be informed about what this is all about. Too bad us citizens don't get a vote.
This Senate version at first glance does look a bit more positive, I must admit. I have mixed feelings for the whole issue, but hope for the best.
Ugh! This is SUCH A LIE!!! Every time it is mentioned on this site, it is only in support! WAKE UP!!!
http://www.atr.org/breaking-comprehensive-list-taxesbr-house-democrat-a4113#
It's also not mentioned at how now the IRS will be able to INVADE YOUR PERSONAL BALANCE SHEETS AT WHIM looking for blood money! Or how your deeply personal medical records will now be government property/accessible! Or how the Public Option is tax supported, price fixes, and inherently designed to run everyone out of business by using coersive mechanisms that only government can! Not only that, but it has provisions which allow the IRS to IGNORE ITS OWN LAWS and make you GUILTY UNTIL PROVEN INNOCENT merely by supposition!
Limitation on Tax Treaty Benefits for Certain Payments (Page 346): Increases taxes on U.S. employers with overseas operations looking to avoid double taxation of earnings.
Codification of the “Economic Substance Doctrine” (Page 349): Empowers the IRS to disallow a perfectly legal tax deduction or other tax relief merely because the IRS deems that the motive of the taxpayer was not primarily business-related.
Application of “More Likely Than Not” Rule (Page 357): Publicly-traded partnerships and corporations with annual gross receipts in excess of $100 million have raised standards on penalties. If there is a tax underpayment by these taxpayers, they must be able to prove that the estimated tax paid would have more likely than not been sufficient to cover final tax liability.
You people are not even considering the ramifications of this! This is going to raise the costs of EVERYTHING! Business that do comply with offering insurance at the government's mandated minimums will have to raise the prices of their products and lower their wages! Insurance companies (which will experience an increase in direct taxes to pay for their compeition (public option)) will have to raise their premiums on everyone! ESPECIALLY THE YOUNG! Not only that, but they'll be mandated to cover items that people may not even want, and are likely never to use!!!
The sheer immorality and unconstitutionality of this bill aside, and it will KILL BUSINESS, discourage investment in US companies, RAISE COST OF ALL PRODUCTS and SERIVCES, medical or otherwise! This system will also create a complete artificial demand, JUST LIKE THE FED and CRA did with the HOUSING BOOM, only there will be no crash and market/price correction--prices will only get high, stay high, and continually grow!!!!
The only GOOD thing this bill does is remove the non-competitive bids given to the pharmecutical companies....BY THE GOVERNMENT!!!! If you want a real representation of what is in this bill, and how it will effect EVERYTHING, go to my page. Wake up people!
I'm aware of the specifics enough to see a few things wrong...
Advice: Don't read a post on Dollarish.com for health care specifics.
Here's a short article about another fun tidbit included in the House's bill: http://www.cato-at-liberty.org/2009/11/02/health-care-bill-improves-lawyers-financial-health/
@gabrielpeter@xanga - Agreed. Go here instead: http://house.gov
@Magniloquentia@xanga - As a matter of disclosure, these statements are from The Americans for Tax Reform. From their "About Us" page:
"Americans for Tax Reform (ATR) opposes all tax increases as a matter of principle. We believe in a system in which taxes are simpler, flatter, more visible, and lower than they are today. The government's power to control one's life derives from its power to tax. We believe that power should be minimized."
I think most people feel that Health Care reform must be paid for. The main way of doing so is to have new taxes or close tax loopholes.
@DistantStarlight@xanga - : D
@gabrielpeter@xanga - Agreed.
And don't take anyone's word for it. Reading it for oneself, though tedious (thanks a lot Pelosi), is best.
Seriously, fuck this bill. Talked to my surgeon. HE said once this is passed he is only taking people who can aford to pay straight up cash for his services.
Thank you Obamacare. Thank you Pelosi you cunt.
Thank you illegal immigrants who are so worried about changing our country. Why dont you go back to your original country and make changes there since thats really where the change needs to be.
"Mandates that individuals must purchase health insurance"
And therein lies the main problem. The government is trying to control every aspect of our lives. What's next? REQUIRING college education???
@averyswife@xanga - If you want to prohibit insurance companies from denying coverage based on pre-existing conditions, you have to mandate universal care. Otherwise, people would wait to buy health insurance until they get sick. This would be like buying life insurance when you know you are dying. It is not an economic model that will work for either a public option or for insurance companies.
@redhairedgrrl@xanga - Which is why the government shouldn't be mandating that either. The free market system should dictate all of that.
@averyswife@xanga - If so, I hope you never have a serious illness and are unemployed!
@redhairedgrrl@xanga - That's why you purchase health insurance if it's a priority to you. My husband grew up in a family that could not afford health insurance and did not believe in taking handouts from the government. They paid for health care OUT OF POCKET. I think it's wrong to tell families like them that they MUST purchase health insurance or GO TO JAIL. What happened to our freedom? The system is fine the way it is (although I think Medicaid/Medicare needs work)....health care is not a universal right and should not be viewed as such.
@averyswife@xanga - The point is, if you have private insurance and are not part of a large group (i.e. through employment), your insurance company can drop you like a hot potato if you have a serious illness.
@redhairedgrrl@xanga - True. I haven't done any research into companies that would do that. I'm only familiar with companies like United Healthcare, Humana, Aetna, Blue Cross Blue Shield, and others that you have to broker through to get coverage. Purchasing private coverage (outside of an employer) is expensive (upwards of $300 a month per person) but through those companies I'm pretty sure your coverage is secure. I may be wrong though.
@averyswife@xanga - The act of retroactively canceling insurance is called rescission. It is not uncommon and it doesn't happen until after you get sick with a serious illness--the insurance companies are happy to take your premium payments while you are well. As published by the Los Angeles Times, over the past five years, the health insurance policies of 20,000 people were denied because of these controversial rescission policies. These rescissions directly saved the health insurance companies $300 million, while burdening patients who thought they had valid health insurance with horrendous medical bills.
See: http://www.npr.org/templates/story/story.php?storyId=105680875
http://www.walletpop.com/blog/2009/09/02/think-youve-got-health-insurance-better-double-check-and-be/