The Healthcare Bill Reviewed

I’m still going through all the details but on the surface the healthcare bill looks pretty decent. It is not everything Obama promised (no public option) but a step towards getting everybody covered. Also initial reports said that the bill will reduce deficits by over a 100 billion in the next ten years. I am skeptical, more on that later. Now down to the things that affect us now:

  • Insurance companies cannot revoke policies
  • Children under 26 can be under parent policies
  • Children with pre-existing conditions must be covered
  • Insurers must pay out 85% of group policy premiums and 80% of individual policy premiums (would that make insurance not very profitable?)
  • 3:1 limit on what older adults can be charged vs youngsters
  • Elimination of lifetime dollar limits on policies
  • High risk pool offers coverage to uninsured with medical problems
  • Expanded Medicaid coverage upto 133% of poverty line.
  • Close the donut hole gradually by 2020. Starts with rebates this year, discounts in 2011.
  • Premium subsidies – Premiums capped for low income families at 6% of income and gradually phased out for higher income.
  • Increased payments to PCPs under Medicaid (probably to get more providers to accept it)

Also the bill has larger changes coming in 2014

  • Nobody can be denied coverage or charged more for preexisting conditions
  • All Americans must be insured or individuals and employers with more than 50 employees both will face penalties. $695 for individual and $2000/employee for employer.
  • Healthcare exchanges must be made available by states to offer a choice of plans
  • Childless adults covered under Medicaid

Now for the part that covers costs and might reduce deficit

  • Increased Medicare ¬†taxes for high income individuals (over $200,000 single, $250,000 couple)
  • Tax on high cost insurance plans (plans costing >10,200 for individuals and 27,500 for families) starting 2018
  • Cuts on annual increases to Medicare reimbursement rates
  • Cuts on funding to disproportionate share hospitals (that treat high numbers of poor/uninsured) starting 2014 (but everybody should be covered by then right?)
  • Cuts to government subsidies on Medicare advantage plans
  • Drug companies will contribute 80 something billion (no idea how) but they get 12 year protection against generics
  • Drug companies pay a tax on drug sales (maybe thats where the money above comes from?)
  • Medical device makes pay a tax on certain products

I’m not exactly sure how all the above and anything that I missed will make more than the government is spending. But the CBO says so.

What do I expect out of this for myself? Steeper premium increases until 2014.

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