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.