trystinn: (Default)
[personal profile] trystinn
As I'm tired of the rampant fear-mongering going on so here's the list of what the new health care reform act will do, broken down by year.

WITHIN THE FIRST YEAR OF ENACTMENT

*Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.

*Insurers will be barred from excluding children for coverage because of pre-existing conditions.

*Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.

*Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

*A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.

*Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.

*A tax credit becomes available for some small businesses to help provide coverage for workers.

*A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.

"WHAT HAPPENS IN 2011

*Medicare provides 10 percent bonus payments to primary care physicians and general surgeons.

*Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.

*A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.

*Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.

*Employers are required to disclose the value of health benefits on employees' W-2 tax forms.

*An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less.

WHAT HAPPENS IN 2012

*Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care.

*An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.

*The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.

WHAT HAPPENS IN 2013

*A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.

*The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.

*The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group.

*A 2.9 percent excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.

WHAT HAPPENS IN 2014

*State health insurance exchanges for small businesses and individuals open.

*Most people will be required to obtain health insurance coverage or pay a fine if they don't. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange.

*Health plans no longer can exclude people from coverage due to pre-existing conditions.

*Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine.

*Health insurance companies begin paying a fee based on their market share.

WHAT HAPPENS IN 2015

*Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.

WHAT HAPPENS IN 2018

*An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions."

Date: 2010-03-22 11:13 pm (UTC)
From: [identity profile] wendyzski.livejournal.com
I've spent half teh day on Facebook going "no...."

No the government isn't out to kill your granny - do you even know what "end of life counseling" really means?

No your small business won't go under because you will have to provide insurance (none of the people who posted that have more than 50 FT employees)

No the government won't restrict your care - the insurance companies are doing quite a good job on that themselves.

etc etc etc...

Date: 2010-03-22 11:28 pm (UTC)
From: [identity profile] tryst-inn.livejournal.com
I'm so very tired of the whole disaster - fear, ignorance, misinformation, greed, selfishness, hard working Americans working and protesting against their OWN best interests in HRC.

I always thought Americans were smarter than all this, but apparently we really, truly aren't.

Date: 2010-03-22 11:36 pm (UTC)
From: [identity profile] keastree.livejournal.com
The problem, as always, with these claims is that the law only lays down the framework, and does not represent the manifestation or implementation.

Perhaps the government isn't out to kill granny, but that does not mean that conflicting aims of 159 new agencies won't get her killed anyway through bureaucratic incompetence or arrogance. That also doesn't mean that a misinterpretation of the law or those regulations at the level of delivery of care will not result in same. The people involved in those decisions will say "Oh well" and go on to the next case--and you will have no appreciable recourse or avenue of appeal. (My bet is that the process will be as Byzantine as the process for Disability is now. As in, meant from the outset to discourage challenge and encourage people to shut up and take it.)

You cannot say with certainty, because no one can, that companies will not begin to make decisions about whether to stay in business or not on the basis of how the regulations that result from this foolishness will play out. You have zero control over their hiring and firing decisions, and even less over whether they become worried, discouraged, and disheartened because the regulations are going to impact whether they can stay profitable when many margins in many sectors are already razor thin.

You also cannot say that the government will not restrict care. There are a hundred ways that this can restrict care that would not directly be the government, but a direct result of the government mandate. I can pretty much guarantee that restrictions in care will happen, and they

This legislation will impact my health care. It will possibly restrict it. I pay for my care out of pocket and have for a decade, because the treatment I get is stuff not paid for by insurance. When the taxes come, and they will, they will impact my ability to buy those services. This legislation has not been funded, and Congress hasn't a clue of how they are going to get the money for it.

etc etc etc....

Edited Date: 2010-03-22 11:38 pm (UTC)

Date: 2010-03-22 11:46 pm (UTC)
From: [identity profile] tryst-inn.livejournal.com
Health insurers already restrict care, gov't has no authority to offer care in this bill - where is this coming from?

That health insurance carriers are already restricting care (falsely claiming treatments are experimental, limiting treatments to dollar amounts each year, refusing to allow prior conditions, etc.), which is killing people RIGHT NOW - that's not a priority to the fear mongerers, is it? That things "might" happen in the future seems to be the only value - that's insanely self-absorbed and neurotic.

This will save people's lives today and tomorrow and into the near future. If and when problems occur, and certainly those will occur as it's ridiculous to think anything is perfect, we will continue to reform health care in this country.
Taxes in the 2010 season went down - the expectation is they will continue to do so.

CNN Money::

The whole package will cost $940 billion over 10 years to provide expanded insurance coverage, according to CBO.

But overall, the plan could reduce the deficit by $143 billion over the first 10 years. And over the following decade, CBO projected, health reform could reduce the deficit by more than $1 trillion, although the agency stressed that such long-term projections are highly uncertain. (Deficit experts offer a fiscal reality check.)

The estimated long-term deficit reduction comes mainly from more than $500 billion in savings from health programs like Medicare, and $438 billion in new tax revenue.

ncrease the Medicare tax on high-income households: The reconciliation bill's changes to the Medicare tax represent the largest single revenue raiser in the health reform package.

The CBO estimates the provision would raise $210 billion over 10 years.

Currently, the Medicare payroll tax is 2.9% on all wages -- with the worker and his employer each paying 1.45%.

The reconciliation bill, like the Senate bill, would raise the percentage paid by high-income individuals by 0.9 percentage points, so an individual would pay 2.35% on his wages.

The reconciliation bill, however, also would subject the investment income of high-income households, such as dividends, interest and rent, to a 3.8% Medicare tax.

High-income is defined as individuals making more than $200,000 ($250,000 for couples filing jointly).

The tax would be on the lesser of one's investment income or the amount of modified adjusted gross income above the income threshold.

In other words, if a couple's total income is $300,000 ($50,000 above the threshold), and they had $40,000 in investment income, the 3.8% tax would apply to the $40,000. If their investment income was $60,000, however, they would only pay the tax on $50,000.

Date: 2010-03-23 12:04 am (UTC)
From: [identity profile] keastree.livejournal.com
This alleged reform is going to screw me. I've done the math and I know the thresholds at which the problem occurs. Plus, when it comes to me and my health, I just don't care about anyone else and their problems. Lots of people who don't have insurance are doing the exact same thing I'm doing and we're ALL worried about what happens to us.

If it's insanely self-absorbed and neurotic to not want to lose all the ground I've gained in the last 3 or 4 years, then that is what I am.
Edited Date: 2010-03-23 12:10 am (UTC)

Date: 2010-03-23 12:35 am (UTC)
From: [identity profile] hestiax.livejournal.com
I have no insurance. I have pre-existing conditions as does my daughter (if I'm honest - I could lie and hope the insurance company doesn't find out about my daughter). It certainly doesn't screw me. In fact it quite possibly could save my daughter's life. My goddessdaughter was just commenting this morning about how different her life would be right now if this had been passed 10 years ago because she could have been covered under her mother's policy. Since she wasn't, and she has very extreme endometriosis which has resulted in surgery every 9 months and numerous ovarian cysts, she's beyond broke and in a very bad state health wise. I know you don't care. I DO. And luckily more people do then don't.

Date: 2010-03-23 12:49 am (UTC)
From: [identity profile] keastree.livejournal.com
Okay. You get what you want. If you get it by taking something away from someone else, then it's fine with you. It just means that you really don't care either.

Date: 2010-03-23 01:13 am (UTC)
From: [identity profile] hestiax.livejournal.com
It pretty much is the definition of taxes and government. Public libraries "take away" by using tax dollars. Fire departments "take away" too as do police departments. Sorry but I believe that health care is a RIGHT and not something only for the rich and privileged few.

Date: 2010-03-23 01:23 am (UTC)
From: [identity profile] keastree.livejournal.com
Actually, I agree that health care is a right, but that is not what you or anyone else is saying here. What you and everyone else are actually saying and arguing is that health care paid for by an insurance risk pool is a right. Whether that is a question of privilege or not is irrelevant.

Date: 2010-03-23 02:41 am (UTC)
From: [identity profile] hestiax.livejournal.com
Not true. Do I think it went far enough? No. Do I think we should have universal health care? Yes. But something is better then nothing and it IS a step in the right direction. With the money that the Insurance companies were spending on lobbying, we wouldn't have gotten single payer. I'm just hoping that we can still get the public option in soon.

Date: 2010-03-23 01:30 pm (UTC)
From: [identity profile] seastormwitch.livejournal.com
The fact of the matter is, the govt. already offers healthcare in various ways. Federally via Medicare, state-wide via Medicaid. Neither of these plans are perfect but neither of them are very damn bad either.

I have worked in the health care insurance world for 10 years. I know in both the govt side and the private side. I *know* how all of this works much better than most people do.

Private insurance companies *do not want* their income to drop. They don't care about you, or me, or any other person out there. They care about their bottom line, period. They are out of control, with no regulation what so ever, right along with drug companies and this is very bad for people like you and I. If you're making #300,000 fucking dollars a year, you can afford health insurance. If you're making $30,000 probably not.

I am now covered by state medicaid because my children are. If I hadn't had that coverage, I would be sitting needing surgery until it because bad enough to be emergent. Otherwise, I would have had no way of being taken care of. I'm a full time student, and I live on financial aid. I have pre-existing conditions. I would have been screwed.

And yeah, it's all well and good if you can find a way to afford your healthcare on your own. But if you can't? That's pretty shitty to say you don't give a damn about anyone else too. I know too many people who suffer without the ability to get healthcare. I care about them too.

Date: 2010-03-22 11:56 pm (UTC)
From: [identity profile] wendyzski.livejournal.com
The "kill your granny" comment was in response to someone who insisted that assisted suicide counseling was part of the bill - which it isn't and never was.

I am considered uninsurable because I have asthma. Even if I were able to afford to buy my own coverage, no one would sell it to me. The last time I priced individual coverage (2002) a policy which excluded my allergies and my asthma was priced at $1128 per month, which is more than my mortgage payments!

When i lost my job in 2002 at a company that was not required to offer COBRA coverage and was only able to find temporary work for nearly 2 years, I went without insurance. I am alive today because my doctor's office took pity on me and gave me samples of medication I could not afford on my own, and because I was able at the time to mail-order some of my prescriptions from Canada. I had to drop several medications, including one for a family history of high cholesterol.

My friend "A" in Kentucky cannot get married because she is disabled and has MS and diabetes and she would lose her medicaid eligibility if she were married. Get married, or die? Hrmmmmm....

"J", who is unemployed and has diabetes, is only able to get any medical care at all because he is involved in two clinical trials at a hospital more than an hour away via public transit.

"L" has only been able to find temporary or contract work since Arthur Andersen basically went up in smoke. She was living the "american dream" and now she has been unable to see a doctor for nearly 10 years and is worried about her family history of heart disease but can't do anything about it.

"R" in OH who no insurance for herself (though her kids are covered under a low income state plan) and thus was unable to get any routine checks for menstrual bleeding that went on continuously for 8 months - she eventually ended up in the ER with a hemoblobin count of 6 (normal is 12). She was hospitalized for 3 days and she is still dealing with the hospital's "hardship assistance" program. Chances are that the taxpayers will end up on the hook for this.

All of these people are smart, most are college educated, but all are unable to afford any medical care at all unless they are at a risk of immediate death. Finding a way to get them basic and preventative care will be MUCH cheaper in the long run.

Date: 2010-03-22 11:29 pm (UTC)
From: [identity profile] hestiax.livejournal.com
Do you mind if I swipe this and post it in a note on my FB? I'm so tired of people proclaiming the end of the world with this.

Gonna do it anyway with attributions. :)

Really love the guys that are forecasting that the Dems will lose all their seats in the next election.

Date: 2010-03-22 11:46 pm (UTC)
From: [identity profile] tryst-inn.livejournal.com
Please do!

Date: 2010-03-22 11:39 pm (UTC)
From: [identity profile] melody1228.livejournal.com
Maybe the Democrats should hire you. This is the best breakdown of what's coming that I've seen yet -- certainly a better explanation than the Democrats have offered up. I hope they come up with something like this soon, because otherwise it may be their necks on the line come November.

Date: 2010-03-22 11:47 pm (UTC)
From: [identity profile] tryst-inn.livejournal.com
Aw, crap - sorry the attribution was lost - Rueters, btw.

I'll edit to include the link.

Date: 2010-03-23 12:04 am (UTC)
From: [identity profile] wendyzski.livejournal.com
http://docs.house.gov/energycommerce/TIMELINE.pdf is also a good referral source. It's what I've been using along with the Reuters one.

Date: 2010-03-23 12:12 am (UTC)
From: [identity profile] dana3.livejournal.com
This is nice and concise, too:
http://crooksandliars.com/node/35790/print

Don't even get me started on the 'death panel' claptrap ...

Date: 2010-03-23 04:14 am (UTC)
From: [identity profile] wastedmouthfull.livejournal.com
The bill in my opinion does not go far enough but at the very least it is a step in the right directions.
After the crap the insurance companies have just put my Grandparents through I think the whole death panel thing is ironic since that is about what the insurance companies are doing to seniors every day.
It is a crime to tell folks who have been married 67 years that you have to go to separate nursing homes because one is sicker than the other.
It is a death panel to tell someone they cant go to this hospital which is giving good care by a doctor that is paying attention to what is going on because insurance wont pay for that hospital, and if you want to stay you have to pay.
I think it is a crime that the Insurance companies have us all over a barrel if this bill could even some of that out im all for it.

Date: 2010-03-23 08:32 am (UTC)
From: [identity profile] evaelisabeth.livejournal.com
Your subject cracked me up, it always amazes me what some American's consider "Socialism" when they very obviously don't really know exactly what "Socialism" is. I guess its more the fashionable word for anything that they don't agree with than anything rooted in reality.

Date: 2010-03-23 09:56 am (UTC)
From: [identity profile] hagazusa.livejournal.com
Great post. So happy this bill went through!

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