Health care reform

[happygirl]

I've been trying to follow and understand what health care reform will really mean for us, but it's all so confusing. Can someone give me a simplified breakdown of how this will affect most Americans.

It appears the plan will fix the medicare part D coverage gap, which sounds good, but how might it affect premiums for those of us who currently have coverage through an employer.

Any clarification/simplification you can offer will be appreciated. Thanks!

[creditcardfree]

I could be wrong, but the new premium of your employer sponsored plan probably has yet to be determined. It will take some time for that to be affected. In other words, you won't see it on your paystub next week!

[minnie1928]

CNN.com had an interesting slideshow on their site that explained what happens now and what will happen in a few years.

[Like2Plan]

It appears the plan will fix the medicare part D coverage gap, which sounds good, but how might it affect premiums for those of us who currently have coverage through an employer.

My understanding is if you have healthcare through your employer, there will be no change (other than what you would experience each year when you make an election).

There are changes that will be phased in.
One of the quickest things to be phased-in(6months after the President signs the bill) is that your children can still be on your insurance policy up through age 26.

I believe the increase of medicare tax by 1% for wage earners over 200k is phased in 2013.

Everyone must have health ins by 2014 (or pay a penalty).

Of course, there could be delays because there may be a court challenge...

[tzsgti]

There are changes that will be phased in.
One of the quickest things to be phased-in(6months after the President signs the bill) is that your children can still be on your insurance policy up through age 26.

Does anyone know what this means? NY already has this for under 29 but all it means is that you can be a dependent on your parents Insurance policy but the parents have to opt in for this and they have to pay a premium. Will the same premium apply to this? If someone has a family plan would adding thier child under 26 raise thie rates?

[elessar78]

What the health-care bill means for you (washingtonpost.com)

Graphic that appeared in today's Washington Post called "What Health Care Bill means to you"... you plug in several variables (do you have health insurance, size of household, household income, marital status) and it tells you how it affects your coverage and how it affects your taxes.

[Radiance]

HappyGirl, you beat me to it, I was about to ask that same question.
Thank you elessar, great link!

Well, this sucks for me. Currently I am insured trhough my employer, so no changes in the horizon.
However, I am working towards becoming self employed by 2011.
My plan was to put my child on his dad's employer insurance
For me I was planning to purchase Catastrophic Insurance only: car accident, emergency hospitalization, etc. which runs for $150/month.
The reason is that those are the only events when I use my insurance.
Check ups, healing and medicines I do holistic/natural only which is not covered by insurance anyway.

Now, when I get there, I will be forced to buy full health insurance, who knows how much will that be

[happygirl]

So my children in their early 20 that have had to purchase their own insurance policies because they're out of college but can't get insurance through their employers could come back onto my policy until they're 26? Not that I want them dependent on me that long, but until they can find a more permanent job that offers insurance.

Thanks

[jIM_Ohio]

the law of unintended consequences is probably not discussed in too many places...

one thing I am anticipating is medium size employers find it cheaper to pay the penalty (for not providing healthcare) than they do to pay the healthcare itself.

It will happen
the question is "how much".

From what I heard, the fine is less than my employer actually pays for my coverage.

[Andrew Jackson]

According to the Washington Posts graphic the new Bill wont effect me I guess. It said I would be assisted if I had premiums over $2200 dollars. Currently my premiums are only $65 a month, well under $2000 a year.

I'm not sure what they mean by this though... "Your maximum out of pocket cost for deductibles and co-payments would be capped at 30% of the total cost." I currently have a $1,000 deductible I believe. Does this mean it is only a $300 deductible now? And my co-payments for doctor visits are 100% of whatever the cost is. My last doctor visit cost me $78, I guess this means it would now be only 30% of $78?

[tzsgti]

So my children in their early 20 that have had to purchase their own insurance policies because they're out of college but can't get insurance through their employers could come back onto my policy until they're 26? Not that I want them dependent on me that long, but until they can find a more permanent job that offers insurance.

Thanks

Yes but its kind of pointless if its like they are doing in NY. You would have to pay for the extension and its about 500 a month per a chile here in NY

Thanks but no thanks. What is the freakin point if you have to pay almost as much as a selfplann?

If its not like that and you could just add your child under 26 for no addional costs that would be awesome

[tripods68]

I heard from Obama's plan those with Employer health covered plan should see a decline in Employer cost per employee. The question now is will that translate to lower premiums; thus increase employee compensation? Or Employers simply pocket the difference.....

[dannin]

Sorry for the length of this post. But should give a pretty thorough overview of the changes in store...

Retroactive
Exclusion for assistance provided to participants in State student loan repayment programs for certain health professionals (retroactive to Jan. 1, 2009)

Qualifying therapeutic discovery project credit (retroactive to Jan. 1, 2009) – provision expires at end of 2010

Modification of section 833 treatment of certain health organizations (retroactive to January 1, 2010)

Make the adoption credit refundable; increase qualifying expenses threshold, and extend the adoption credit through 2011 (retroactive to Jan. 1, 2010)

Small Business Tax Credit for certain small businesses providing health insurance to employees (retroactive to Jan. 1, 2010). In 2013, restricted only to insurance purchased through an exchange and only available for two consecutive years

Exclusion of unprocessed fuels from the cellulosic biofuel producer credit (retroactive to January 1, 2010)

Changes within the first year
Many of these take effect six months after the bill is signed into law.

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.

Changes for 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 must report value of health benefits on W-2’s.

An annual fee is imposed on manufacturers and importers of branded drugs according to market share, does not apply to companies with less than $5 million of sales.

Increase in additional tax on distributions from HSAs and Archer MSAs not used for qualified medical expenses to 20%.

Changes for 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.

Changes for 2013
$500,000 deduction limitation on taxable year pay to officers, employees, directors, and service providers of covered health insurance providers (goes into effect in 2013, but applies to compensation for services performed from Jan. 1, 2010 forward)

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% of income. The threshold remains at 7.5% for the elderly through 2016.

Medicare Hospital Insurance tax increased by 0.9%, thus the Medicare payroll tax is raised to 2.35% from 1.45% percent for individuals earning more than $200,000 and married couples with incomes over $250,000.

Unearned Income Medicare Contribution on 3.8% on investment income for taxpayers with AGI in excess of $200,000/$250,000.

A 2.3 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.

Limit health flexible spending arrangements in cafeteria plans to $2,500; indexed to CPI-U after 2013.

Changes for 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.
Changes for 2015

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

Changes for 2018
The Cadillac health care tax: 40% excise tax on health coverage in excess of $10,200/$27,500 (subject to adjustment for unexpected increase in medical costs prior to effective date) and increased thresholds of $1,650/$3,450 for over age 55 retirees or certain high-risk professions, both indexed for inflation by CPI-U plus 1%; adjustment based on age and gender profile of employees; vision and dental excluded from excise tax; levied at insurer level; employer aggregates and issues information return for insurers indicating amount subject to the excise tax; nondeductible.

[banditfist]

Don't buy insurance and pay the penalty. If you ever do get sick, buy insurance at that point. You cannot be denied.

Eventually, only sick people will be on insurance....and so ends private health insurance. Only a matter of time.

HappyGirl, you beat me to it, I was about to ask that same question.
Thank you elessar, great link!

Well, this sucks for me. Currently I am insured trhough my employer, so no changes in the horizon.
However, I am working towards becoming self employed by 2011.
My plan was to put my child on his dad's employer insurance
For me I was planning to purchase Catastrophic Insurance only: car accident, emergency hospitalization, etc. which runs for $150/month.
The reason is that those are the only events when I use my insurance.
Check ups, healing and medicines I do holistic/natural only which is not covered by insurance anyway.

Now, when I get there, I will be forced to buy full health insurance, who knows how much will that be

[elessar78]

Interesting thoughts banditfist. I wonder what provisions the bill has for people who try to make an end run on the system in this manner.