Posted on 03/26/2010 5:32:03 PM PDT by Whenifhow
Timeline of Major Provisions in the Democrats’ Health Care Package
2009
• 2-year tax credit (total cap of $1B) for new chronic disease therapy investments
• Medicare cuts to hospitals begin (long-term care (7/1/09) and inpatient and rehabilitation facilities (FY10)
2010
• States and Federal officials review premium increases
• FDA authorized to approve “follow-on” biologics
• Increase brand name pharmaceutical Medicaid rebate (from 15.1% to 23.1%)
• Medicare payments to physicians in primarily rural areas increase (2 years)
• Deny “black liquor” eligibility for cellulosic biofuel producers credit
• Tax credits provided to certain small employers for health care-related expenses
• Increase adoption tax incentives for 2 years
• Codify economic substance doctrine and impose penalties for underpayments (transactions on/after 3/23/10)
• Provide income exclusion for specified Indian tribe health benefits provided after 3/23/10
• Temporary high-risk pool and high-cost union retiree reinsurance ($5 B each for 3.5 years) (6/23/10)
• Impose 10% tax on indoor UV tanning (7/1/10)
• Medicare cuts to inpatient psych hospitals (7/1/10)
• Prohibits lifetime and annual benefit spending limits (plan years beginning 9/23/10)
• Prohibits non-group plans from canceling coverage (rescissions) (plan years beginning 9/23/10)
• Requires plans to cover, at no charge, most preventive care (plan years beginning 9/23/10)
• Allows dependents to stay on parents’ policies through age 26 (plan years beginning 9/23/10)
• Provides limited protections to children with pre-existing conditions (plan years beginning 9/23/10)
• Hospitals in “Frontier States” (ND, MT, WY, SD, UT ) receive higher Medicare payments (FY11)
• Hospitals in “low-cost” areas receive higher Medicare payments for 2 yrs ($400 million, FY11)
2011
• Medicare Advantage cuts begin
• No longer allowed to use FSA, HSA, HRA, Archer MSA distributions for over-the-counter medicines
• Medicare cuts to home health begin
• Wealthier seniors ($85k/$170k) begin paying higher Part D premiums (not indexed for inflation in Parts B/D)
• Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT scans, etc.
• Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable medical equipment
• Impose new annual tax on brand name pharmaceutical companies
• Americans begin paying premiums for federal long-term care insurance (CLASS Act)
• Health plans required to spend a minimum of 80% of premiums on medical claims
• Physicians in “Frontier States” (ND, MT, WY, SD, UT ) receive higher Medicare payments
• Prohibition on Medicare payments to new physician-owned hospitals
• Penalties for non-qualified HSA and Archer MSA distributions double (to 20%)
• Seniors prohibited from purchasing power wheelchairs unless they first rent for 13 months
• Brand name drug companies begin providing 50% discount in the Part D “donut hole”
• 10% Medicare bonus payment for primary care and general surgery (5 years)
• Employers required to report value of health benefits on W-2
• Steps towards health insurance administrative simplification (reduced paperwork, etc) begins (5 yr process)
• Additional funding for community health centers (5 years)
• Seniors who hit Part D “donut hole “in 2010 receive $250 check (3/15/11)
• New Medicare cuts to long-term care hospitals begin (7/1/11)
• Additional Medicare cuts to hospitals and cuts to nursing homes and inpatient rehab facilities begin (FY12)
• New tax on all private health insurance policies to pay for comp. eff. research (plan years beginning FY12)
2012
• Medicare cuts to dialysis treatment begins
• Require information reporting on payments to corporations
• Medicare to reduce spending by using an HMO-like coordinated care model (Accountable Care Organizations)
• Medicare Advantage plans with a 4 or 5 star rating receive a quality bonus payment
• New Medicare cuts to inpatient psych hospitals (7/1/12)
• Hospital pay-for-quality program begins (FY13)
• Medicare cuts to hospitals with high readmission rates begin (FY13)
• Medicare cuts to hospice begin (FY13)
2013
• Impose $2,500 annual cap on FSA contributions (indexed to CPI)
• Increase Medicare wage tax by 0.9% and impose a new 3.8% tax on unearned , non-active business income for those earning over $200k/$250k (not indexed to inflation)
• Generally increases (7.5% to 10%) threshold at which medical expenses, as a % of income, can be deductible
• Eliminate deduction for Part D retiree drug subsidy employers receive
• Impose 2.3% excise tax on medical devices
• Medicare cuts to hospitals who treat low-income seniors begin
• Post-acute pay for quality reporting begins
• CO-OP Program: Secretary awards loans and grants for establishing nonprofit health insurers
• $500,000 deduction cap on compensation paid to insurance company employees and officers
• Part D “donut hole” reduction begins, reaching a 25% reduction by 2020
2014
• Individuals without gov’t-approved coverage are subject to a tax of the greater of $695 or 2.5% of income
• Employers who fail to offer “affordable” coverage would pay a $3,000 penalty for every employee that receives a subsidy through the Exchange
• Employers who do not offer insurance must pay a tax penalty of $2,000 for every full-time employee
• More Medicare cuts to home health begin
• States must have established Exchanges
• Employers with more than 200 employees can auto-enroll employees in health coverage, with opt-out
• All non-grandfathered and Exchange health plans required to meet federally-mandated levels of coverage
• States must cover parents /childless adults up to 138% of poverty on Medicaid, receive increased FMAP
• Tax credits available for Exchange-based coverage, amount varies by income up to 400% of poverty
• Insurers cannot impose any coverage restrictions on pre-existing conditions (guaranteed issue/renewability)
• Modified community rating: individual or family coverage; geography; 3:1 ratio for age; 1.5 :1 for smoking
• Insurers must offer coverage to anyone wanting a policy and every policy has to be renewed
• Limits out-of-pocket cost-sharing (tied to limits in HSAs, currently $5,950/$11,900 indexed to COLA)
• Insurance plans must include government-defined “essential benefits ” and coverage levels
• OPM must offer at least two multi-state plans in every state
• Employers can offer some employees free choice vouchers for health insurance in the Exchange
• Government board (IPAB) begins submitting proposals to cut Medicare
• Impose tax on nearly all private health insurance plans
• Medicare payment cuts for hospital-acquired infections begin (FY15)
2015
• More Medicare cuts to home health begin
2016
• States can form interstate insurance compacts if the coverage with HHS approval (2016)
2017
• Physician pay-for-quality program begins for all physicians
• States may allow large employers and multi-employer health plans to purchase coverage in the Exchange.
• States may apply to the Secretary for a limited waiver from certain federal requirements
2018
• Impose “Cadillac tax on “high cost” plans, 40% tax on the benefit value above a certain threshold: ($10,200 individual coverage, $27,500 family or self-only union multi-employer coverage)
http://republicans.waysandmeans.house.gov/UploadedFiles/WM_hcr_timelinel.pdf
Find the bill online at
http://thomas.loc.gov/
At the top of the page, click on
H.R.4872: Reconciliation Act of 2010
Oof. Good post. Thanks. Saving.
Mark
What Obamacare Means For Americans
Video - only
http://noisyroom.net/blog/2010/03/26/what-obamacare-means-for-americans/
THE GREAT RENEGER
Video - only
http://noisyroom.net/blog/2010/03/26/the-great-reneger/
Max Baucus on Obamacare’s hidden agenda – redistribution of wealth
Video - only
The content is irrelevant. Any federal version of health care is unconstitutional since Article 1 Section 8 does not specifically grant Congress the power to regulate health care! The people are not bound to comply with any unconstitutional act of Congress! People need to hold their Congress critters feet to the fire on this critical point!
An increase in the Medicare tax is a tax on the middle class, isn’t it?? Breaks Obama’s pledge, I think. Also the mandated tax for long term care will be up to another $200 per month out of your paycheck. As for home health care agencies, why don’t they just close all of them up, rather than peck them to death. Every year, cuts, cuts, cuts. So tell the elderly they must stay home alone when very ill or go into a government run institution to die, cause the care in them is abominable. It is all the same. You are old, you have lived a good life, now go die. We are not paying, period. But we will pay for an abortion if you need it.
Thanks for the URL and cite to the Bill. We’re finally seeing some real info. There’s even an omission (income) in the list above in regards to the tax.
An increase in the Medicare tax is a tax on the middle class, isn’t it?? Breaks Obama’s pledge, I think. Also the mandated tax for long term care will be up to another $200 per month out of your paycheck. As for home health care agencies, why don’t they just close all of them up, rather than peck them to death. Every year, cuts, cuts, cuts. So tell the elderly they must stay home alone when very ill or go into a government run institution to die, cause the care in them is abominable. It is all the same. You are old, you have lived a good life, now go die. We are not paying, period. But we will pay for an abortion if you need it.
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The article about Long Term care said it would be a voluntary program, but I wouldn’t doubt that it would be mandatory at some point.
http://www.freerepublic.com/focus/f-news/2480436/posts
From the article:
Those who participate will pay monthly premiums. After five years, they’ll be covered and can receive benefits if they need care — whether they are 20-somethings in snowboard accidents or 80-somethings with Parkinson’s disease.
What about the Tricare for the Military/retired Military that was in the OBAMANATIONcare?
Three threads:
http://www.freerepublic.com/focus/f-news/2478330/posts
http://www.freerepublic.com/focus/f-news/2480081/posts
http://www.freerepublic.com/focus/f-news/2477352/posts
‘Can I expect my TRICARE enrollment fee, premiums, deductibles or co-pays to go up because of this legislation? There is nothing in the legislation that would change any TRICARE fees.’
That still doesn’t answer the question of the NEW BIG FEES passed in the 2009 DOD bill, that go into effect in 2011.
Does OBAMANATIONCARE negate the BIG NEW FEES in the DOD bill? Just because there are no new fees in OBAMANATIONCARE doesn’t mean that they aren’t still in the 2009 DOD bill.
http://economicspolitics.blogspot.com/2009/05/tricare-for-life-is-obama-trying-to.html
This option would help reduce the costs of TFL, as well as costs for Medicare, by introducing minimum out-of pocket requirements for beneficiaries. Under this option, TFL would not cover any of the first $525 of an enrollee’s cost-sharing liabilities for calendar year 2011 and would limit coverage to 50 percent of the next $4,725 in Medicare cost sharing that the beneficiary incurred. (Because all further cost sharing would be covered by TFL, enrollees could not pay more than $2,888 in cost sharing in that year.) http://www.cbo.gov/ftpdocs/99xx/doc9925/12-18-HealthOptions.pdf
Saving but still don’t understand what some of this means.
Sure are a lot of cuts in Medicare while still increasing taxes.
I see nothing but rising taxes and costs of insurance.
there is no rule of law...
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