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  • joekdoe04 joekdoe04 Sep 7, 2011 3:25 PM Flag

    WHAT YOU DON’T KNOW ABOUT HEALTH CARE REFORM

    Components of the bill
    - Prevents insurance companies from denying coverage to individuals/family members with pre-existing health conditions; a temporary plan is being developed to cover high-risk individuals with pre-existing conditions until the full reforms go into effect in 2014
    - Prevents insurance companies from placing lifetime limits on benefits
    - Bans “rescission” so insurance companies can’t cancel coverage if individuals keep their policies current or if they become ill
    - An individual’s out-of-pocket healthcare expenses are capped
    - Closes the “donut hole” (Part D) for Medicare prescription drug coverage (under Bush, Medicare helped pay for drugs up to $2,600 and above $4,550, but individuals had to pay 100% of the costs in between these amounts); now Medicare helps cover costs irrespective of the amount – seniors will now pay only 25% of drug costs up to $4,550 and only 5% of drug costs above that amount
    - In 2010, an emergency provision will offer seniors a $250 rebate on the costs incurred within the “donut hole”
    - Individuals living at or below the poverty line were eligible for healthcare under Medicaid, but by 2014 individuals/families living slightly above (making up to $14,404/$29,327) the poverty line will also be eligible for benefits
    - Individuals/families making less than $43,320/$88,200 per year will qualify for government subsidies to help purchase health insurance
    - All individuals must have health insurance or face a government fine; all large (over 50 employees) employers must offer health insurance to employees or pay a fine
    - Small businesses can get a tax credit if they offer health care
    - There are hardship exemptions if individuals can’t afford health insurance
    - Families can keep their children in college on their plans through age 26
    - Promotes health insurance “exchanges” so consumers can buy “wholesale”
    - Creates consumer assistance offices to help consumers file complaints or appeal decisions from insurance companies; beginning in 2011, insurance companies can no longer make excessive rate hikes without justification and approval, and those doing so may be barred from participating in new health insurance exchanges
    Funding sources:
    - Large employers (over 50 workers) that don’t offer health benefits will be charged a $2,000/worker fee; if the employer offers coverage but employees instead purchase federally subsidized insurance the fee is $3,000/worker receiving federal subsidies or $750/worker (whichever is lower)
    - Annual fees on pharmaceutical companies ($27 billion), health insurance companies ($60 billion), and medical device-makers ($20 billion)
    - Annual penalties on individuals who do not have health insurance (up to a maximum of $695/person)
    - Increase in the Medicare payroll tax from 1.45% to 2.35% for individuals making $200,000+ and families making $250,000+
    - 3.8% tax on unearned income for millionaires
    - Insurance companies will be subject to a tax on each high-end insurance plan (so-called “Cadillac” plans) they offer

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