This week there was a historic decision handed down by the supreme court on Healthcare Reform or what people call "Obamacare". It’s actually called the Patient Protection and Affordable Care Act. There has been a lot of complaining out there about what is or is not in the law.
So what’s actually in the Law? Below is a breakdown of what is already in effect
and what will happen in the next few years. It may not be perfect but it’s a
great first step toward equality in our healthcare system
Already in effect:
It allows the Food and Drug Administration to approve more generic drugs (making for more
competition in the market to drive down prices)
It increases the rebates on drugs people get through Medicare (so drugs cost less)
It establishes a non-profit group, that the government doesn't directly control,
PCORI, to study different kinds of treatments to see what works better and is
the best use of money.
It makes chain restaurants like McDonalds display how many calories are in all of their
foods, so people can have an easier time making choices to eat healthy.
It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a
way to slowly ease into getting rid of "pre-existing conditions" altogether. For
now, people who already have health issues that would be considered
"pre-existing conditions" can still get insurance, but at different rates than
people without them.
It renews some old policies, and calls for the appointment of various positions.
It creates a new 10% tax on indoor tanning booths.
It says that health insurance companies can no longer tell customers that they won't get any
more coverage because they have hit a "lifetime limit". Basically, if someone
has paid for health insurance, that company can't tell that person that he's
used that insurance too much throughout his life so they won't cover him any
more. They can't do this for lifetime spending, and they're limited in how much
they can do this for yearly spending.
Kids can continue to be covered by their parents' health insurance until they're 26.
No more "pre-existing conditions" for kids under the age of 19.
Insurers have less ability to change the amount customers have to pay for their plans.
People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise
have to spend.
Insurers can't just drop customers once they get sick.
Insurers have to tell customers what they're spending money on.
(Instead of just "administrative fee", they have to be more specific).
Insurers need to have an appeals process for when they turn down a claim, so customers have
some manner of recourse other than a lawsuit when they're turned down.
New ways to stop fraud are created.
Medicare extends to smaller hospitals.
Medicare patients with chronic illnesses must be monitored more thoroughly.
Reduces the costs for some companies that handle benefits for the elderly.
A new website is made to give people insurance and health information.
A credit program is made that will make it easier for business to invest in new ways to
A limit is placed on just how much of a percentage of the money an insurer makes can be
profit, to make sure they're not price-gouging customers.
A limit is placed on what type of insurance accounts can be used to pay for
over-the-counter drugs without a prescription. Basically, your insurer isn't
paying for the Aspirin you bought for that hangover.
Employers need to list the benefits they provided to employees on their tax forms.
Any health plans sold after this date must provide preventative care
(mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.
If you make over $200,000 a year, your taxes go up by less than 1% (0.9%).
No more "pre-existing conditions" at all. People will be charged the same regardless of
their medical history.
If you can afford insurance but do not get it, you will be taxed. This is the "mandate"
that people are talking about. Basically, it's a trade-off for the "pre-existing
conditions" bit, saying that since insurers now have to cover you
regardless of what you have, you can't just wait to buy insurance until you get
sick. Otherwise no one would buy insurance until they needed it. You can opt not
to get insurance, but you'll have to pay the tax instead, unless of course
you're not buying insurance because you just can't afford it.
Insurers now can't do annual spending caps. Their customers can get as much health care in a
given year as they need.
Make it so more poor people can get Medicaid by making the low-income cut-off higher.
Small businesses get some tax credits for two years.
Businesses with over 50 employees must offer health insurance to full-time employees, or
pay a penalty.
Limits how high of annual deductible insurers can charge customers.
Cut some Medicare spending
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically,
people using these accounts now have to pay taxes on any money over $2500 they
put into them.
Establish health insurance exchanges and rebates for the lower and middle-class,
basically making it so they have an easier time getting affordable medical coverage.
Congress and Congressional staff will only be offered the same insurance offered to people in
the insurance exchanges, rather than Federal Insurance. Basically, we won't be
footing their health care bills any more than any other American citizen.
A new tax on pharmaceutical companies.
A new tax on the purchase of medical devices.
A new tax on insurance companies based on their market share. Basically, the more of the
market they control, the more they'll get taxed.
The amount you can deduct from your taxes for medical expenses increases.
Doctors' pay will be determined by the quality of their care, not how many people they treat
If any state can come up with their own plan, one which gives citizens the same
level of care at the same price as the PPACA, they can ask the Secretary of
Health and Human Resources for permission to do their plan instead of the
PPACA. So if they can get the same results without, say, the mandate, they can
be allowed to do so. Vermont, for example, has expressed
a desire to just go straight to single-payer (in simple terms, everyone is
covered, and medical expenses are paid by taxpayers).
All health care plans must now cover preventative care (not just the new ones).
A new tax on "Cadillac" health care plans
(more expensive plans for rich people who want fancier coverage).
The elimination of the "Medicare gap"