Thanks to nopc.info for the summary:
Summary Timeline for Major Items in Senate Health Care Bill
Provisions that take effect immediately upon enactment:
Insurance Regulations
• Prohibition on pre-existing condition exclusions for private insurance on the individual market.
• Prohibition on revoking insurance for patients who falsify applications to fraudulently obtain private insurance coverage (however, penalties for fraud against federal health programs are increased).
Taxes
• “Annual Fee” tax on prescription drugs of $2.3 billion, allocated according to market share.
• New 10% tax on indoor tanning services effective July 1, 2010.
Other
• New restrictions on not-for-profit hospitals.
Special Favors
• Special tax benefit for BCBS organizations that maintain medical loss ratios of at least 85%.
Medicare
• Physician payments decrease 21% effective March 1, 2010.
Provisions that take effect six months after enactment:
Insurance Regulations
• Group and Individual policies issued after this date may not contain lifetime coverage limits, must provide first-dollar coverage for preventive care as defined by the U.S. Preventive Services Task Force, and must cover “children” of primary policyholders up to age 26.
Taxes
• FSA plans limited to $2,500 per year (currently no limit).
• New limits on what health care can be paid for with FSA, HSA, and HRA funds.
• Deduction for Part D eliminated.
• “Annual Fee” tax on medical devices of $2.0 billion, allocated according to market share (rises to $3.0 billion after 2017).
• “Annual Fee” tax on health insurance, allocated according to share of total premiums. Begins at $2 billion in 2011, then increases to $4 billion in 2012, $7 billion in 2013, $9 billion in the years 2014, 2015, and 2016, and eventually $10 billion for 2017 and every year thereafter. Two insurers in Nebraska and one in Michigan are exempt from this tax.
Medicare
• 10% Bonus for primary care physicians and general surgeons.
• Restrictions and substantial cuts to Medicare Advantage plans.
Medicaid
• Allows states to expand eligibility to 133% of the federal poverty line (FPL) for childless adults.
Other
• Private health plans must maintain a “medical loss ratio” of at least 85%. Failing that, they may rebate policyholders or increase medical expenditures. “Annual fee” tax does not count toward this ratio.
• First phase of small business tax credit for certain qualified small employers.
Taxes
• “Annual Fee” tax on health insurance increases to $4 billion.
Medicare
• Payment penalties for hospitals with the highest readmission rates for selected conditions.
Other
• Health insurance company employees may not be paid more than $500,000 per year.
Tax Increases
• “Annual Fee” tax on health insurance increases to $7 billion (does not count toward the required 85% medical loss ratio).
• 40% excise tax on health insurance premiums above $8,500 (individual plans) or $23,000 (family plans). Higher thresholds apply to the 17 highest-cost states until 2015, and indefinitely to retirees over age 55, and employer-provided plans for certain professions. This tax does not count toward the required 85% medical loss ratio.
• Itemized deduction for out-of-pocket medical expenses is limited to expenses over 10% of AGI (currently 7.5%); those over age 65 can use the 7.5% rate until 2016.
• Medicare tax increased from 2.9% to 3.8% for incomes over $250,000 (joint filers) or $200,000 (all others). (This is stated as an increase of 0.9 percentage points, to only the employee’s share of the FICA tax.)
Primary health reform takes effect:
Tax Increases
• “Annual Fee” tax on health insurance increases to $9 billion (does not count toward the required 85% medical loss ratio).
• Individual mandate begins: Tax penalties for not having insurance begin at $95 or 0.5% of income, whichever is higher, rising to $495 or 1% of income in 2015 and $750 or 2% of income thereafter (indexed for inflation after 2016). These penalties are per adult, half that amount per child, to a maximum of three times the per-adult amount per family. The penalty is capped at the national average premium for the “bronze” plan.
• Employer mandate begins:
– Provide “qualified” insurance or pay $750 tax per employee.
– Even if qualified insurance is provided, pay $3,000 tax per employee who qualifies for “affordability credit” (premium subsidy) based on family income and size, and opts to accept it.
Other
• Strict federal regulation of health plan benefit packages, premiums, and rating rules for both Exchange-participating and employer-sponsored group health plans.
• Imposition of actuarial value restrictions (in addition to restriction on medical loss ratio in effect since 2011).
• Health Insurance Exchanges.
• OPM-managed plans for the general public (in lieu of public option).
• “Affordability Credits” to those with family income under four times FPL who do not qualify for Medicaid in their state.
Medicaid
• Medicaid eligibility expanded to 133% of FPL for everyone under age 65 in participating states (such as Nebraska).
• All states except Nebraska must pay a share of the cost or drop Medicaid.
Tax Increases
• Individual mandate penalty rises to $495 per adult ($247.50 per child), maximum $1,485 per family, or 1% of family income, whichever is higher (capped at the national average premium for the “bronze” plan).
Insurance Regulations
• Limits on deductibles and co-payments imposed on Exchange-participating and employer-sponsored group health plans ($2,000 for single plans, $4,000 for family plans, indexed for inflation in health insurance premiums).
Medicare • Establishment of Independent Medicare Advisory Board (IMAB) to recommend cuts in Medicare benefits; these cuts will go into effect automatically unless Congress passes, and the President signs, an override bill.
Other
• Second phase of small business tax credit for certain qualified small employers.
Tax Increases
• 40% excise tax on health insurance premiums above $8,500 (individual plans) or $23,000 (family plans) applied to remaining 17 states.
• Individual mandate penalty rises to $750 per adult ($375 per child), maximum $2,250 per family, or 2% of family income, whichever is higher (capped at the national average premium for the “bronze” plan). After 2016, the penalty will be increased each year to adjust for inflation.
• “Annual Fee” tax on health insurance increases to $10 billion (does not count toward the required 85% medical loss ratio).
• Itemized deduction for out-of-pocket medical expenses is limited to expenses over 10% of AGI for those over age 65.
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In the hours Sunday leading up to the vote that will go down in infamy, I was engaged in a heated debate with a left leaning acquaintance.  He was so far left that he swallowed the line that not only were insurance companies evil, so were all profit making enterprises.  He was jubilant that the days of government run health care were upon us.
I warned him that the laws of supply and demand are not subject to the laws of man … In simple terms: Welcome to rationing.
His response: “Nobody will be turned down for care.”  My counter argument was to provide some examples from Canada, a story where a person was told to leave the hospital, having arrived with a stopped heart.  He response: “He could have gone to another hospital.”  The answer: “No he could not.”  Once the government has ruled, you lose your choices.
If fact, Canadians with money regularly use the USA for serious and higher quality care, especially politicians: Â Canadian Newfoundland premier Danny Williams went to Sarasota Florida in February for heart surgery … a low-risk, low cost procedure “not approved” in Canada.
The sad fact is that government health care has to be rationed, or else costs will spiral out of control.  Thomas Sowell has written extensively on the matter and provides the facts.
Government health care around the world:
- 23% of people wait  4 months or more for elective surgery.  5% in the USA.
- 90% of Ontario, Canada patients wait 336 days for a new hip.  (Breaking news, now down to 182 days). In the USA: 7-14 days.
- Canada has 11.2 CT scanners per million; USA 32.2.
- Canada has 5.5 MRI’s per million; USA 26.6.
Bottom line: You have a better chance of surviving cancer in the USA than in Europe or Canada, according a National Center for Policy Analysis study last year.
Yes, government cannot do better then private enterprise … and we now risk destroying the best health care in the world.
(Cross posted to Redstate.com)
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Ok, we have the BHO-care as law! Â Sigh!
I read the following from a ChangeWave email today:
Take Our Medicine, Please
Back in 2008, before the U.S. presidential election, Barack Obama promised to “spread the wealth” if he was elected president. Well, with today’s signing of the massive healthcare overhaul legislation, the country is about to see this happen.
While many of the changes to U.S. healthcare can be characterized as “middle of the road,” as President Obama described, there are obviously areas where the government is extending its reach too far — just as the vocal opposition has articulated consistently during the past year’s debate.
I haven’t had an opportunity to read the few thousand pages of the healthcare bill (why should I be any different than our elected officials?), but it’s certain that many details have yet to be sorted out. However, it’s also clear that cost-cutting and operational efficiencies will be the mantra in the industry and those companies that are best equipped to deliver products, services and technologies at economical price points will be the biggest winners.
Yep. Â We have officially joined the Socialist Alliance! Â What is that? Â If you don’t know, you are not “with the program”.
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The ramrodding of the health care bill in the House last night will embolden and invigorate the radicals, as I predicted months ago (Earthquake in Mass! Will Obama Listen, or Double Down?)
… the Dem leadership will not take this as a warning shot for the November mid-terms, but will double-down their bets — press healthcare harder, and push more of their leftist program.  (After all, they are smarter than the rest of us.  We just don’t understand as well as they do!)
All the revulsion from the Christmas eve Senate bill … that swept Scott Brown into office … All the outrage from the (“little”) people …. meant NOTHING to alter the radical agenda Obama and his commune have for the country.
So it is time to reflect and review our Rules for Radicals, the published user’s manual for the Obama cabal.  What rules did they use to push this one through?
Ah! Rule 8: Keep the pressure on. Never let up. I’d had to award full marks to Pelosi and Obama for never believing they couldn’t use the power to persuade, bribe or otherwise entice members to vote against the will of the people.
“Keep trying new things to keep the opposition off balance. As the opposition masters one approach, hit them from the flank with something new. (Attack, attack, attack from all sides, never giving the reeling organization a chance to rest, regroup, recover and re-strategize.)”
What went wrong?  Dan Perrin tells us this morning that Stupak lied.  Until the final moment, Stupak gave no indication that he and the other pro-life members had a deal.  Of course, some members got water, some get a hospital, and some get to keep their bank …
ASÂ GOVERNMENTÂ TAKES OVER THE ENTIRE STUDENT LOAN PROGRAM!
I need a day to think about all this … but I am convinced we will see the radical left GROW in intensity. Will we see an anesty program? Â We WILL see the health care bill being sold like it was something everyone wanted and will enjoy for decades to come.
We will see spending discipline (what’s that?) disappear as the “savings” are spent on the doctor fix and whatever other program floats into the empty skulls of shot in Washington.
A sad day for freedom as the socialists win a battle …. But not the war!
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Obama, like all “progressives” (formerly known as avowed socialists), believes in rule by an elite class.
An IBD column yesterday has some stunning quotes, dug up by George Will.
Professor Obama, who will seek re-election on the 100th anniversary of Wilson’s 1912 election, understands, which makes him melancholy. Speaking to Katie Couric on Feb. 7, Obama said:
“I would have loved nothing better than to simply come up with some very elegant, academically approved approach to health care, and didn’t have any kinds of legislative fingerprints on it, and just go ahead and have that passed. But that’s not how it works in our democracy. Unfortunately, what we end up having to do is to do a lot of negotiations with a lot of different people.”
Note his aesthetic criterion of elegance, by which he probably means sublime complexity.
This reminded me of a political conversation with a friend of mine, who strongly felt that government should be run by PhD’s only. Well folks, this is what we have got!
Obama regularly lectures us on the right answer. He tells us where we and his opponents are wrong. He does not like having to explain his reasons to the “little people”.
Obama wants to “fundamentally change” America .. even if he can’t get the votes fair and square through the Senate and House.
Vote “no” for health care reconciliation. Vote YES for America!
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