Health Care Reform Bill Passes House - What's In It?
The House version of the health care reform bill passed the House on Saturday night. Now it needs to be merged with some sort fo Senate version of the bill and signed by the President to become law. So how does this reform bill actually affect consumers?
- Insurance mandate - Uninsured Americans will pay a penalty; low-income people exempt. House bill charges a penalty of 2.5% of adjusted gross income: that's $500 on $20,000, for example.
- Employer coverage - All employers with a payroll above $500,000 must help pay for some kind of health insurance for their employees, or pay a tax. The Senate Finance Committee version of the bill does not have this requirement.
- Insurance exchange - Allows people who are not covered to buy health insurance in nation- or state-wide markets. Available to employees of small businesses, and others not eligible for coverage.
- Public plan - Would create a new federal government-run insurance plan with its own physician and hospital rates, separate from those negotiated by Medicare. Senate Finance Committee instead offers nonprofit insurance cooperatives in each state.
- Subsidies - Households earning up to 400 percent of the federal poverty level would be eligible for subsidies of health insurance premiums when they buy insurance through the exchange.
- Small business subsidies - Tax credits for small employers that provide health care coverage for employees.
- Coverage - House and Senate Health Committee versions require plans to pay for 70% of all health care spending that the plan covers; Senate Finance Committee version requires 65%. Insurers cannot deny coverage because of pre-existing conditions, and premiums may not vary according to age on the individual insurance market as widely as they do now. People receiving federal subsidies for insurance may not enroll in a plan that includes coverage of abortions.
- Medicaid - Households with incomes up to 150% of the federal poverty level would now be eligible for Medicaid. Senate Finance Committee would expand to 133% of the federal poverty level, starting in 2014.
Sweeping Health Care Plan Passes House [NY Times]
RELATED:
How Would Health Care Reform Affect You?
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The powers afforded the federal government are specifically enumerated, and this isn't even close to one of them.
That mandate's quite a mandate -- if you don't do it and don't pay the fine for not doing it, hello prison!
What a train wreck. That "the world is ending in 2012" theory is becoming all the more real every day.
"Insurance mandate: Uninsured Americans will pay a penalty; low-income people exempt."
The above doesn't affect me, but F off government. Get out of our business.
Out of college I had an office job that required me to get a health insurance license, and I'm still confused by many of the options available to me (though I'm lucky enough to have generous insurance options available to me through my employer).
I'm not going to take a political stand on this thread, I just wish people who "don't want this coming out of my paycheck" realized how much they're already paying for people with no or insufficient insurance.
@Laura Northrup: well that wouldn't work out for the people who need it most - low income people wouldn't be able to use not paying the fine or getting coverage to get into prison to get medical care
[i had a homeless guy break into my car in front of a cop once so he could get INTO prison]
@hopson77:
Wow - you think the Federal Government as currently comprised cares about enumeration? They are on a systematic course to destroy the constitution.
Good to see Repugnicans didn't succeed in their quest to make sure we all died quickly after getting sick.
@catastrophegirl: I support health care reform, but I'm wondering how low income you have to be to be exempt and whether it's adjusted for the area you live in. Seriously, if you're making $30,000 a year in a major city like NYC and not getting health insurance from your employer, you should not have to choose between going broke or going to prison.
@hopson77:
But neither are a lot of things (roads, the FAA, the CDC, etc.). Does that mean we should wipe out anything not specifically mentioned in the constitution? There may be some people who feel that way, but we have decided, through our represenantive forme of government, that this would be a bad idea.
Another sad day in our nation's history. The willingness of people to vote their rights away is astounding. This incarnation reads as if it were written in the boardroom of an Insurance company.
hopson: Yes and if it passes the Senate we need to sue to stop implementation.
Jerry: FAA, covered, CDC unconstitutional. Our representative government is limited, it may not violate the constitution.
I hope that the Senate actually uses some sense and refuses to pass a bill. This had gotten ridiculous. $1 Trillion dollars. More costs imposed on businesses that are already firing people and not hiring. Huge govt. bureaucracy that has already proven to be incapable of running things now in charge of health care. Corporations are now no longer permitted to choose who they do business with (the no pre-existing denial provision). Hopefully Ben Nelson and some of the other Moderate Senators will filibuster any bill that even resembles the House bill.
Further, it really bothers me that the Federal govt. is forcing companies to cover all of their employees. That seems to be something that they should be doing, not the Feds. Of course the only reason Congress gets away with this is the fact that the Supreme Court has basically blown the doors off the Commerce Clause and will allow the Feds to do whatever they please.
@hopson77:
I would agree with you, but the Supreme Court has essentially allowed Congress to pass anything it wants via the Commerce Clause. I think this is something that is absolutely outside of what Congress SHOULD be doing, but the sad fact is that it's pretty unlikely that a court would strike this down. The bulk of this bill is comprised of items that should be squarely within the province of the states, not the Feds.
@ZeGoggles: this is ripped straight from the program passed in Massachusetts 3-ish years ago. The biggest proponents of the plan were health insurance providers, and our governor who was in their pocket. The biggest dissenting voices were, well, every human being I know.
The program sucks. The federal program will suck.
They should try reforms that don't cost us, the taxpayers, more money in a black hole money pit of another entitlement program.
o reforms so that docs dont' have to pay HUGE premiums for malpractice
o allow insurance companies to sell over state lines, open up interstate trade, something congress is supposed to do.
o make insurance what it's for. catastrophic events. do you really ask what it costs if someone else is paying? Why not? You ask what other things cost, why not this? Forcing Docs/Hospitals to compete would bring costs down. Think Lasik, you can call any Lasik Doc and they will QUOTE you the cost of the procedure. Call you PCP and ask what it costs to get blood drawn for a test... they have no clue. this brings us to:
o everyone gets a flex savings type account to 'save' pre-tax money for doc visits, etc. but this one isn't use or loose, it rolls over year to year so it's a true savings account type thing.
I love the idea of 'no pre-existing conditions'. However the 'tax' to pay if I don't' carry insurance is CHEAPER than for the insurance itself. And if I get cancer or some such, I can't be denied when I go in to get insurance to have someone else pay for it.
@Esquire99: Your opposition to preventing insurance companies from denying coverage for pre-existing conditions (which are often used frivolously) renders the rest of your post equivalent to the dialogue for an adult in a Peanuts cartoon.
@Esquire99: Yeah, well the states gave up their rights when they started clamoring for that sweet, sweet, income tax money.
(Not that I'm one of those loons who thinks that the income tax is unconstitutional. Or even one of those people who thinks every dollar of tax money is eeeeebil.)
@Esquire99: "Huge govt. bureaucracy that has already proven to be incapable of running things now in charge of health care."
So you agree we need to shut down the military?
Or you have a problem with the not-tax-supported post office and its ability to deliver your emo poems from your door to your grandma's door in Kansas in three days? (To borrow from Jon Stewart)
@ohnoes:
Tell me how this following is fair.
Bob has a disease that costs $10,000 per month to treat
Bob goes to XYZ Insurance company to get coverage
XYZ would normally say, "Well, since you can't pay a $10,001 per month premium, there is absolutely no way this will be profitable. In fact, it will cost us a ton of money to insurance this person. Thus, we will deny them coverage.
But now, Congress has said they have to provide coverage. Thus, XYZ is forced to enter into a contract that they know will provide them absolutely no benefit and will actually cost them a ton of money.
@trmentry: "o everyone gets a flex savings type account to 'save' pre-tax money for doc visits, etc. but this one isn't use or loose, it rolls over year to year so it's a true savings account type thing."
With all the other pointless garbage in this bill, it would have been nice to see the flex account rules relaxed; mainly what you said... getting rid of the "use it or lose it" clause.
@Eyebrows McGee (now with more baby!):
The post office is horribly run and is currently operating at a $2bil deficit.
The military is run well from a discipline and getting things done perspective, but has so many holes through which money leaks it's almost funny.
I am not loving this requirement for insurance or fee. I see the intention behind it, but I feel there's too much that can go wrong with this, even something as simple as it going into effect before a reasonable public option is introduced.
Introduce a reasonable public option - then why do we need insurance at all? base it on the NHS idea (but fix what is broken there), and then there is nothing to fine people for.
@HesNoKennedy: Most people with no or insufficient insurance don't go to doctors. Look at MA, which faced a physician shortage once it implemented its insurance mandate.
@trmentry:
You have many reasonable, and likely effective, ideas. Unfortunately, no one will every pay any attention to them and will instead claim that you're ridiculous for suggesting that we actually try to control costs. Clearly the best way is a $1 trillion entitlement program setup to simply pay the inflated costs.
Economically this makes no sense. The only health care system that works is going to be one kind of extreme or another. Either we create a universal health care system (Which would be MUCH better than what WILL get passed. The tea-baggers effectively settled on the worst of two evils by attempting to scuttle the process and refusing to be a part of the process.) or we institute a solution that controls for adverse selection without enforcing a mandate (i.e. a hybrid system).
It's a clusterfuck, and the paranoia and general ignorance of a large number of people isn't helping. Objections and constructive criticism welcome, insanity- not so much.
@trmentry: Yeah, those ideas don't make anybody money. In fact they do the opposite! Congress is not interested.
@morlo:
It's more that those options don't create govt. programs that the various members of Congress can take credit for passing. Plus, they don't give any tangible benefits to the populous, so they think their representative isn't doing anything for them. Plus, there's the money issue.
This is how I think most Americans feels about it: "I like the part where sick people who need help get it. Everything else, including how we make it happen, I hate."
@subtlefrog: Exactly, eliminate protective markets and set up safeguards against medical cartels, and we'd be set with a public option (which ends monopolization). Either that or go full NHS, which is not a goddamn death-sentence already. All I know is that what we have now sucks- and what we'll soon have will suck just as bad if not worse. Design by committee is the absolute dumbest way to do anything this complex. Save it for designing constitutions and getting fat on jelly doughnuts while you gossip at work.
It seems that it is perfectly acceptable for the oligarchical corporate structure to absolutely control every aspect of our lives, however, the concept of giving the working class a tiny amount of leverage against their corporate masters is anathema. I'll never understand people that despise every possible bit of government regulation of big business, yet at the same time push all sorts of individual loss of freedoms (4th amendment violations such as dui checkpoints, prohibition, habeus corpus et cetera...). All the while they tolerate absolute control from a corporate standpoint. Personally, it makes sense to play the government against the oligarchy to keep them both at bay and afraid.
@subtlefrog: There won't be a public option. There are hundreds of billions of dollars at play which is simply enough to buy any government made by man. Even if God sent a Messiah to effect the public option, the health care industry would raise a mercenary army to crucify Him and His followers easily.
@Esquire99:
Actually, the post office has posted a profitable or break-even year 13 of the last 14 years, and hasn't needed taxpayer money to support it in well over 4 decades.
The Mass. plan was a giant mistake. Why can't we take what Canada or England already has and just copy it for our country?
Am I just missing something? Why do we have to make everything three billion times more complicated than it has to be?
@morlo: You're right, they have to wait until a problem gets bad enough to warrant a trip to the emergency room at Cook County General, which costs, at a minimum, thousands more than routine checkups.
@Eldritch: Methinks campaign finance reform and disemvoweling corporations in congress might put an end to a lot of the asshattery.
I'm amazed at what i'm seeing here. We need 'insurance reforms' to limit malpractice - Why?!?! If you personally injure me there isn't such a limit. If i got you professionally there shouldn't be, either. That, and the few states that HAVE passed this HAVEN'T had a decrease in insurance.
The military get some of the best care 'round, medicare has the highest approval rates of any insurance, the public option is WAY more effecient (medicare vs medicare advantage, medicare is 13x more effecient). I REALLY disagree with there being a mandatory insurance requirement WITHOUT there being an accompanying public option.
@pahncrd:
You realize there are people in the middle, right? Not everyone despises "every possible bit of government regulation" and not all of us push the loss of individual freedoms. Some of us feel that there is a certain level of government regulation that is tolerable and necessary, but that certain things (like a govt. takeover of health care) cross the line. Not everything is Liberal or Conservative, Red or Blue, Republican or Democrat. Some of us like certain Democrat principals and certain Republican principals.
@arcticJKL: If I am correct, there are quite a few people who haven't paid the fine in MA and have yet to be jailed, I saw an article on this recently and would have to dig it up.
I can't see the gov't jailing those who refuse to buy health insurance, wouldn't make the best of headlines.
@ZeGoggles: yeah, my flex account is hard to use in advance since it gets deposits out of each paycheck - and the last one of the year is right before christmas. so i'm saving a dental bill i paid out of pocket to send in at the end of the year so i can clean out every penny.
Health care needs reform, there's no doubt. But I do not believe that this bill is the reform that is needed.
@Megleris: I thought the military was having problems with their medical stuff? Wasn't there a big scandal a year or two ago about how badly the hospitals run and how long the waits are for people to get treatments?
@Megleris:
We don't need insurance reforms to limit malpractice, we need Tort Reform to limit malpractice suits. If you're going to attack a theory, at least get the terms right. Something like tort reform isn't going to lower rates overnight. More than likely, it's just going to stop rates from rising so rapidly. Tort reform will also limit suits against drug and medical device companies, which should keep the costs of drugs down and the costs of medical equipment down.
I'm actually really angry about the 'not including plans that cover abortion' thing. It's a medical procedure! Get with the program! And stop hating women for having the final say over what happens to their bodies!
Since it managed to get a GOP vote and is thus the only of the bills so far voted on in this proces to do so, I say the Senate should just pass the House bill as is and send it on to the President. Then any further attempts to tweak it can be done as technical corrections bills or through the Budget Reconciliation process.
This would of course require getting 60 votes for cloture for the Senate to vote on the House bill, but any Dem that can't vote for a bill that a Republican has already voted for should be booted out of the caucus.