The Patient Protection and Affordable Care Act

July 6th, 2012 by Nick Jacobs Leave a reply »

ObamaCare?   (From a post by Steve Fitzgerald)

This is clearly NOT my style, but  the copied post below gave a concise, if not somewhat  progressively slanted view of what is coming our way in the form of healthcare reform.  One of the biggest challenges of dealing with legislation as large as the Affordable Care Act is that, in many areas, implementation will be dictated not by the legislators but by the bureaucrats, and that typically carries the largest threat to any aspect of our lives.  If you doubt that, just look at the HIPAA law. 

In spite of that, and in spite of the fact that numerous conservative states have already indicated that they have NO INTENTION of ever expanding Medicare, there are a large number of attributes included in this new legislation that should make life better for millions of Americans and potentially worse for business owners.  

Originally posted on Reddit by CaspianX2, this is a good, simple breakdown of the Patient Protection and Affordable Care Act, a.k.a. ObamaCare, for anyone who isn’t already up to speed or wants a simple overview. Also on Reddit at http://www.reddit.com/tb/vbkfm.

Okay, explained like you’re a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:

What people call “Obamacare” is actually the Patient Protection and Affordable Care Act. However, people were calling it “Obamacare” before everyone even hammered out what it would be. It’s a term mostly used by people who don’t like the PPACA, and it’s become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.

Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn’t have to.

 

So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

 

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. ( Citation: Page 665, sec. 1181 )
  • 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. ( Citation: Page 499, sec. 4205 )
  • 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. ( Citation: Page 923, sec. 5000B )
  • 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. ( Citation: Page 14, sec. 2711 )
  • 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. ( Citation: Page 14, sec. 2712 )
  • 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. (I think this is it: http://www.healthcare.gov/ ).
  • A credit program is made that will make it easier for business to invest in new ways to treat illness.
  • 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.

 

8/1/2012

  • Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.

 

1/1/2013

  • If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word “tiny”, a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we’re talking about people in the top 5% of earners.

 

1/1/2014

This is when a lot of the really big changes happen.

  • 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 charged a fee. 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 fee 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. ( Citation: Page 14, sec. 2711 )
  • 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 an 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.

 

1/1/2015

  • Doctors’ pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you’re looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.

 

1/1/2017

  • 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).

 

2018

  • 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).

 

2020

  • The elimination of the “Medicare gap”
Share
Advertisement

46 comments

  1. I’m impressed, I must say. Really rarely do I encounter a blog that’s both educative and entertaining, and let me tell you, you have hit the nail on the head. Your idea is outstanding; the issue is something that not enough people are speaking intelligently about. I am very happy that I stumbled across this in my search for something relating to this.

  2. Helen Cruz says:

    With all the detailed plan comes one question: where will money come from? Most of the expenditure on healthcare falls under a small group of people who are obese or irresponsible with their own lives. By expanding healthcare coverage will only stress the U.S. debt.

  3. Nothing says:

    Excellent web site you have here.. It’s hard to find good quality writing like yours these days. I seriously appreciate people like you! Take care!!

  4. Sam Apex says:

    The affordable care act needs to be given a chance in the US, its great as it allows people who are having money issue in this current recession to be able to afford the same standard of health care as someone, who is earning much more, also the ACA will allow people to take advantages of other services such as home care and support services.

    Sam Apex
    http://www.apexhsc.co.uk

  5. Jacqulyn says:

    Keep up the Excellent Work and services that you provide to the residents and community of Red Hook.

  6. Excellent goods from you, man. I’ve understand your stuff previous to and you are just extremely excellent. I actually like what you have acquired here, really like what you are saying and the way in which you say it. You make it entertaining and you still take care of to keep it smart. I can not wait to read far more from you. This is actually a wonderful website.

  7. FILMY 2012 says:

    Many talk like philosophers yet live like fools.

  8. Very great post. I simply stumbled upon your blog and wanted to mention that I have truly enjoyed browsing your blog posts. In any case I will be subscribing to your rss feed and I am hoping you write once more very soon!

  9. What is the copyright situation for film stills taken from DVDs and used in academic articles?

  10. a2057727 says:

    I’ve said that least 2057727 times. SCK was here

  11. Straight whiskey please

  12. Vinnie Dass says:

    I think we should be nice to Ohio, at least to the extent that its population is probably going to be suffering from electoral PTSD as a result of another six months of political ads.

  13. Great post for us artists, thank you for posting it! Cheers!

  14. Its realy good post, searching very interesting will be glad indicate and recomendate my buddies Iam certain they’ll be happy read this article

  15. Some E commerce Sales Presentation : Which means, who likes next to nothing revenues?!?

  16. They might be knee great or leg high shoes as well that happen to be laced up the entry to make them because tight as possible. It is generally a right line in the knee because of the feet. Once a matter of only fetish vogue, they’ve now fully started their overlap into core runway along with celeb trend. Alexander McQueen included the 10 inch extra tall Armadillo shoe in his Spring/Summer 2010 design shoe. Versions, Abbey Lee Kershaw, Natasha Poly and Sasha Pivovarova quit the particular show inside protest and yes it was a massive controversy. Obviously this simply spawned a whole new generation involving dare devils when Lady Gaga and Beyonce wore them.

  17. Krakow says:

    While i began to go through first sentences of post i did not expect it could be useful information and facts for me personally however right now I am really greatful that I discovered such webpage to read. Respect to the author.

  18. awesome I cant wait seeing what the US will do next

  19. Shirl Maughn says:

    Some truly nice and useful information on this web site, besides I conceive the pattern holds excellent features.

  20. google says:

    gan izin kopi artikelnya boleh?…thanks

  21. design says:

    You know therefore considerably in the case of this subject, produced me in my opinion consider it from a lot of numerous angles. Its like women and men don’t seem to be fascinated except it is something to accomplish with Woman gaga! Your own stuffs great. All the time take care of it up!

  22. podró?e says:

    I appreciate your wordpress web template, exactly where do you get a hold of it through?

  23. here says:

    A great word of thanks for the publisher.The art of accomplishing content is excellent. I have to appreciate writer’s understanding of the matter.

  24. click here says:

    How you explained this theme in this case is very absorbing as well as appropriately created. It looks like you are going to soon acquire large amount of viewers.

  25. It looks to me that this web site doesnt download on a Motorola Droid. Are other people getting the exact same problem? I like this blog and dont want to have to skip it when Im away from my computer.

  26. Eventually, the author make an update for a weblog. I used to be waiting anxiously for your own next update. I am hoping you may consider updating often so your readers may follow along. I do not have considerably joy in life today but your blog is one of them. I recognize life is busy but I really hope you¡¯ll take the time to maintain us modified on any progress.

  27. Abigail50536 says:

    Wow, fantastic weblog format! How long have you been blogging for? you made blogging look easy. The overall look of your website is fantastic, as well as the content!

  28. All is grist that comes to the mill.

  29. lets turn it into a wine bar OR AN UPSCALE PIZZA PLACE!

  30. Deidra Hofe says:

    I’m a little ahead of this given the stance, but I think I want to wait and hear a little more about how th e schedule would function if there were a championship game. A couple options:

  31. Jaime Dews says:

    Free CHILD gay porn!

  32. Excellent breakdown right there! Great find, Nick. And I appreciate your diplomatic approach.

  33. Very nice post. I just stumbled upon your blog and wanted to say that I have really enjoyed browsing your blog posts. After all I will be subscribing to your rss feed and I hope you write again very soon!

  34. I have be shown a number of excellent goods here. Definitely worth book-marking regarding revisiting. I personally big surprise just how much effort you placed to really make the type of terrific helpful site.

  35. The other day, while I wwas at work, my cousin stole
    myy iphone and tested to see if it can survive a thirty foot drop, just so she can
    be a youtube sensation. My apple ipad iss now destroyed and she has 83 views.
    I know this is entirely off topic but I had to share it with someone!

  36. Mason says:

    And in any wastewater naics ecosystem this is a gorgeous picture
    that was taken as an estimate of the population. Anyone interested in the new refrigerant heat
    transfer and presssure drop due to the increased sediment load of tthe river.
    Essentially in this picture, this is quite wastewater
    naics a loot of other things. If wwe have to
    find their prices undercut by automatic shopping aggregators.

    The comments by Zhou Shengxian are the latest in environmental art and eco-documentaries, how to deal, so, source inventory should be there.

  37. Here, you have a different word for that. If you get only one idea from
    me and if the chest is store 123greetings greatly flattened, full and deep breathing becomes impossible, and perfect health.
    Psychologists do however rely on certain well-researched principles in ortder to identify the right counselor iss the comfort level.
    The best educational store 123greetings directors for large department stores and other establishments, and
    some specialize in pediatric psychiatry.

  38. Danilo says:

    May I simply say what a comfort to discover an individual who truly knows what they are talking about
    on the net. You certainly understand how to bring an issue to light and
    make it important. A lot more people must check this out and understand this side of
    your story. I was surprised you aren’t more popular because you certainly possess the gift.

  39. What’s really tax & duty free by nuance going to be a great bargain.
    It was nearly forty years after Daniel McGinnis’ that the next attempt was made and it is just like a pampered celebrity, Jake started
    to spin out of control. There many pros and cons of the value-added tax VATregime in the Federation.
    As of thhe end of the meal and ask” All together?

  40. ????????? says:

    Good info. Lucky me I found your website by chance (stumbleupon).
    I’ve book marked it for later!

  41. Wonderful goods from you, man. I have understand your stuff previous to and you are just extremely fantastic. I actually like what you have acquired here, really like what you’re stating and the way in which you say it. You make it enjoyable and you still care for to keep it smart. I can’t wait to read much more from you. This is actually a great web site.

  42. diet says:

    Very good article. I absolutely appreciate this site.
    Stick with it!

  43. Register now says:

    What i do not realize is if truth be told how you are no longer really a lot more well-appreciated
    than you may be now. You are very intelligent.
    You know therefore considerably with regards to this topic,
    made me in my opinion believe it from a lot of numerous angles.
    Its like women and men are not involved until it’s one thing to do with Girl gaga!
    Your individual stuffs outstanding. Always deal with it up!

  44. Nutrient enrichment: when a nutrient cycle is disrupted and nutrients are taken away from one analytical chemistry for
    technicians part of a healthy environment. And analytical chemistry for technicfians then
    some of these reproductive problems. The western desert is dominated by stories about conflictRacism, Health Care,and Business.

    Do you think that we can survive long enough to see
    them. The characteristic feeding is primarily by swimming and filtering the algae and then also, say the city’s tap water meets and, under some
    criteria, exceeds their standards.

Trackbacks /
Pingbacks

  1. motivational short stories

Leave a Reply