What the Health? Understanding Obama’s 11 Year Plan for Health Reform

If we maintain this status quo WHAT THE HEALTH? 14K AMERICANS will lose their Health Insurance Daily * Understanding Obamacare's 11 Year Plan* 158 2010 • Beginning in October, individual health insurance plans (as VOTES VOTES opposed to employer group plans) must allow children up to age 26 to remain covered as dependents. 2010 • The Medicare Part D prescription drug coverage gap is reduced by RI$250 OFF 26 YEARS OLD payment of $250 to those reaching $2,830 out-of-pocket for the year. Starting June 21, plan sponsors (mostly employers) will be eligible for reimbursement of 80 percent E80% of certain claims from $15,000 to $90,000 for pre-Medicare retirees **** reimbusement ages 55 to 64, • Health care reform establishes a tax of 10 percent on indoor SALES FREE tanning services. This would raise 10% TAX $2.7 billion between 2010 and 2019. As far as we know, getting a tan outside is still free. 2011 • Long-term care insurance program starts; it will reimburse 2011 some costs of home and nursing home care. $2.3 Billion Pharameceutical • Medicare recipients in the prescription drug "doughnut hole will get a 50 percent discount on Manufacturers FEE brand-name drugs, with additional discounts beginning to close the gap by 2020. " 오 10 % • Employers with fewer than 25 50% DISCOUNT ON employees and average annual BRAND-NAME DRUGS wage less than $50,000 will be INCENTIVE eligible for sliding scale tax credit, if they provide health insurance and pay at least 50 percent of cost. LONG-TERM COMMUNITY HEALTH CENTER • Primary care doctors and certain surgeons serving under-served areas (some cities CARE EMERGENCY PROGRAM FUNDING and many rural areas) to receive 10 percent incentive payment from Medicare for their services. 1x 25 employees = tax credit • Funding for community health centers expanded, to benefit mainly low-income and uninsured people. 2012 • A $2.3 billion annual fee on pharmaceutical manufacturers FEWER begins, gradually increasing in the following years. HOSPITAL MEDICARE 2012 Reimbursements • Not-for-profit insurance MEDICARE payments cooperatives will be initiated to compete with commercial insurers, hopefully with lower premiums. |LOWER PREMIUMS O Not-For-Profit Insurance • Medicare payments begin to new "accountable care organizations" will be established to experiment with various cost-reduction measures. 2013 • Reduction of Medicare reimbursements to hospitals with high rates of patient re-admissions that are deemed STANDARDIZED 3.8% Medicare Tax "preventable." INSURANCE FORMS 2013 • Standardized insurance forms introduced to reduce paperwork, 10% COUPLES SINGLES duplication and administrative Income above $250,000 Income above $200,000 costs. • Contributions to tax-sheltered flexible spending accounts (FSAS) 7.5% will be limited to $2,500 per year, ITEMIZED TAX $210 BILLION indexed for inflation. Threshold for claiming itemized tax DEDUCTIONS increased between 2013 & 2019 deduction for medical expenses increased from 7.5 percent of income to 10 percent. Those over 65 can still deduct medical 2014 expenses above 7.5 percent of income through 2016. • A 3.8% surcharge would be NO DENYING COVERAGE to people with medical conditions New Health Insurance Exchanges imposed on investment income for individuals making over $200,000 and couples making 60% 70% 80% over $250,000. This tax increase is estimated to bring in $210 Insurance Premiums May Only Vary By billion between 2013 and 2019. New tax of 3.8 percent on income from investments. This tax is intended to help fund the Home Family Size Tobacco Age health reform program. 2014 SUBSIDIES END Тах For Purchasing Insurance at 400% • Insurance companies will be prohibited from denying coverage to people with medical conditions Credit Through Exchanges the poverty rate and may not refuse to renew policy because claims were submitted. Group Health Plans must be O Annual Coverage Limits Quality Plan CERTIFIED O Preexisting Condition Exclusions • Insurance premiums may only vary by age and three other "quality health plans" Coverage Until 26 Set Premium Rates in rating bands conditions. Limits places on charging higher rates to older people. Higher rates will be allowed on basis of place of residence, family size and tobacco use. MEDICAID EXPANDS COVERING • New health insurance "exchanges" created for individuals and small 133% businesses to buy coverage. Tax OF POVERTY LINE credits for most Tnner most consumers purchasing insurance through the exchanges will be provided, based on household income. Subsidies Childless Adults Covered By Medicaid Must Have CT Health Insurance end when household income exceeds 400 percent of the poverty rate, or currently $88,000 for a family of four. Employers with > 50 Employees can be penalized • Insurance sold through the exchanges will be offered in four 2018 tiers, covering 60, 70, 80, and 90 percent of the health service costs respectively. Employer-sponsored 40% Cadillac plans must meet the same Health "qualified coverage" standard a Plans plans sold on the exchange. • All group health plans will have to 2020 be certified as "qualified health plans" and a minimum table of required benefits will be established. This is to prevent IR $2,830 employers offering low-benefit "sham plans." . "Qualified health plans" must eliminate annual coverage limits STOPS ENDED and preexisting condition exclusions, extend coverage to children up to age 26, and set premium rates in "rating bands" after consultation with the federal government. OUT OF POCKET • Medicaid expanded to cover TrOOP Covered By Medicare low-income people up to 133 Spending Cost percent of the federal poverty line, or $29,300 for a family of four. $0-$295 $0-$295 Deductible None • Childless adults meeting $295-$2700 $295-$896.25 25% 75% low-income test will be covered for the first time by Medicaid. $2700-$6,154 6.25-$4,350.25 All Costs • U.S. citizens and legal residents will be required to have and maintain health insurance, or pay a over $6,154 over $4,350.25 5% 95% fine starting at $95 per person in Jad cec 2014, increasing to $695 in 2016. SMALL BUSINESSES Family penalty capped at $2,250. Penalties indexed for inflation after 2016. Penalties enforced and collected by the IRS. Employers with more than 50 workers penalized if any of their full-time workers buy coverage through the exchange, as opposed to through employer-sponsored coverage. Penalty is $2,000 per worker per year, exempting the first 30 employees. "Full-time" defined as 30 hours per week. Must Provide Health Insurance with 50+ Employees Less Than 100 Employees Health Insurance Exchanges 2018 35%-50% 25 Employees or less Early Retirees (55-64) • A 40 percent tax would be imposed on insurance companies Тах Credit Assistance providing "Cadillac" health plans valued at more than $10,200 for individuals and $27,500 for families. < 50 Workers Tax Credit FINE Exchanges 2020 • "Doughnut hole" Medicare GOOD VS. BAD prescription drug benefit gap ends. Seniors continue to pay the standard 25 percent of drug costs until they reach the threshold for Medicare catastrophic coverage, when their copayments drop to 5 O 46% + 45% + 36% percent. • Under current law, Medicare stops covering drug costs after a plan and beneficiary has spent more than $2,830 on prescription drugs. It starts paying again after an individual's out-of-pocket AMERICANS IN FAVOR OF HEALTH CARE REFORM AMERICANS AGAINST HEALTH CARE REFORM AMERICANS THINK HEALTH CARE REFORM expenses exceed $4,550. Called IS A GOOD IDEA the doughnut hole, it will be closed by 2020. FUN FACTS BIRTH CONTROL COVERED RESTRICTED FUNDS FOR RESTAURANTS MUST LIST UNDER OBAMACARE ABORTIONS CALORIE COUNTS AO MENU The administration rejected a In a deal with conservative Restaurants with more than request from the Roman Catholic Church for a broad Democrats, President Obama 20 locations must list calories will sign an Executive Order on Every Menu Item. exemption for insurance *that will reaffirm its provided to employees of consistency with longstanding Catholic hospitals, colleges and charities. restrictions on the use of federal funds for abortion." Clarity Way Find your path to recovery Sources : CNN | FOX NEWS | FORBES | BUSINESSWEEK I HEALTHCARE.GOV | CBO.GOV I WSJ| NPR •dlo