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More in depth (yet still bulleted) info on the bill

Posted by: PRodNano (a.k.a PRodQuanta) on Jun 30, 12:38 in response to mike255's post Usa Supreme court Require every american citizen must...

Okay, explained like you're a five year-old, without 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 PPaACA, and it's become popularized in part because PPaACA is a really long and awkward name, even when you turn it into an acronym like that.

Anyway, the PPaACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPaACA, 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, 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 life 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 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%)

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.
  • Insurer's 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 Medicare 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-class, basically making it so poor people can get some 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.

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 PPaACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPaACA. 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"

.

Aaaaand that's it right there.

The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it's not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.

Plus, as previously mentioned, it's necessary if you're doing away with "pre-existing conditions" because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.

Usa Supreme court Require every american citizen must Health insurance mike255 Jun 29, 15:04

Horrible. It will be done through a tax which means we'll be paying. Why should I have to pay for other people to get health insurance? {nm} MontyBurnz Jun 29, 15:28

you do now; ever been to an ER at a county hospital? {nm} daveart Jun 29, 16:11

No no no...You do not get it. If you choose not to buy insurance, the penalty is higher taxes. If you have, or buy health insurance, in BUY StarBondFund Jun 29, 17:25

Yes, my employer provides insurance. But why should people be forced to pay for something they don't use? MontyBurnz Jun 29, 19:11

needing medical attention is not something you plan for {nm} Moviesnob Jun 29, 19:15

Part of "forcing" everyone to have health insurance (or to pay a tax if they choose to forgo) is a concession to the health industry. Paul2k Jun 29, 19:27

With more people on insurance, good luck getting into see a doctor when you need to. MontyBurnz Jun 29, 20:46

Also, it is going to allow the government to outlaw any food item they want, such as further regulation of sweet items soda, candy, etc. MontyBurnz Jun 29, 22:20

Movie theatres will go out of business when the products they sell in order to stay in business are outlawed because they're not healthy {nm} MontyBurnz Jun 29, 22:24

This will not/ can not happen (and I think you know that). PRodNano Jun 30, 10:06

Supply will always meet demand. If this is the case, it will create more jobs. {nm} PRodNano Jun 30, 09:58

Also, the bill also stipulates that doctors will start getting paid on how effectively they treat their patients, not by how many they see. PRodNano Jun 30, 10:08

There's a wrinkle in that supply/demand logic. You can't just churn out more doctors. It takes years and lots of money to create a doctor. Paul2k Jun 30, 10:48

Good points Paul. However, I was more refering to allowing more students into medical schools. I believe the amount that they let in PRodNano Jun 30, 12:31

This is true. In Canada, we have a hard time getting find a general practitioner. It's easier to go to a clinic. But specialists are elchan Jun 30, 14:32

In your life time, there's a high probability that you *will* use health insurance. Most likely you will need it when you are older elchan Jun 30, 07:53

I'm not disagreeing with the verdict, but the problem is, the court decided it wasnt a tax when it agreed to hear the case Moviesnob Jun 29, 19:17

basically, the court said its not a tax for purposes of the anti-injunction act, but is a tax that congress can levy it. pretty weird {nm} Moviesnob Jun 29, 19:23

I agree with universal health care. This is what separates us from animals. The social pact. elchan Jun 30, 07:57

+1 :) {nm} Jane_Citizen Jun 30, 14:20

For those who don't know what the bill is about and don't want to read all the literature, inside is the logic: PRodNano Jun 30, 10:12

Not sure that's any better than what we have now. Actually, sounds worse. Here's why... MontyBurnz Jun 30, 10:25

Medicaid/Medicare isn't going away with the ACA, so that local aid you got should stay in place. I'm not entirely sure on the workings of Paul2k Jun 30, 10:40

I didn't have MedicAid or Medicare. What I had was called Medical Assistance (MA). I believe it's different than those you mentioned. {nm} MontyBurnz Jun 30, 11:39

It's possible that Medical Assistance is just the local/state name for Medicaid. Medicaid is the federal name, but the funds from it are Paul2k Jun 30, 12:05

Does the new law require employers to offer health insurance to every employee, regardless of whether they're full or part time? {nm} MontyBurnz Jun 30, 12:25

Business with over 50 full-time employees must offer coverage to those employees or pay a fine. Not sure about part time. {nm} PRodNano Jun 30, 12:39

Is there a certain standard employer-offered insurance must meet that is part of the law? {nm} MontyBurnz Jun 30, 13:07

I'm not sure, but I assume it has to be at least as good as the coverage that the government offers. {nm} PRodNano Jun 30, 13:10

I played Russian roulette once and didn't get killed. Thus, banning Russian roulette games for people's safety is not logical? PRodNano Jun 30, 12:46

If it doesn't work for you, you probably make too much money yet don't have a job that offers health insurance, a pretty rare occurence. MontyBurnz Jun 30, 12:55

That's actually quite hilarious, because that doesn't describe any one of our situations :) {nm} PRodNano Jun 30, 13:03

i've worked four jobs in the past seven years that rendered me ineligble for Medicaid but did not offer health care benefits to me {nm} mickpix Jun 30, 13:58

More in depth (yet still bulleted) info on the bill PRodNano Jun 30, 12:38





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