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The health care bill: Fact from fiction

Photo Credit: Cliffview Pilot
Photo Credit: Cliffview Pilot

EDITORIAL: The historic $938 billion health care overhaul is now law, guaranteeing coverage for 32 million uninsured Americans and touching all of our lives. Amid the sometimes nasty back-and-forth is the most important question: What exactly does it mean for YOU? Let’s see….

No brainer: The uninsured come out ahead. What’s more, roughly 32 million people shut out of the market get their feet in the door. No longer can they be deemed too sick or too poor to afford health care.

Jerry DeMarco (Publisher/Editor)

You won’t see much difference if you already work for a large employer and have coverage. You might be surprised to learn you STILL might benefit.
No. really.

For instance: There will be no more lifetime limits on coverage; no more policies canceled retroactively if you get sick; and NO MORE denial of children with pre-existing conditions.

On top of that: New plans must cover checkups and other preventative care WITHOUT CO-PAYS.

Bottom line: No matter what kind of shape you or your budget is in, you‘ll be able to get quality health care.

Households with income up to 133 percent of the federal poverty level — a little under $30,000 for a family of four — would be eligible.

What’s more, the age for dependent children eligible under their parents’ plans would be extended to 26 (most states cut it off at 18 or 19).

Retirees and workers in high-risk professions like firefighting will have higher thresholds tied to inflation.

Within four years, companies that employ 50 or more workers will will get tax credits covering up to 50% of employee premiums. Those premiums would be capped at a percentage of income, ranging from 3 to 9.5 percent.

Those who cannot find a plan that costs less than 8 percent of their income would be allowed to buy a catastrophic policy.

Among the catches: Well-off families will pay more in taxes. Not the middle class but those who make much higher incomes (Meanwhile: A temporary high-risk pool will be set up to cover adults with pre-existing conditions).

Also: If you don’t have health insurance, you could face a federal penalty. It is projected to be $95, or 1 percent of income, whichever is greater, the first year, and eventually rise to $695, or 2 percent of income, by 2014.

And here’s one you probably haven’t heard about: The government will impose a 10 percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010.

What isn’t clear yet are whether out-of-control out-of-pocket costs will be affected.

What is clear is that the Medicare prescription drug program will eventually provide half-price discounts on name-brand drugs and offer rebates to those seniors caught in the gap in coverage known as the “doughnut hole.” By next year, half of that gap will be filled.

The timing:

Within a year

— Provides a $250 rebate to Medicare prescription drug plan beneficiaries whose initial benefits run out.

90 days after enactment

— Provides immediate access to high-risk pools for people who have no insurance because of preexisting conditions.

Six months after enactment

— Bars insurers from denying people coverage when they get sick.

— Bars insurers from denying coverage to children who have preexisting conditions.

— Bars insurers from imposing lifetime caps on coverage.

— Requires insurers to allow young people to stay on their parents’ policies until age 26.


— Requires individual and small group market insurance plans to spend 80 percent of premium dollars on medical services. Large group plans would have to spend at least 85 percent.


— Increases the Medicare payroll tax and expands it to dividend, interest and other unearned income for singles earning more than $200,000 and joint filers making more than $250,000.


— Provides subsidies for families earning up to 400 percent of the poverty level — or, under current guidelines, about $88,000 a year — to purchase health insurance.

— Requires most employers to provide coverage or face penalties.

— Requires most people to obtain coverage or face penalties.


— Imposes a 40 percent excise tax on high-end insurance policies.

By 2019

— Expands health insurance coverage to 32 million people.

: Washington Post

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