I’m still going through all the details but on the surface the healthcare bill looks pretty decent. It is not everything Obama promised (no public option) but a step towards getting everybody covered. Also initial reports said that the bill will reduce deficits by over a 100 billion in the next ten years. I am skeptical, more on that later. Now down to the things that affect us now:

  • Insurance companies cannot revoke policies
  • Children under 26 can be under parent policies
  • Children with pre-existing conditions must be covered
  • Insurers must pay out 85% of group policy premiums and 80% of individual policy premiums (would that make insurance not very profitable?)
  • 3:1 limit on what older adults can be charged vs youngsters
  • Elimination of lifetime dollar limits on policies
  • High risk pool offers coverage to uninsured with medical problems
  • Expanded Medicaid coverage upto 133% of poverty line.
  • Close the donut hole gradually by 2020. Starts with rebates this year, discounts in 2011.
  • Premium subsidies – Premiums capped for low income families at 6% of income and gradually phased out for higher income.
  • Increased payments to PCPs under Medicaid (probably to get more providers to accept it)

Also the bill has larger changes coming in 2014

  • Nobody can be denied coverage or charged more for preexisting conditions
  • All Americans must be insured or individuals and employers with more than 50 employees both will face penalties. $695 for individual and $2000/employee for employer.
  • Healthcare exchanges must be made available by states to offer a choice of plans
  • Childless adults covered under Medicaid

Now for the part that covers costs and might reduce deficit

  • Increased Medicare  taxes for high income individuals (over $200,000 single, $250,000 couple)
  • Tax on high cost insurance plans (plans costing >10,200 for individuals and 27,500 for families) starting 2018
  • Cuts on annual increases to Medicare reimbursement rates
  • Cuts on funding to disproportionate share hospitals (that treat high numbers of poor/uninsured) starting 2014 (but everybody should be covered by then right?)
  • Cuts to government subsidies on Medicare advantage plans
  • Drug companies will contribute 80 something billion (no idea how) but they get 12 year protection against generics
  • Drug companies pay a tax on drug sales (maybe thats where the money above comes from?)
  • Medical device makes pay a tax on certain products

I’m not exactly sure how all the above and anything that I missed will make more than the government is spending. But the CBO says so.

What do I expect out of this for myself? Steeper premium increases until 2014.