The senate passed its own version of the healthcare bill today with a vote of 60-39. Obama touted this as "real, meaningful health insurance reform that will bring additional security and stability to the American people". Now both houses of Congress hope to form a compromised bill together for Obama to sign before the New Year, an unlikely achievement, but we'll see.
The House version of the bill:
1. Public-option: The government can set insurance rates. The industry is afraid that the rates might be set below market value, thus losing them money. This provision is unlikely to survive in the final bill sent to Obama's desk given the fact that the bill barely passed the Senate.
2. Increases income taxes on individuals making over $500,000 and families of four making over $1 million a year by 5.4%
3. Cuts Medicare spending by ~$500 billion.
4. Subsidies would be provided to families of four making $88,000 a year (or 400% the federal poverty level).
5. Health insurance exchanges will be allowed to help businesses and individuals to save money.
6. Premiums cannot change based on gender and/or prexisting conditions.
7. Medicaid coverage would extend to families of four making $33,000 a year (or 150% of the federal poverty level).
8. All individuals must have insurance coverage or face a fine of 2.5% of his/her income, with an exception of poor Americans.
9. Companies with a payroll over $500, 000 will need to provide insurance or pay a fine of up to 8% of its income.
10. Abortions would not be allowed in subsidized insurance and private policies exchanged.
The Senate version of the bill:
1. Does not have the public option.
2. 40% taxes on insurance companies that provide "Cadillac plans" at the value of $8,500 per individual and $23,000 per family (I'm assuming a family of four).
3. Also cuts Medicare by ~$500 billion
4. Subsidies would be provided to families of four making $88,000 a year (or 400% of the federal poverty level).
5. Health insurance exchanges are also allowed.
6. Premiums cannot change based on gender or prexisting conditions.
7. Medicaid coverage would extend to families making $29,000 a year (or 133% of the federal poverty level).
8. All individuals must have coverage or face a fine of $750 or 2% of his/her income, with exceptions of poor Americans. The higher fine is chosen.
9. Companies with over 50 employees would face fines up to $750 per employee that relies on government coverage funded by subsidies.
10. States would get to choose whether to provide coverage for abortions in exchanged insurances.
Just to clarify a few things, do not confuse medicaid with medicare. Medicare is public insurance provided for people over 65. Medicaid is a welfare program for poor, disabled, and old people that provides health services. It is largely determined by income, whereas Medicare is completely based on age.
From an insurance company's point of view, they should be pretty happy at all the new customers they'll be receiving, at least in the long run. In the short run, they'll be hurt by the riskier policy holders: diabetics, cancer patients, etc. However, those losses would eventually be offset by the fact that they can charge higher premiums on older people. Those costs could also shift towards younger people because there is nothing in the bills that prevent insurance companies from charging people extra based on age.
Next point of discussion would be the fines. I have doubts that they would persuade some Americans from buying coverage, at least for the Senate bill. The fines seem to be cheaper than the insurance they are encouraged to purchase. For those Americans that can afford insurance, but choose not to buy it, the law is much like the seat belt law: it's there to prevent people from facing huge medical costs that could be paid for by medicaid. Simply because those people may afford insurance, but they may not be able to pay for their own medical bills.
I'm sure there are exceptions for the abortion provision of the bills. Women who are endangered by childbirth, rape, and other noteworthy causes would be exception. Congress isn't that heartless...I hope.
There is no mention of undocumented immigrants, but they are definately part of both bills. Now, there are those of you that say that these immigrants should not be entitled to subsidies. But the work that most of these people do offset the income taxes that they don't pay. For example, a small box of strawberries cost about $1.99 (a rough estimate) because of cheap immigrant labor, but it could easily cost over twice as much if it these immigrants aren't working in the fields. The money they save us could even exceed the taxes we collect from them.
This health care reform is no doubt the highlight of Obama's presidency. It's unlikely he'll get any other major changes passed (except maybe something about the environment) because his popularity fades over time. And as it fades, so does his mandate.
That's all I have to say for now. If there are any other important provisions of either bills that I missed, feel free to point them out (the bills are a huge stack of papers and I'm sure there are more provisions that weren't included in this news article).
Friday, December 25, 2009
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