Obamas health care reform

Discussion in 'Politics' started by .........., Mar 15, 2010.


    Uninsured people with medical problems will have a workable alternative. The bill pumps $5 billion into high-risk insurance pools run by the states to provide coverage to those in frail health. Taxpayer-backed insurance won't be free, but premiums should be much lower than what's charged by private insurers willing to take those in poor health.

    For people with private health insurance — about two-thirds of Americans — there would be some new safeguards. For example, insurers would be barred from placing lifetime dollar limits on coverage and from canceling policies except in cases of fraud. Children could stay on their parents' coverage until age 26.


    Health insurance companies would face unprecedented federal regulation and particularly close scrutiny of their bottom line. A fixed percentage of income from premiums would have to go to medical care, otherwise insurers would be forced to provide rebates to consumers. That share is 85 percent for large group plans, and 80 percent for plans in the small group and individual markets.

    One of the central reforms of the bill won't start until 2014, when the exchanges open. From then on, insurers will not be able to turn away people with medical problems or charge them more.


    Starting in 2014, self-employed people and those whose employers don't offer coverage would be able to pick a plan through a health insurance exchange, like a supermarket. It's modeled on the federal employee health program available to members of Congress, with a range of private plans. Small businesses could also join.

    About 25 million people would buy coverage through state exchanges, and nearly 6 in 10 would be eligible for help with their premiums. The new tax credits would be computed according to income and other household characteristics. The money would go straight to the insurer. To consumers it would look like a discount — generous for lower-income families, less so for those solidly in the middle class.

    For example, a family of four making $44,000 would pay $2,763 in premiums _about 6 percent of its income_ for a policy worth $9,435.

    But a similar family making $66,000 would have to pay $6,257 in premiums, close to 10 percent of its income. That may be less than a mortgage, but it's more than a car payment.

    Once the exchanges open, most Americans would be required to carry health insurance or pay a fine. Medicaid would be expanded to cover childless adults living near poverty, bringing the total who'd gain coverage to more than 30 million.

    People with employer-provided insurance would not see major changes. But if they lost their job, they'd be able to get coverage through the exchange.


    Seniors have been understandably worried about the health care plan, much of it financed with Medicare cuts the government's own experts say could be unsustainable.

    In the crosshairs are subsidies to private Medicare Advantage insurance plans, which now enroll about one-quarter of seniors. The government overpays the plans when compared to the cost of care under traditional Medicare. That largesse translates to lower costs for seniors in the plans, and the overhaul could trigger an exodus from Medicare Advantage as insurers are forced to raise rates to stay in business.

    But seniors stand to gain as well. Obama would gradually close the coverage gap in the middle of the Medicare prescription drug benefit. The so-called doughnut hole would start to shrink immediately, but it wouldn't be fully closed until 2020. In the meantime, seniors in the gap would get a 50 percent discount on brand name drugs.

    The plan also improves preventive benefits for seniors in traditional Medicare.


    Primary care doctors and general surgeons practicing in underserved areas such as inner cities and rural communities would get a 10 percent bonus from Medicare. But the more significant changes for doctors would unfold slowly. The goal is to start rewarding doctors for keeping patients healthy, not just treating them when they get sick.

    The plan would use Medicare as a testing ground for new ways of coordinating care for patients with multiple chronic illnesses such as high blood pressure, diabetes and heart problems, a common combination. Primary care doctors would become care managers for such patients, keeping close tabs on medications and basic health indicators.

    Doctors and hospitals would be encouraged to band together in "accountable care organizations" modeled on the Mayo Clinic.


    Obama's plan wouldn't require employers to provide insurance to their workers, but it would hit them with a stiff fine if even one of their workers gets a federally subsidized coverage. Companies with 50 or fewer workers would be exempt, and those with 25 workers or fewer could get federal assistance.

    But the fines could turn into a big headache for many employers, particularly since they may not be able to tell if their workers are getting benefits from the government. For example, a company with 100 employees that fails to provide coverage could face a fine of $140,000 under the plan Obama unveiled Feb. 22. Getting the bill from the IRS would become a dreaded moment for business owners.
  2. As a single payer liberal guy its not everything I wanted, but its more then every Democratic President since Truman has been been able to accomplish

    Thank you President Obama,you have my vote in 2012
  3. This is a very good plan and a very good start.

    Why people don't support this simply amazes me... they either must be in fear of change of any kind, lack empathy to some degree or just plain unaware of the facts.
  4. the money from the insurance pool should only come from those who need it by taking it out of their salary every mth.
  5. maxpi


    sooo... what's the upshot in regards to cost to the public? If it costs the public money then it's bad for the public, the public sector has been broke for a long time, spending can only make things worse...
  6. When someone is uninsured and requires serious medical attention either one of two things happen:

    1. Bankruptcy.

    2. Collection account that will likely never be paid off.

    Who pays the bill in both cases? The public.

    If everyone is forced to contribute to the insurance pool, the costs of the above situations will decline sharper than the upfront costs (hopefully anyway).

    There is never a perfect solution, but financially speaking, unisured people are a financial time bomb waiting to happen.
  7. ............ thanks for the post. Do you have a reference for that.
  8. Sounds like shit to me.