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HEALTH WHAT
Tthehenation's
Democrats' overhaul of
health care system

CARE
IT DOES
will unfold over the next ten
years. Some of the changes

REFORM
will take place this year, but
HOW IT some of the most monumental
AFFECTS
YOU reforms won't be
implemented for years.
COVERED
IF THEN 2%
You are in with an income of you would of income
Millions who don’t have insurance
a family
of four up to $29,200 pay no
more than
for insurance
premiums.
now will have to buy coverage
starting in 2014 or pay a fine. There

IF up to $88,200 THEN 9.5%

is an exemption for low-income You are with an income of you would of income
people and subsidies for households a family pay no for insurance
making up to $88,200. For instance: of four more than premiums.

EMPLOYER COVERAGE
BUT $2,000
companies would
with more than have
Businesses aren’t required to 50 employees* to pay per worker
provide coverage for employees ... *Two part-time workers would count as one full-time worker.

HIGHER OR LOWER
PREMIUMS?
Premiums are likely to keep
IF
cost
controls
BUT
for those who
PRE-EXISTING CONDITIONS
Practices such as denying coverage to people with
pre-existing conditions will be banned starting in 2014.
can take advantage In the meantime, the government will set up a tempo-
going up either way, experts say. work, of new government
increases would ld llevell off
ff with
ith tax credits, their insurances costs will go rary insurance pool to cover those patients starting this
time, but not likely go down. down if they keep the same level of coverage. year.

MEDICARE MORE TAXES? HEALTH CARE EXCHANGES

PRESCRIPTIONS
The bill addresses the
“doughnut hole” that leavess
seniors without prescriptionn
coverage after they use $2,830 worth of
drugs in a year but before their out-of-
pocket expenses reach $4,550. Everyone
who enters the “doughnut hole” this year
would get a $250 rebate. Beginning next
year, drug discounts will be phased in to
close the hole completely by 2020.
A new tax will take effect in The idea of a government-run insurance plan hass
2018 on employer-sponsored been dropped, but state-based insurance purchas--
health care policies that cost ing pools will be available for small businesses,
uals
more than $10,200 for individuals the self-employed and the uninsured to pick a plan.n.
and $27,500 for families. By bundling those buyers together, the idea is they’d gain cost
A 0.9 percentage point increase in the advantages that they currently don’t have buying insurance on their
Medicare payroll tax will be placed on individu- own.
als making more than $200,000, or married National for-profit plans overseen by the federal government would
couples above $250,000. For those making be among the options. They would be privately run and one would
more than those levels, the tax will also apply to have to be nonprofit. The exchanges wouldn’t start operating until
investment income. 2014.

ADULT CHILDREN ON WHY ARE STUDENT LOANS ADDRESSED IN THE BILL? IS ABORTION COVERED?
PARENTS’ POLICIES? Politically, the student loan provisions were expected to get killed by a No health plan will be required to offer coverage
Any insurer that provides Republican filibuster, but it will get a simple majority vote this way. Also, for the procedure. Plans that do cover abortion will
coverage for dependent the changes could help win over some wavering House Democrats. charge separate premiums that will be kept in a
children will have to extend it The student loan bill will have the government lend money directly, separate account from taxpayer money. States
to age 26 starting right away. cutting out banks and other financial institutions. That will save billions of could ban abortion coverage in plans offered
dollars that would be redirected to grants for needy students. through the exchange.

THE COST OF COVERAGE HOW

OW FAR DOES $940
$ BILLION
ILLION GO?
The Congressional Budget Office forecasts that the health care overhaul will cost If health-reform spending dollar bills were stretched end to end they wou
would fall just
$216
$940 billion over 10 years, but savings and taxes will more than pay for it and
$187 $201 short of reaching the sun.*
generate an overall federal budget savings of $138 billion in that time.
$161
2010-2019 TOTAL: $940 billion $104
In billions
$54 91,096,770 miles
les
$2 $5 $5 $5
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 * The average distance to the sun from the Earth is 92,955,888
888 miles

THE COST AND THE DEFICIT MILLIONS OF NEWLY 30 31 31 32

25
INSURED PEOPLE 19

-$137.8 bill ion 0

2010
0
2011
1
2012
1
2013 2014 2015 2016 2017 2018 2019
Projected net effect on the
federal deficit between 81% 82% 82% 82% 89% 91% 92% 92% 92% 92%
2010 and 2019 PERCENTAGE OF INSURED NON-ELDERLY

COVERAGE WHEN THE BILL WOULD TAKE EFFECT

Number of people without insurance 2010 2011 2014
who will get it and how much in
care that would have never been A temporary insurance pool will be A new Center for Medicare & New insurance regulations will bar health plans from excluding coverage based on
paid for will now be covered. created by the federal government for Medicaid Innovation will be created pre-existing conditions. It will be more difficult for insurers to charge higher premiums
those who haven’t been able to get private to find cheaper and higher quality based on heath status, gender or other factors. Premiums can vary only because of
$500 million 337,000 insurance because of pre-existing ways of billing and delivering care. age, geography, family size and tobacco use.
conditons. The temporary plan will be The health insurance exchanges will start. In each state, the exchanges will allow
Care paid for that replaced by the insurance exchanges in
hospitals and Drug companies with sales of individuals and small employers to select among standardized health packages.
2014. Small businesses could deduct up to more than $5 million will have to
others would 35 percent of what they pay for workers’ Those who don’t qualify for Medicaid, but make less than four times the poverty
pay a fee to the federal government
have to KENTUCKY health insurance. tied to their share of the market.
standard, could get tax credits to help offset the cost of insurance. The credits will be
cover available only to those who are not eligible for insurance or offered other acceptable
Insurance companies will be banned Workers will see the cost of their coverage.
$506 million from dropping patients when they get sick. employer-sponsored coverage on
Penalties for those who don’t buy coverage will be $95, increasing to $325 in 2015
INDIANA Care that would A nonprofit Patient-Centered Outcomes W-2 forms. and $695 in 2016, but no more than 2.5 percent of income.
Research Institute, independent of the
be paid for
government, will be created to study how 2013 Employers with 50 or more employees will have to pay $2,000 a year for each
485,000 diseases can be effectively “prevented, Those under 65 won’t be able to full-time employee if they don’t offer coverage. Employers who offer coverage but
Would get it diagnosed, treated, monitored, and deduct health care expenses from whose employees receive tax credits will have to pay $3,000 for each worker
managed.” their taxes until they spend 10 receiving a tax credit.
3RD U.S. $130 million Insurance plans will be required to percent of their income, up from Health insurers will have to pay an annual fee based on market share.
HOUSE Care that would extend dependent-care coverage to age 7.5 percent now.
DISTRICT be paid for 26. Health-insurance companies 2018
won’t be able to deduct executive A tax on high-cost employer-provided health plans will take effect. The tax would
30,000 Tanning salons would be taxed an
additional 10 percent. compensation in excess of be applied to coverage costs that exceed $27,500 for a family and $10,200 for an
Would get it $500,000 per year. individual.

Sources: Congressional Budget Office; House Committees on Ways & Means, Energy & Commerce, and Education & Labor; Health Care and Education Affordability Reconciliation Act of 2010, By Steve Reed, The Courier-Journal

READ MORE ONLINE Read the bill and get links to those for and against the bill at www.courier-journal.com.