"OBAMACARE" AND BUSINESS
The newly passed health care legislation states that employees with 50
or fewer employees would be exempt from coverage provisions, while
employers with 50 or more employees would be greatly encouraged
(with the stick, not the carrot!) to provide health insurance for their
workers as they would face the strong possibility of having to pay large
fees to the federal government if they don't offer any coverage. How so?
An employer of this size that does not offer health insurance would have
to give Uncle Sam a fee of $2,000 for each full-time employee in the
company if at least ONE full-time employee receives a subsidy from
our generous Uncle to purchase health insurance on his own. Even if
health insurance IS offered, said employer may be made to assist any
lower-income employees who want to buy coverage on their own, if
they find the cost of the plan offered by the company too expensive.
A "free choice" voucher whose face value would equal the amount of
what said employer would have paid to provide coverage in its offered
plan would then be provided to these cash-strapped employees. Also,
an employer with 200+ employees that does not offer health insurance
would have to automatically enroll them all in the plan.
All of these stipulations would take effect on Jan. 1, 2014. Again, the
stick is implemented here, rather than the carrot. And the cost of the
goods and services sold by these companies would have to rise in order
to pay for these mandates in "Obamacare". These costs would come in
addition to the higher taxes we'll be paying to implement and maintain
the national health care program.
WHAT'S IN STORE FOR FAMILIES AND THEIR CHILDREN?
Families will be affected differently, depending on their different circum-
stances, i.e. incomes, job situations, and states of residence. Those
families in the upper reaches of the income scale will certainly be sub-
jected to higher taxes. For families in the lower section, they'll receive
health care in a few years as they receive subsidies to buy it. For middle-
income families, the health care legislation will affect them according to
the aforementioned criteria.
Children with pre-existing health conditions, as mandated by the health
care legislation, could not be excluded from coverage by insurers. This
provision, with the bill having been signed into law by President Obama,
is already in force. Adults with pre-existing conditions will be kept from
exclusion starting in 2014. Meanwhile, this will make for higher insurance
premiums for everyone presently with health coverage in order to pay for
the treatment and care of those with pre-existing conditions now being
brought into coverage by federal mandate. Children up to age 26(!) who
are still dependents will be able to remain on their parents' family policy.
This replaces the ability of individual states to regulate the age at which
children are to be dropped from their parents' policies; at present, that age
is around 18 years. There are no estimates so far as to what this will cost.
Frightening food for thought, as premiums for people with health insur-
ance will rise, making them pay for coverage for the young dependents
in other families in addition to the coverage for their own family members.
CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP)
Children's eligibility for CHIP, which assists lower-income families, must
be maintained according to the reform measure. Even if a state is hard-
pressed by budget shortfalls, it would not be able to drop any children
from the program until 2019. States that would find themselves in this
position might have to raise existing taxes or implement new taxes in
order to pay for the reform package. Also, under the bill's language,
"qualified health plans" will have to provide immunizations and other
preventative health services for children from infancy through adoles-
cence --- and no cost-sharing would be allowed. This proviso takes effect
in September of this year.
WHAT ABOUT SENIORS?
Some senior citizens may lose Medicare benefits, while others will gain
from an enlargement of Medicare's prescription drug plan. Under the
health care legislation, government payments to Medicare Advantage
(plans run by private insurers such as Humana which serve as an alter-
native to traditional Medicare) will be slashed by $132 billion over 10
years. These plans generally offer extra benefits that seniors in traditional
Medicare don't receive. These extra goodies will likely be dropped as
Medicare Advantage plans need to constrict their budgets due to the cuts
in funding from Washington, while Uncle Sam redirects that money
toward subsidizing people's mandated purchases of at least basic health
coverage in accordance with "Obamacare". While the bill does not contain
cuts to traditional Medicare benefits, Medicare payments for home health
care would be chopped by $40 billion between now and 2019, with certain
payments to hospitals would be pared by $22 billion over that same time
Furthermore, the bill would provide for seniors who, after paying $2,700
on medicine out of pocket in a year would have their coverage halted until
they have spent a total of $6,154 on medicine, after which their coverage
would resume. Each senior in this position would receive $250 to help,
with the federal government slowly increasing the percentage of drug
costs it pays within this stretch, culminating in paying 75% of all senior
drug costs between $2,700 and $6,154.
A Medicare payment advisory board, independent of the federal govern-
ment, would be established. Consisting of 15 members, it would submit
legislative proposals to reduce per capita Medicare spending if said spen-
ding grows too fast --- this being defined as exceeding the growth rate of
Consumer Price Index (CPI) measures for a 5-year period ending in 2013.
Should that occur, starting in 2014 this board will draft and submit pro-
posals to Congress and the president for consideration.
Some critics say that the board will be greatly instrumental in Medicare
cutbacks. Although legislative wording in the health care reform bill
prohibits the board from suggesting rationing care, changing benefits,
or raising taxes, many critics worry that any or all of these events will
occur elsewhere in the "reformed" health care system.
Next week we'll look at the overall effect "Obamacare" will have on not
only our health care and our health but on our economy, our freedoms,
and our lives.