What is Obama's proposals for health care?

Answer 1

There are many and different views. Some of them are these:1. Mandate to Purchase

A mandate that all Americans (and legal residents) purchase Health Insurance. It will be a misdemeanor offense on a federal level (resulting in a fine by additional taxation) for a live legal resident person to be found uninsured regardless of ability to purchase said insurance. The impact of this fine by additional taxation inposed on the poor who can not afford health insurance and who will not qualify for medicaid and medicare is not fully understood yet (as to its effectiveness and/or utility), as more fully described below.

2. Fines and Collection (IRS/HHS)Misdemeanor Penalties (The Fines, now declared a TAX by the Supreme Court). The Internal Revenue Service (IRS) is the designated Collection Agent (Collector). The fines ("Shall be collected in the same manner as taxes") will be automatically imposed upon annual Federal Tax filing and added to your Tax bill if no Health insurance plan has been acquired for any person on the tax return including listed dependents. The Department of Heath and Human Services has been tasked with the responsibility of collecting the information about Health Insurance compliance; that is, HHS will be the department which determines if you have a "compliant" heath insurance plan. The IRS will be cross-referencing its data on individual employment status (and employer) with HHS's database on heath insurance to determine who (if anyone) is not in compliance with the PPACA, and if the taxpayer and/or employer is to be fined.

Fines imposed on the low income and the poor can easily be deducted from any refund the tax payer might be expecting for that or future tax years. The fines collected from those unable to find funding for a health insurance policy are expected to raise 1 to 2 billion dollars in Federal Tax revenue for the first year. This effectively increases the available Tax revenues collected and reduces the Tax refund rate against taxes collected.

The law prohibits the IRS from confiscataing your home for being a live person who is unable to afford health insurance.

Additional Government budget savings should also be realized through reduced dependent exemptions on tax payer returns. Some tax payers are expected not to claim certain otherwise qualified dependents on their tax return for whom they could not afford a health insurance policy during that year. The fear of misdimeanor offender status along with a taxing fine may serve to disuade filers from claiming all their qualifying dependent exemptions on a tax return further reducing the overall rate of Tax Refunds issued by the IRS on an anual basis.

3. Guarantee for Pre-existing conditionsA requirement that Insurance companies not deny coverage to a person for an existing medical condition, but they can still use the pre-existing condition as a risk rating factor. Also, removal of insurance companies to discriminate in rate determination based on certain criteria (such as gender).

4. State Exchange MandateA requirement that the States each set up an insurance Exchange to facilitate the placement of Insurance for those who can not obtain coverage on the open market. If a state fails to create this Exchange, then residents of that state will be able to purchase insurance from a larger national Exchange which is to be run by HHS. The consequences for state governments which fail to set up this are minimal.

5. Minimum Coverage RequirementThe establishment of a national minimum standard for coverage allowed on a Medical Insurance Policy. This sets things like maximum deductibles, minimum types of procedures covered, minimum drug coverage, etc.

6. Employer Mandate

A mandate that commercial entities (who have not yet applied for and received a waiver) who employ over 50 full-time employees provide an avenue to purchase coverage through the employer. The employer does not have to pay for the full cost of a compliant plan - however, those failing to do so will be fined a sum roughly equal to the amount of subsidy that the government had to provide to the employee to purchase a plan themselves. Businesses which have less than 50 full-time employees but have significant number of part-time (less than 30 hours/week) employees use the following formula to convert their PTE to FTE: Total number of hours worked by all PTE / 120 = equivalent number of FTE.

7. Quality of CareThe gleaned mechanisms for the improvement in the quality of health care services is a provision of coverage for certain prevntative care procedures and in a subsection that stiffens penalties for Health care workers who have certain past and future offenses including drug possession on their record. These health care workers license to practice can be revoked.

8. PriceNo definitive guide for ultimate consumer premiums

Possible self regulating price control mechanisms

1. Access to preventative care one would hope leads to lower future costs.

2. Through reduced capacity of profibility by the insurer. 15 to 20 percent per regulating profit per annum unit.

9. State and Federal Expansion of Medicare/Medicaid

The Federal government will subsidize the states 100% in the first year of the legislation for expanding Medicare/Medicaid to cover ALL individuals with a household income equal to or less than the Federal Poverty Level (FPL). In addition, for those states which chose to opt-in to an additional program, the Federal government will subsidize between 80-90% of the costs for expanding Medicare/Medicaid coverage to all individuals with a household income of up to 133% of the FPL, Again, for the first Year of the Legislation. Medicare/Medicaid counts as a valid healthcare plan for these individuals, so they do not have to purchase any additional coverage to be in compliance.

Federal subsidies to the states 100% in the first year, will be reduced on an annual schedule to a maximum of 80% by the fourth year as costs are shifted to each states own public tax and budgeting mechanism.

10. Subsidized plans for lower-incomes

For those families with a household income of 100-400% of the FPL, there is a sliding level of subsidy for purchasing a compliant plan off of the State-managed Exchanges. If in a state which participates in the expanded Medicare/Medicaid program, no subsidy will be given for those between 100-133% of FPL - they are eligible for free Medicare/Medicaid instead.

11. Dependents eligible for Parent's Coverage to 26

Dependents are now eligible to remain on their parent(s)' family policy up until age 26. If the parents so choose to maintain coverage for their dependent adult child, they may do so with restrictions on residency, marriage, and other limitations now removed. The child must still be considered a "dependent" according to the PPACA, though they do not have to be claimed as such on the parent's tax forms.

12. Limits on Insurance Company overhead

Insurance companies must now pay a minimum of 80 or 85% (depending on the size of the insurer) of all premiums receipts for care - those failing to do so must refund premiums to their clients in the amount equal to that required to meet the minimum percentage (that is, they must return premiums until their outlays for care are at least 80/85% of the new adjusted premium).

14. New Taxes / Fees

There are new consumer and employer tax exposures. New federal taxes are imposed on all manner and types of medical devices, implants, equipment and supplies, there are also several notable new taxes placed on the Heath Insurance and Heathcare industries, expected to raise in the low tens ($10-20) of billions, to offset both the costs of implementing the PPACA and regulatory oversight. Rough estimates are these new taxes and fees will amount to between 0.3 and 0.8% of the total healthcare industry costs (currently, about $2.6 trillion). These taxes can be funded through increased consumer insurance rates as well as the Insurer profit control mechanism.

Here is some speculation on effects and comments on the requirements outlined above:

1. Mandate to Purchase

The mandate does not require undocumented residents to purchase coverage. The undocumented (illegal) resident must still receive emergency care under current regulations but the act offers no mechanism to enforce payment as it does on a legal resident or citizen. So these costs will continue to be passed to others. It also does not cover those legally in the country, but not with a residential visa (i.e. tourists, business travelers, etc) - it does mandate coverage for folks such as foreign students, however. It is also not known if the size of the current taxing fines are too much or too little to encourage all to get coverage.

2. Fines and Collection (IRS)

a. The Criminilization of Poverty issue. The poor, if not considered poor enough for medicare and medicaid yet still can not afford to pay 1/3 to 1/2 of their gross income for health insurance, are by default declared a misdemeanor offender subject to the Tax Fine.

b. Fines (Now Declared by SCOTUS to be a tax) will be collected regardless of whether a person has ever received care from a medical professional or even if that tax payer has never failed to pay a health care bill. The fine is for the lack of health insurance ownership, not for use of healthcare providers and not for leaving an unpaid health care bill. The formerly financially responsible citizen who has fully paid every medical cost ever incurred, will still be declared an offender and fined by tax.

c. There is no exemption for people who pay there own bills (i.e. self-insure) or use other avenues to cover their own heath care costs instead of buying a plan from a U.S. insurer. There are those individuals who have traditionally purchased health insurance in the International Marlket Place from insurers who do not reside in the U.S. but never the less are well respected providors.

d. Certain existing High-Deductible plans and all risk international plans will no longer qualify as "acceptable" coverage, and must be replaced with a compliant plan.

e. All those not eligible for government-provided Medicare/Medicaid/etc. must purchase a plan; failure to do so results in a tax fine. The fines are adjusted to income level (2.5% of income), but have a minimum amount: $700/individual, $2000/family regardless of ablity to pay.

3. Employer Mandate

There is debate over the definition of a Small Business, whether a small company that employees only 50 to 100 people can actually be expected to provide an affordable, effective health care plan and withstand the increased labor costs. Significant increases in labor costs are necessarily passed on to consumers fanning the flames of inflation.

The costs of certain locally produced goods and services that are heavily dpendent on labor overhead could see consumer prices increase significantly.

Note that employers are only expected to pay a certain minimum cost for health insurance (either as part of the health insurance purchase, or as a fine to the government). Currently, that cost is $2000 per employee. The employer may chose to further subsidize the health insurance, but that is not mandated.

Also there is debate over the effect on jobs and small business ability to hire new workers or to stay in business. Small businesses traditionally generate about 65% of all new jobs in the United States, and employ about 50% of the workforce as a whole. It is argued that the mandate will raise labor costs significantly, reducing the incentive to hire new employees enough to hurt the employment rate even further.

As a counter-argument, mandatory health insurance for employees will result in a healthier workforce (how much healthier is not currently quantifiable). Currently, businesses lose a bit under $600 Billion annually due to employee absences (and the resulting loss of productivity). Whether reducing this loss will be enough to offset the costs of mandatory subsidies is unknown.

4. Quality of CareThere would seem to be a crack down on health care workers. Some speculate that such a crackdown could remove hundreds of thousands of workers from the industry resulting in an overall decrease in quality of care and a further shortage of available health care workers, though the possible numbers leaving the industry are not reliably known.

Preventative care measures being covered could also lead to better overall quality of both care and health.

5. Price

There is no guarantee of lower premiums for a few reason

There is no proven relationship showing that the price of health insurance is related to costs associated with the uninsured patient.

Ther is no means by which to calculate at the outset what it will cost to cover the pre-existing conditions of all americans. It could cost anywhere from 200 to a thousand percent of what was spent previously in the country on an annual basis. Premiums rates as well as tax payer expectations will have to adjust to reflect certain realities.

Many Americans have been erroneously informed that the cost of the uninsured patient is somehow passed on to them through increased premiums to the insured.

In reality, costs related to care for the uninsured patient are simply not payable by an insurance company because they are uninsured. These costs are actually covered primarily by local hospital district taxes of the tax paying residents of the associated tax district along with state and federal tax funding and is not reflected in the cost of an insureds health insurance policy.

So, although there is no reason to expect a decrease in health insurance premiums, in fact just the opposite, there is significant reason to believe that there will be reduced tax burden on those Americans who pay hospital district taxes as well as savings to state and Federal budgets through reduced subsidizing of state medical facilities and local district hospitals. Whether these savings on the local, state and federal budgets will be passed back to the citizenry through reduced taxes has not been addressed.

However, hospitals also adjust their charges to insurance companies to compensate for costs they aren't reimbursed by local taxes for treating the uninsured. So, while the full cost of treating the uninsured is not passed directly onto the insured population, a non-trivial portion of it certainly is (putting a number to this portion is extremely difficult, though).

This contribution is an attempt to address the question with both schools of thought. It's been several months since I read the Affordable Health Care Act, So please feel free to add or contribute, edit inaccuracies, add additional input pros and or cons.

This is a very complex issue deserving of the broadest possible input.

Answer 2

President Obama's health care plans include:

- Making Health Insurance compulsory

- Stopping "some of the worst practices of the insurance companies"

- Introducing price competition between insurance companies

- Creating three standard insurance coverage levels to make choosing an insurance plan easier

- Introducing a comparison website where consumers can compare prices and purchase plans

- Maintaining private insurance and private health care providers but providing more subsidies to enable the poor to buy insurance.

Answer 3

its obama by the way

he wants to give everyone a lifetime supply of tylonal and band aids

Answer 4

Children may stay on their parents insurance until age 26.

People cannot be denied health insurance for pre-existing conditions

Everyone must buy health insurance.