Congress Delivers a Healthcare Bill

You can read about it here.

You can read the details here. (Adobe Reader Required)

Commentary up the wazoo here.

A couple of rubs:

The proposal would also impose a “play-or-pay” requirement on employers, who would either have to offer qualifying insurance to their employees and contribute  a substantial share toward the premiums, or pay a fee to the federal government that would generally equal 8 percent of their payroll. Small employers (those with an annual payroll of less than $250,000) would be exempt from those requirements. As a rule, full-time employees with a qualifying offer of coverage from their employer would not be eligible to obtain subsidies via the exchanges, but an exception to that “firewall” would be allowed for workers who had to pay more than 11 percent of their income for their employer’s insurance. In that case, the employers would have to pay an amount equal to the per-worker fee due for firms subject to the “play-or-pay” penalty. Firms with relatively few employees and relatively low average wages would also be eligible for tax credits to cover up  to half of their contributions toward health insurance premiums.

Comment on the underlined part: Which would of course, run some Businesses out of business. Either you play along or pay taxes out the nose. The small Employers part is nice. But this would put the squeeze on the Medium to large businesses.

Of course, you’ve got your “Let’s Cover our backsides” Caveats:

Important Caveats Regarding This Preliminary Analysis

There are several reasons why the preliminary analysis that is provided in this
letter and its attachments does not constitute a comprehensive cost estimate for
the coverage provisions of America’s Affordable Health Choices Act:

• First, our analysis was based on specifications regarding insurance coverage that were provided by the tri-committee group and that differ in important ways from the “discussion draft” version of legislative language that was
released on June 19, 2009. The specifications that we analyzed are supposed to be reflected in the draft language released by the three committees today, but we have not yet been able to analyze that language to determine whether it conforms to those specifications. Our review of that language could have a significant effect on our analysis. More generally, as our understanding of the specifications improves, that also could affect our future estimates.

• Second, some effects of the proposal have not yet been fully captured in our analysis. In particular, we have not yet estimated the administrative costs to the federal government of implementing the specified policies, nor have we
accounted for all of the proposal’s likely effects on spending for other federal programs. We expect to include those effects in the near future, but we also  expect that they will not have a sizable impact on our analysis.

• Third, the budgetary information shown in the attached table reflects many of the major cash flows that would affect the federal budget as a result of implementing the specified policies, and it provides our preliminary assessment of the proposal’s net effects on the federal budget deficit (subject  to the caveats listed above). Some additional cash flows would appear in the budget—either as outlays and offsetting receipts or outlays and revenues—but would net to zero and thus would not affect the deficit. CBO and the JCT staff have not yet estimated all of those cash flows but expect to do so in the near future.2 Those additional cash flows would include the premiums collected by the public plan and its outlays as well as risk-adjustment transfers from plans with relatively healthy enrollees to plans with relatively unhealthy enrollees.

The Requirements:

The proposal’s major provisions—including the establishment of an individual mandate to obtain insurance, an expansion of eligibility for the Medicaid program, and the creation of new insurance exchanges through which certain people could purchase subsidized coverage—would be implemented beginning in 2013.

All legal residents would be required to enroll in a health insurance plan meeting certain minimum standards or face a tax penalty (described below). Individuals not required to file a tax return would be exempt from the penalty; exemptions for hardship and other  reasons would be determined by a new and independent federal agency overseeing the health insurance exchanges (also described below).

The penalty assessed on people who would be subject to the mandate but did not obtain insurance would equal 2.5 percent of the difference between their adjusted gross income (modified to include tax-exempt interest and certain other sources of income) and the tax filing threshold. The amount of the penalty could not exceed the national average
premium for plans offered in the exchanges.

New health insurance policies sold in the individual and group insurance markets would be subject to several requirements regarding their availability and benefits. Insurers would be required to issue policies to all applicants and could not limit coverage for people with preexisting medical conditions. In addition, premiums for a given plan could not vary because of enrollees’ health but could vary because of their age by a factor of two (under a system known as adjusted community rating). Individual policies that were purchased before 2013 and maintained continuously thereafter would be “grandfathered,” meaning that they would not have to conform to the new rules but would still fulfill the individual mandate. Existing group policies would have to conform to the new rules by
2017.

In order to fulfill the individual mandate, policies that were not grandfathered would have to cover a broadly specified minimum benefit package (which was assumed to have the same scope of benefits as seen in a typical employer-sponsored plan) and would have to have a minimum actuarial value of 70 percent and a limit on out-of-pocket costs no
greater than $5,000 for individual coverage and $10,000 for family coverage. (A health insurance plan’s actuarial value reflects the share of costs for covered services paid by the plan.) After 2013, the maximum levels of those out-of-pocket caps would be indexed to general inflation.

The proposal would establish a national exchange through which certain individuals and employers could purchase health insurance; states could also opt to operate their own exchanges (either one per state or one covering several states). All insurance plans sold  through an exchange would be required to cover the “basic” benefit package described above. “Enhanced” plans would have an actuarial value of 85 percent, and “premium” plans would have an actuarial value of 95 percent.

Except as specified below, individuals and families who enroll in exchange plans and have income between 133 percent and 400 percent of the federal poverty level (FPL) would be eligible for premium subsidies and cost-sharing subsidies (see table below).

Federal premium subsidies in a given area would be tied to the average premium of the three lowest-cost plans providing basic coverage in the exchange in that area. The subsidies would limit an enrollee’s contribution to a percentage of income ranging from 1.5 percent to 11.0 percent (see table); those caps would not be indexed over time. The federal government would fully fund cost-sharing subsidies, which would increase the actuarial value of enrollees’ coverage to specified tiers based on income.

Say goodbye to your freedoms folks. Because in a socialist society. You have none, at all.

Besides all that, how the hell are we going to pay for all this? Seeing our Economy is in the toilet and all. Stupid is, stupid does, I guess. :struggle: :silly:

Update: Ed Morrissey, As always, does a bang up job analyzing this new Bill and as I suspected; There’s some crap in it. :pissedoff: