Q&A about the Affordable Care Act (Obamacare)
The Henry J. Kaiser Family Foundation posted a quiz about the health reform law. You can see the quiz at http://healthreform.kff.org/quizzes/health-reform-quiz.aspx, but I’m just going to leap ahead and post the correct answers because there is so much disinformation out there this election year. It’s important to get the facts out.
Whether you agree with the new law or not, at least let’s talk about it using the facts. Everybody is entitled to their own opinion. Nobody is entitled to their own facts.
1. Will the health reform law require nearly all Americans to have health insurance starting in 2014 or else pay a fine?
Yes. Starting in 2014, most U.S. citizens and legal residents will be required to obtain health coverage, or pay a penalty. Some exemptions will be granted, for example, for those with religious objections or where insurance would cost more than 8% of their income.
2. Will the health reform law allow a government panel to make decisions about end-of-life care for people on Medicare?
No. No such panels exist. While early versions of the law did contain provisions that would allow Medicare to reimburse physicians for voluntary discussions with patients about end-of-life planning, these provisions were dropped from the final legislation.
3. Will the health reform law cut benefits that were previously provided to all people on Medicare?
No. The law reduces payments to the privately administered Medicare Advantage plans, but they will still be required to provide all benefits that are covered by traditional Medicare.
4. Will the health reform law expand the existing Medicaid program to cover low-income, uninsured adults regardless of whether they have children?
Yes. Medicaid will be expanded to cover nearly all individuals under age 65 with incomes up to 133% of the federal poverty level ($14,400 for an individual or $29,300 for a family of four in 2010).
5. Will the health reform law provide financial help to low and moderate income Americans who don’t get insurance through their jobs to help them purchase coverage?
Yes. Individuals without access to affordable coverage who purchase coverage through the new insurance Exchanges and have incomes up to 400% of the federal poverty level will be eligible for premium tax credits based on their income.
6. Will the health reform law prohibit insurance companies from denying coverage because of a person’s medical history or health condition?
Yes. Starting in 2014, all health insurers will be required to sell coverage to everyone who applies, regardless of their medical history or health status.
7. Will the health reform law require all businesses, even the smallest ones, to provide health insurance for their employees?
No. The law does not require employers to provide health benefits. However, it does impose penalties, in some cases, on larger employers (those with 50 or more workers) that do not provide insurance to their workers or that provide coverage that is unaffordable.
8. Will the health reform law provide tax credits to small businesses that offer coverage to their employees?
Yes. Beginning in 2010, business with fewer than 25 full time equivalent employees and average annual wages of less than $50,000 that pay at least half of the cost of health insurance for their employees are eligible for a tax credit.
9. Will the health reform law create a new government run insurance plan to be offered along with private plans?
No. The law does not create a new government-run health insurance plan. The existing Medicaid program will be expanded to cover more low-income people, government regulation of the health insurance industry will be increased, and tax credits will be provided to make private health insurance more affordable for people.
10. Will the health reform law allow undocumented immigrants to receive financial help from the government to buy health insurance?
No. Undocumented immigrants are not eligible to receive financial help from the government to buy health insurance, nor are they eligible for Medicaid or to purchase insurance with their own money in the new Exchanges.
You can download an analysis of the the quiz here: http://healthreform.kff.org/~/media/Files/KHS/Source%20general/Quiz%20Analysis.pdf
OK. Most of that’s true. But it’s a rosy picture view of a government program. Here’s the dark side. Massive hiring of federal employees to oversee this new bureaucratic juggernaut. I’ve heard as many as 16,000 IRS agents alone. Companies with 50 employees will likely do everything they can, including laying people off, to get below 50. Larger companies that don’t have unions—in other words 99 percent of the private sector—will probably at least consider dumping their employee insurance and pay the penalty. It’s chicken feed compared to the cost of employee benefits. Only a government program could be so cleverly designed to screw people at both ends. Tax credits to the poor to help them buy insurance sound like a good idea. But it’s been my experience—and I know people in poverty—that tax credits to the poor are usually burned up paying debts accrued over the previous year. One person I know receives a massive earned income tax credit every April. It’s usually all gone in a month. I predict that tax credits to the poor for health care insurance will not be used for health insurance. It’s interesting that the mandate doesn’t kick in until 2013 long after the 2012 election. That’s nice piece of sleight-of-hand by Obama because people are going to resent that tax/mandate/whatever, and he wouldn’t have a snowball’s chance of re-election after it kicks in. Finally, it’s a little specious to say this program won’t benefit illegal aliens. There are conservatively 12 million illegal aliens in the U.S. Maybe four million of them have citizen children. Figure 3 kids per family and that’s 12 million citizens who shouldn’t be here that taxpayers are going to have to subsidize. A large part of the more than $1 trillion to be spent on this program will go to the children of illegal aliens. Hope all is well in Tokyo. Happy Fourth of July.
There are negatives, but I wonder where I’d be without the new law if I wanted to move back to the U.S.
In addition to my Japanese national health insurance, I’ve had a U.S. ex-pat plan since 2001 for which I pay thousands of dollars in premiums per year, and have never made a claim – until last month.
In May, I was hospitalized for an emergency for a week with a heart problem that came on suddenly. I’m ok now, and doing diet and exercise. But the result is that I’m left with a “pre-existing condition.”
Without this new law there is no way on earth I would be able to afford a new health insurance plan in the U.S. No way.
It’s a huge problem. 60% of bankruptcies in the U.S. are because of medical debts. There are right-wingers who think people should sell their homes and businesses before getting help from the government with medical costs. It’s not humane.
I think the law is more complicated than it needed to be. It has problems, as any piece of legislature does created with compromise. But, on balance, there is more good than bad. And it’s necessary.