Health Reform Timeline Complicated, Ambitious
- By admin aapc
- In CMS
- March 30, 2010
- 22 Comments
The health care reform bill and its accompanying reconciliation package are complicated and include an ambitious timeline. USA Today provides an interactive timeline that boils down the 2,700-plus pages into easy-to-understand dates. While many provisions start in 2010 (including an immediate tax on tanning salons), various provisions won’t kick in until 2018.
According to the USA Today article, here are revision dates that will impact everyone:
2010
- Temporary high-risk insurance pool: A $5 billion pool would be created in June to provide health to individuals who have pre-existing conditions and have been uninsured for at least six months.
- Pre-existing conditions: Insurers will be barred beginning September from denying coverage to children who have pre-existing medical conditions.
- Adult dependent children: Insurers will have to provide coverage for adult dependent children up to 26 years old beginning September.
- Insurance coverage limits: Payers would be prohibited beginning September from placing lifetime limits on how much they pay out to individual policyholders and from rescinding coverage except in cases of fraud.
- Preventive services: Insurance companies will be required to cover preventive services such as immunizations and cancer screenings for women beginning September.
2011
- Medicare Part D “doughnut hole” filled: Beginning New Year’s Day, drug companies would provide a 50 percent discount on brand name drugs for seniors who face a gap in coverage.
- Primary care boost: Primary care physicians and general surgeons who practice in areas lacking primary care doctors would receive a 10 percent bonus payment from Medicare beginning Jan. 1 and ending 2015.
- Help for long-term care: A voluntary long-term care program called CLASS, beginning Jan. 1, would allow subscribers, after five years of contributions, to get a $50 per day cash benefit to help pay for long-term care.
- Rebates from payers: Beginning Jan. 1, insurers would be required to provide rebates to enrollees if they spend less than 85 percent of their premium dollars on care as opposed to administrative costs.
2013
- Health savings accounts: A national contribution limit of $2,500 to tax free accounts for health costs will standardize the limit. Currently, employers set the limit.
- Good and bad tax news: 1) Employees will be able to deduct 10 percent of unreimbursed medical expenses rather than 7.5 percent; BUT 2) the Medicare tax would increase from 1.45 percent to 2.35 percent on earnings over $200,000 for individuals and $250,000 for family. Medicare tax also would be imposed on investment income.
2014
- Individual mandate: Beginning Jan. 1 most Americans would be required to buy health insurance or pay fines of $95 or $285 per family or 1 percent of taxable household income, whichever is greater.
- Employer penalty: Starting the same day, employers with 50 or more employees would pay a fine if any full-time workers qualified for federal health care subsidies.
- Medicaid expansion: Medicaid will expand to include anyone under 65 whose income eligibility was up to 133 percent of the federal poverty line or $29,327 for a family of four.
- Subsidies: Also beginning New Year’s Day, federal subsidies, varying by household income, would help offset the cost of buying insurance for citizens and legal residents who qualify.
- Health insurance exchanges: State-based exchanges would offer places where uninsured individuals and small businesses could comparison shop for policies.
2015
- Individual mandate: This penalty for not carrying insurance would increase to $325 per family member and $975 per family or 2 percent of taxable household income, whichever is greater, starting Jan. 1.
2016
- Individual mandate: Penalties increase to $695 per family member (up to $2,085) or 2.5 percent of taxable household income, whichever is greater.
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Does anyone have any estimates on what they think an individual or family plan will cost in $2014?
I am very excited about this Healthcare Policy and look forward to seeing how the changes will have a positive impact on lowering the deficit and allowing everyone the right to affordable healthcare. I do believe that it will greatly reduce the healthcare deficit. Great job President Obama and the entire Administration!!! Cudos!
Healthcare does not mean that families will suddenly not be poor. I can’t imagine the burden on some households where they truely cannot afford to spend any extra money for healthcare. The threat that their own government could impose such ridiculous fines is beyond comprehension. Medicare and Medicaid can be a nightmare for physicians, coders, billing and office staff. I can’t imagine what the healthcare system will be like in the future, so many regulations etc. Physicians offices would be expected to comply with all regulations, even though there will be so many no one could possibly know them all. Physicians will be the bad guys. And in order to control costs to the government, services will be cut drastically, not to mention payments. Reform was an option. Overhaul should not have been.
Trina, You obviously have no idea what this plan will cost. How do you think that the currently overworked and underpaid primary care providers are going to be able to assume an additional 32 million new patients? The numbers of PCPs not accepting new patients will grow significantly and the additional burden will fall, once again, on the ER in your local hospital. How can something that is so costly be expected to reduce the healthcare deficit? Are you aware that your physician is about to take a 21% cut in Medicare reimbursement? Or that there is nothing in the HCP that encourages the use of lower cost ambulatory surgery centers for surgery? Did you know that the insurance companies are throwing out everyone they don’t want now to head off the HCP requirements that they continue to cover those patients? People who sing the praises of this plan are either misguided or die-hard democrats, which is pretty much the same thing.
In response to Diana’s question: If the government allows the insurance companies to continue their rate hikes at an average of 15% a year, you can expect to pay around $28,800 per year or $2,400 per month for family coverage in 2014. I made this calculation using a current base of $1500 month for family coverage with a standard deductible plan. Theoretically, increasing the number of participants will lower premiums, but the insurance companies need to be regulated and held accountable in order for this to happen. The other issue is there will not be enough primary care physicians to meet the increased demand as few doctors are going into primary care and many more are leaving due to reimbursement cuts. I suspect that mid-level practitioners will be given broader scope practice rights and essentially be able to work unsupervised to fill the void of physicians.
I agree with what Amber says. The other thing that people are not looking at is the fact that the more people insured, the more administrative workers are needed. Insurances for the most part are a for profit market. Premiums are to cover not only the cost of medical care for the subscribers, but also administrative and other company employees, as well as bringing in a profit. The cost is passed to the subscriber. Then add in more government regulation; providers have to add staff to make sure they are compliant with all of the regulations, IT staff to keep their EMR’s running, billers, coders, ect. This cost gets passed onto the patient. Unfortunately, a few dishonest folks in the medical field has started an expensive mess for everyone else when it comes to insurance. Going back to cash only I think would solve the mess we are currently in.
One of the big issues that government was pushing as a big improvement was that this bill would eliminate the “pre-existing” condition that many insurance companies use against many people. After reading this article, I only see that “children” are mentioned. Does anyone know if this will apply to adults also? If not, I would say that was a big exaggeration to get people behind this bill.
Hi Cheryl, I believe I read somewhere that the pre-existing condition elimination for adults will come in a later year (2018?). For now, they are just creating the high-risk insurance pool to help adults with pre-existing conditions.
If anyone thinks this will reduce the deficit, they better start thinking differently. No government program has every reduced the deficit and in fact there will be tough times ahead with a government plans as health care costs will increase, there will be policies enacted without actually putting them on paper (ie – end of life type policies to reduce costs), decisions that will benefit political beneficiaries (oh yes this will happen), reduction of services since the government will reduce medicare reimbursements to help cover the cost of this, all other insurance carriers other than government will be levied a tax to help cover the cost of healthcare (how will this keep costs down), etc.
Having lived under national health care and still involved with family living it, there are tough times coming. In Canada, an MRI takes 6-8 months to obtain, elective surgery gets canceled because there are no more discretionary funds, tests are not performed because they are too expensive, procedures are not performed because you don’t qualify under the rules, etc.
Now for how well it will be run: the feds run Medicare and that is a disaster. If you think that is good then look at the VA and the Native American Plan which have costs that far exceed the imagination.
If it appears there is bias here, you are correct as no government program is ever cheaper than a free enterprise program (and I am not just looking at healthcare). There is disgrace in the waste of government programs and favors that are provided to friends of the current political party. How does this benefit us as citizens. I believe our forefathers left their countries to get away from this and here we are buying right back into it.
Amen Mike and Sharon. Even without my thinking being as deep as yours on this issue, it total angers me that Presiden Sheriff of Nottingham is mandating the American people to pay for insurance! Who the h— does he think he is? And just like his off shore drilling allowance, he knows the people don’t want it. So I hope he doesn’t want a second term. The government just wants their paws in this because there are big bucks involved. And yes Mike, maybe we should have a funeral for free enterprise and start flying the flag of dictatorship. Hypocrisy that they hung Saddam isn’t it?
Sharon,
Why do people have to criticize democrats??? It just totally amazes me how that republicans think they have it all figured out yet, in 8 years no problems were ever solved under the republican president so what makes you think you are so much better than those “misguided” democrats?? Why didn’t your president take care of any of these issues while in office?? He helped in creating the problems we are now facing that you want to blame on the current president!
I would like to hear your solution to ALL the problems in our country. Do you think that because you are “republican” you have the answer. Could you please forward your answer to the White House?? I’m sure they would be glad to consider any suggestions you might have. Are we not Americans first??? Republican, democrat, who cares??? Lets fix these problems we are having so that the middle class doesn’t have to continuously carry this country. It’s getting pretty old!!!!!!!!!!!!!
Michelle,
Oh Please spare me. For all the eight years of our previous President there was nothing but bashing. How quickly you have forgotten. I believe the focus here was on this healthcare bill. I believe Sharon is right. With the reduction in reimbursement it leaves little incentive for medical students to go into primary care. So you’ll have fewer PCP’s and more patients resulting in PCP’s closing their practices to new patients. Now you have a longer wait to see a doctor unless you burden the ER’s. At last count this healthcare bill has created 159 new agencies….that would be government agencies, with government employees who will be expected to get paid. And since the government is not a business, the only way they make their money is to tax the people and businesses.
So just exactly who do you want to carry this country? The government? Creating a larger government is not the answer. A government big enough to do everything for you is also big enough to take everything from you. They’ve taken over part of the auto industry, banking and mortgage industry, student loans and now healthcare. What’s next? And what business has the government run successfully….Medicare, the post office, social security, your driver’s license bureau? The economy is at it’s best with free enterprise. And that I fear is slowly being taken away.
“Medicaid expansion: Medicaid will expand to include anyone under 65 whose income eligibility was up to 133 percent of the federal poverty line or $29,327 for a family of four.” This is supposed to state Medicare not Medicaid.
Sorry, I was wrong…..
It is natural that we would have differing views because our situations vary. For example, our rural clinic with 35% (and growing) Medicaid versus only 4% Medicare in our payor mix is looking forward to the change below that is included in this new law. Are there provisions that we aren’t happy with? Sure, but there are some good changes included as well.
From the Kaiser article – Primary care doctors and surgeons practicing in areas with a shortage of physicians get a 10 percent bonus payment from Medicare between 2011 to 2015. Medicaid will pay primary care doctors Medicare rates in 2013 and 2014, to coincide with the Medicaid expansion. Medicare typically pays at least 20 percent higher rates than Medicaid.
nada a routine MRI is a 30 to 142 day wait. Are you prepared to wait if it is YOUR loved one in need of an MRI?? Such delusion in thinking this reform is a good thing!!
The first part of the comment above was cut off and is: In the healthcare field as employees we need to remember we are also patients. In Canada a routine Mri is 30-142 day wait. Are you prepared to wait if YOUR loved one is in need of an MRI?? Such delusion in thinking this reform is a good thing!!
I agree with Dale. You have good rational points, unlike the highly emotional response Michelle offered. By the way Michelle, George W. Bush was the United States president not mine or yours; just as Barack Obama is our current president, not your president and Bill Clinton was our president. These are duly elected leaders and we vote them in for a time. If they do good things, they are usually re-elected, if they mess up, they are usually not. Congress makes the decisions, and the president has veto power if he/she disagrees with the recommendation of congress. That is what makes a free enterprise, representative republic, the greatest model of democracy the world has ever seen. Let’s just hope that we do not get to the point of no return regarding governmental power and a cradle to grave, womb to tomb, nanny state form of government.
I could not agree more with Mike’s comments. We need to stop playing the democrat/republican blame games! We need to stand together as Americans and be more self reliant and stop depending on government to solve our problems. I feel sorry for future generations if we stay on this path of out of control spending. God bless our great country!
I agree with Mike and Dale 100%. If anyone thinks this national healthcare system is going to be a good thing you are in store for a rude awakening. Where do you think they get this money to pay for this healthcare???? The taxpayers. I feel so badly for my 10 year old son because when he is an adult he and the rest of all our children are going to be paying big time for this horrendous mistake!!!!! It’s not about being a Republican or Democrat. It is about being an American and being smart. We do not have the billions of dollars to support this major healthcare overhaul. We are already seriously in debt to other countries….. We should be coming together instead of letting party status tear us apart. I am not a republican or a democrat. I am an Independent. At this point I do not like or trust both parties. In my opinion they are all crooks who are only out for themselves. They want us to be poor and themselves to be rich. They don’t want us to be the best that we can be, they want us to be under them and always have to depend on them. Anyway, I could go on and on. All I have to say is if you want to pay an absurd amount in taxes, have your loved ones or yourself who are sick depend on the government (because yes they will decide how to treat your problem not the doctor) then this plan is just for you. Also if Obama sold you on this healthcare as the greatest thing since sliced bread then I have a pink unicorn for sale to the highest bidder……
I agree with everyone. It is not about being a Dem or Republican. It is about health care.
We can all find something good in the bill. What did we do with healthcare before Obama?
Do you think the premiums were high? What is the estimate for future premiums? If it is the
amounts I have been reading-Who will be able to afford it? We still have many questions to answer.
I think this is just the start.
Government run healthcare will be a nightmare. How do you like the lines at the DMV? The Post Office is going bankrupt. We pay ever-increasing amounts of money in taxes to support public schools yet we have some of the highest dropout rates and illiteracy in the world. Medicare and Medicaid are going belly up, as is social security. The best run government program in the U.S. is the military, but we are cutting funding to them. I think government run health care will be different, don’t you? besides, if it is not performing well, we can always take more taxes from the rich. “There will be a time for making a profit, but that time is not now”, according to President Obama.