# Health Care Bill: What does it entail? **URL:** \ **Category:** Factual Questions\ **Created:** [March 22, 2010, 4:05am UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305 "2010-03-22T04:05:39Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\ **Post date:** [March 22, 2010, 5:45pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/21 "2010-03-22T17:45:35Z")
> [@The\_Great\_Philosopher](#): > > The majority of Republican criticism has been disingenuous at best and false at worst. [Moderating] Just a reminder to stick to factual information, please, and refrain from political commentary. Colibri General Questions Moderator ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [March 22, 2010, 5:56pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/22 "2010-03-22T17:56:42Z")
> [@The\_Great\_Philosopher](#): > > No.. you’re right that a lot of the major provisions don’t take effect until 2014 but there’s a bunch of stuff that kicks in this year as well. […] **there will be $250 tax rebates for anyone in the "doughnut hole**",… Bolding added This is the part I’m wondering about. You say “rebates”, what exactly are they? Deductions, credits, or refundable credits? Also, it’s only when they file there taxes? Do you know if they have to itemize? ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [March 22, 2010, 6:05pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/23 "2010-03-22T18:05:45Z")
If a person is required to purchase health insurance, but does not do so, for how many years can the person be fined, and if after so many years of fines the person still does not purchase health insurance, what happens? ---
**Author:** ![Dag\_Otto](https://avatars.discourse-cdn.com/v4/letter/d/439d5e/32.png) [@Dag\_Otto](https://boards.straightdope.com/u/Dag_Otto)\ **Post date:** [March 22, 2010, 6:07pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/24 "2010-03-22T18:07:13Z")
> [@The\_Great\_Philosopher](#): > > Republicans question these figures for reasons which I don’t find very convincing - I can explain them a bit if you like. I’d be interested, if you care to open another thread. ---
**Author:** ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)\ **Post date:** [March 22, 2010, 6:28pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/25 "2010-03-22T18:28:38Z")
> [@The\_Great\_Philosopher](#): > > 1. **Cost-saving measures** : Finally, a separate problem for the US health care system is that in its current form its spending is unsustainable. Health spending is skyrocketing and entitlement programs, in particular Medicare, will bankrupt the country within about 70 years unless they are significantly reformed. The bill includes a lot of small-scale trial programs to try and save costs, the idea being that we can see what works and what doesn’t on a small scale, and then take what works and expand it later. These measures include an excise tax on ‘Cadillac plans’, a Medicare commission and ‘bundling payments’, where doctors get paid once for someone’s total treatment, rather than at present where they get paid per treatment or scan they recommend, encouraging needless treatments. A) Is savings on the cost to entitlements actually saving cost? In other words I thought the idea was to make procedures (drugs and treatments themselves) more affordable for everyone. Other than the “bundling” there seems little to address actual cost and even in that case there look to be a fair number of loopholes. B) To give the devil (Republicans) his due, one of the bones they wave the most around here is that nothing in this includes any real tort reform; something many in all the various parties feel is needed to really make any difference in health care costs. So I may not agree with them in general or about this particular bill but I can see where they are coming from in not supporting it. ---
**Author:** ![Tom\_Tildrum](https://avatars.discourse-cdn.com/v4/letter/t/e95f7d/32.png) [@Tom\_Tildrum](https://boards.straightdope.com/u/Tom_Tildrum)\ **Post date:** [March 22, 2010, 6:49pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/26 "2010-03-22T18:49:13Z")
> [@Muffin](#): > > If a person is required to purchase health insurance, but does not do so, for how many years can the person be fined, and if after so many years of fines the person still does not purchase health insurance, what happens? My recollection is that there was no enforcement or sanction mechanism provided for the fine, but that may have changed in later versions of the bill. ---
**Author:** ![Rigamarole](https://avatars.discourse-cdn.com/v4/letter/r/77aa72/32.png) [@Rigamarole](https://boards.straightdope.com/u/Rigamarole)\ **Post date:** [March 22, 2010, 6:55pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/27 "2010-03-22T18:55:54Z")
There’s no cap on rates though right? So what’s to stop an insurance company from saying, “Sure, we’ll offer you coverage even though you have cancer. Your premiums will be $500,000/month”? ---
**Author:** ![Sister\_Vigilante](https://avatars.discourse-cdn.com/v4/letter/s/9de0a6/32.png) [@Sister\_Vigilante](https://boards.straightdope.com/u/Sister_Vigilante)\ **Post date:** [March 22, 2010, 6:56pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/28 "2010-03-22T18:56:18Z")
Just a quick aside: Where I live 30 hours a week or more qualifies as full time. I’m also curious as to what time this will actually be put into place. Now? Years from now? If I suddenly get really sick, can my insurance company still drop me at present? ---
**Author:** ![Rigamarole](https://avatars.discourse-cdn.com/v4/letter/r/77aa72/32.png) [@Rigamarole](https://boards.straightdope.com/u/Rigamarole)\ **Post date:** [March 22, 2010, 6:59pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/29 "2010-03-22T18:59:27Z")
> [@Sister\_Vigilante](#): > > If I suddenly get really sick, can my insurance company still drop me at present? Yes. The pre-existing condition thing for all adults doesn’t go into effect until 2014. ---
**Author:** ![StuffLikeThatThere](https://avatars.discourse-cdn.com/v4/letter/s/bc8723/32.png) [@StuffLikeThatThere](https://boards.straightdope.com/u/StuffLikeThatThere)\ **Post date:** [March 22, 2010, 7:06pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/30 "2010-03-22T19:06:38Z")
> [@Rigamarole](#): > > There’s no cap on rates though right? So what’s to stop an insurance company from saying, “Sure, we’ll offer you coverage even though you have cancer. Your premiums will be $500,000/month”? In the state of Ohio, this is the current situation. There’s some law that says coverage must be available, but there are no cost caps. I have thyroid cancer. We nearly lost coverage last year, and had to shop private insurance. There is only one group in the state that will accept me, and they want $2250/month for premiums with a $7500 deductible. Other states (Illinois, I believe) have high-risk pools where people who have been denied coverage by traditional plans can get insured. There are premiums, but they are more in line with what you’d usually see, and the plan is run by the state. I believe a national high risk pool is/was under discussion to help people like me. I do not know that status of that issue. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [March 22, 2010, 7:09pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/31 "2010-03-22T19:09:38Z")
> [@Rigamarole](#): > > There’s no cap on rates though right? So what’s to stop an insurance company from saying, “Sure, we’ll offer you coverage even though you have cancer. Your premiums will be $500,000/month”? > [@StuffLikeThatThere](#): > > In the state of Ohio, this is the current situation. There’s some law that says coverage must be available, but there are no cost caps. I have thyroid cancer. We nearly lost coverage last year, and had to shop private insurance. There is only one group in the state that will accept me, and they want $2250/month for premiums with a $7500 deductible. > > Other states (Illinois, I believe) have high-risk pools where people who have been denied coverage by traditional plans can get insured. There are premiums, but they are more in line with what you’d usually see, and the plan is run by the state. > > I believe a national high risk pool is/was under discussion to help people like me. I do not know that status of that issue. The new bill makes it illegal for health insurance companies to set rates based on pre-existing conditions. From [here](http://www.gather.com/viewArticle.action?articleId=281474978121489): > [@](#): > > “Insurers will be prohibited from denying coverage or setting rates based on gender, health status, medical condition, claims experience, genetic information, evidence of domestic violence, or other health-related factors,” according to the summary. “Premiums will vary only by family structure, geography, actuarial value, tobacco use, participation in a health promotion program, and age (by not more than three to one).” ---
**Author:** ![The\_Great\_Philosopher](https://avatars.discourse-cdn.com/v4/letter/t/3ec8ea/32.png) [@The\_Great\_Philosopher](https://boards.straightdope.com/u/The_Great_Philosopher)\ **Post date:** [March 22, 2010, 7:27pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/32 "2010-03-22T19:27:21Z")
> [@kopek](#): > > A) Is savings on the cost to entitlements actually saving cost? In other words I thought the idea was to make procedures (drugs and treatments themselves) more affordable for everyone. Other than the “bundling” there seems little to address actual cost and even in that case there look to be a fair number of loopholes. It depends what you mean by ‘savings’ and ‘cost’. This [Politifact article](http://www.politifact.com/truth-o-meter/statements/2009/dec/18/barack-obama/obama-said-health-care-reform-will-reduce-cost-hea/) goes through the 3 main options very well. In terms of reducing costs for individual people (which seems to be what you’re talking about), the CBO estimated that the Senate bill would slightly reduce people’s premiums, on average by about 3%. Some people buying on the individual markets might pay up to 10 to 13% more in premiums than they do now, although the coverage they get from those plans will also be much better because of the new minimum standards (they’d pay more right now to get those same plans than they would when the bill kicks in). Plus the bill expands Medicaid and offers new subsidies for a lot of people to help them afford insurance. So yes, it does slightly reduce personal costs for individuals, while also expanding health coverage, reducing the deficit and slowing inflation in national health care spending, which personally I think is an impressive achievement. > [@](#): > > B) To give the devil (Republicans) his due, one of the bones they wave the most around here is that nothing in this includes any real tort reform; something many in all the various parties feel is needed to really make any difference in health care costs. So I may not agree with them in general or about this particular bill but I can see where they are coming from in not supporting it. Unfortunately this is more of a clever trick by Republicans than an actual criticism of the bill. Democrats repeatedly and publicly expressed their willingness to include tort reform in the bill, including Obama himself numerous times, such as back in September and at the Republican retreat in Maryland in January. But Republicans, as Mitch McConnell has admitted, made the decision a long time ago that they would not be voting for the bill, full stop. McConnell said this is because he doesn’t like the fundamental structure of the bill - I suspect it also had to do with the fact that it’s Obama’s signature domestic initiative - but either way, it’s not because of tort reform. If Republicans wanted to they could’ve had tort reform put in the bill in a heartbeat. They chose not to compromise when Democrats offered it to them, then criticized Democrats for not compromising on it! I suppose it’s clever in a way. More to the point though, it’s not true that tort reform is needed to “really make any difference” to healthcare costs. Tort reform actually [wouldn’t make much difference](http://www.huffingtonpost.com/matt-osborne/tort-reform-is-a-red-herr_b_282754.html). In 2005 the CBO estimated that tort liabilities account for 0.5% of healthcare spending at most, probably a lot less, and the value of torts as a proportion of GDP has actually fallen over the last couple of decades. Numerous studies in states in that link showed no correlation between falling tort liabilities and premium levels. Tort reform is probably something worth doing, but as far as lowering healthcare spending goes, it’s not that important. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [March 22, 2010, 7:32pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/33 "2010-03-22T19:32:01Z")
> [@The\_Great\_Philosopher](#): > > It depends what you mean by ‘savings’ and ‘cost’. This [Politifact article](http://www.politifact.com/truth-o-meter/statements/2009/dec/18/barack-obama/obama-said-health-care-reform-will-reduce-cost-hea/) goes through the 3 main options very well. In terms of reducing costs for individual people (which seems to be what you’re talking about), the CBO estimated that the Senate bill would slightly reduce people’s premiums, on average by about 3%. **Some people buying on the individual markets might pay up to 10 to 13% more in premiums than they do now, although the coverage they get from those plans will also be much better because of the new minimum standards** (they’d pay more right now to get those same plans than they would when the bill kicks in). Plus the bill expands Medicaid and offers new subsidies for a lot of people to help them afford insurance. So yes, it does slightly reduce personal costs for individuals, while also expanding health coverage, reducing the deficit and slowing inflation in national health care spending, which personally I think is an impressive achievement. > > snip… I buy on an individual market right now - a HDCP in conjunction with my HSA. Anyone have any more current info on how HSA/HDCP would be affected? It looks like, based on the minimum coverage requirement and the cap on deductibles, my HSA/HDCP is kaput. I’m sure it won’t be a problem to find the $7400 extra a year I’ll need when I go back on hubby’s plan…☹ ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [March 22, 2010, 8:18pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/34 "2010-03-22T20:18:40Z")
> [@Sister\_Vigilante](#): > > If I suddenly get really sick, can my insurance company still drop me at present? > [@Rigamarole](#): > > Yes. The pre-existing condition thing for all adults doesn’t go into effect until 2014. You are correct about pre-existing, but I read the Sister’s question as about ‘rescission’. From the House PDF linked above: “5. ENDS RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.” ---
**Author:** ![The\_Great\_Philosopher](https://avatars.discourse-cdn.com/v4/letter/t/3ec8ea/32.png) [@The\_Great\_Philosopher](https://boards.straightdope.com/u/The_Great_Philosopher)\ **Post date:** [March 22, 2010, 10:55pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/35 "2010-03-22T22:55:38Z")
> [@Rigamarole](#): > > There’s no cap on rates though right? So what’s to stop an insurance company from saying, “Sure, we’ll offer you coverage even though you have cancer. Your premiums will be $500,000/month”? Under the healthcare reform bill, starting in 2011, insurance companies are legally required to spend 80% of premium revenue on medical care. There will be a rate review system in place to check and enforce this rule. If the insurance companies jack up their rates and can’t provide medical receipts justifying it, they will have to rebate the extra money they took in premiums back to the enrollee. Plus, I’m not sure about this, but I think the prohibition on discriminating based on medical history (apart from smoking) means that insurers wouldn’t be able to find out that you have cancer before offering you coverage. Anyone know whether this is right? ---
**Author:** ![The\_Great\_Philosopher](https://avatars.discourse-cdn.com/v4/letter/t/3ec8ea/32.png) [@The\_Great\_Philosopher](https://boards.straightdope.com/u/The_Great_Philosopher)\ **Post date:** [March 22, 2010, 11:08pm UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/36 "2010-03-22T23:08:10Z")
> [@Rigamarole](#): > > There’s no cap on rates though right? So what’s to stop an insurance company from saying, “Sure, we’ll offer you coverage even though you have cancer. Your premiums will be $500,000/month”? In fact, I’ve looked at the provisions again, and there is indeed a restriction on premium increases. Insurance companies are not allowed to increase rates for someone because of a pre-existing condition, medical history, gender, family or occupation. They are allowed to increase rates because of age or smoking, but the increases in those cases are limited to 3:1 and 1:1.5 respectively. I’m still not sure whether the insurance company would know you had cancer in advance, but either way it will be illegal for them to raise premiums because of it. ---
**Author:** ![Visual\_Purple](https://avatars.discourse-cdn.com/v4/letter/v/5daacb/32.png) [@Visual\_Purple](https://boards.straightdope.com/u/Visual_Purple)\ **Post date:** [March 23, 2010, 12:46am UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/37 "2010-03-23T00:46:41Z")
> [@Sateryn76](#): > > Under this bill, the amount your employer pays for your insurance is going to be included in your W2 starting next year. Is it safe to assume that this will then be included in your income, and therefore subject to income taxes? So called “Cadillac” policies will be subject to an excise tax. However, nothing I see makes the employer payment otherwise taxable. I suspect the W-2 requirement is more to make visible the extent to which employer money is going to health care and to alert employees if they are approaching excise tax level. ---
**Author:** ![The\_Great\_Philosopher](https://avatars.discourse-cdn.com/v4/letter/t/3ec8ea/32.png) [@The\_Great\_Philosopher](https://boards.straightdope.com/u/The_Great_Philosopher)\ **Post date:** [March 23, 2010, 4:16am UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/38 "2010-03-23T04:16:35Z")
> [@Sateryn76](#): > > I buy on an individual market right now - a HDCP in conjunction with my HSA. Anyone have any more current info on how HSA/HDCP would be affected? > > It looks like, based on the minimum coverage requirement and the cap on deductibles, my HSA/HDCP is kaput. I’m sure it won’t be a problem to find the $7400 extra a year I’ll need when I go back on hubby’s plan…☹ I don’t know about your plan specifically, but there’s two provisions I’ve head about that might be relevant: firstly [Politifact](http://www.politifact.com/truth-o-meter/statements/2010/feb/25/barack-obama/obama-says-under-democratic-health-plan-family-ins/) seems to claim that people who currently have plans on the individual market can ‘grandfather’ them in - i.e. keep them beyond 2014, even if they do not meet the minimum requirements. Secondly, 57% of people buying in the individual market will be eligible for subsidies. The subsidies are tied to income: At 100 to 133 percent of poverty, anyone in the exchanges they will pay up to 2 percent of income. From 133 percent to 150 percent, they’ll pay 3-4 percent. From 300 percent to 400 percent of poverty it goes up to 9.5 percent of income. The poverty threshold varies depending on how many kids you have, but [here’s a list](http://en.wikipedia.org/wiki/Poverty_in_the_United_States#Recent_poverty_rate_and_guidelines) of the thresholds from Wiki. ---
**Author:** ![Cyberhwk](https://avatars.discourse-cdn.com/v4/letter/c/7993a0/32.png) [@Cyberhwk](https://boards.straightdope.com/u/Cyberhwk)\ **Post date:** [March 23, 2010, 4:51am UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/39 "2010-03-23T04:51:48Z")
OK, so how is this going to work for me? I currently only make about $24K a year, but I’m a 27 year old single male with no family. My employer doesn’t offer any coverage but I have my own $7,500 deductible policy. [LA Time Chart](http://www.latimes.com/features/health/la-na-healthcare-passage22-2010mar22-html,0,3934537.html) Right know I have coverage so it says I’ll be eligible to purchase it on the exchange. However at the “Unemployed” it says my max “Out of Pocket” will be ~$1,800 (I’m assuming the function is constant). My point is I pay a mere $924 a year now because I have a bare bones policy with a high deductible. But that’s only my choice. I’d gladly pay more for a more robust policy, it was just a waste of money before the rescission guarantees. Could I use the subsidy to do just that? $1,800 is $150 a month. I use that and buy the most bitchin policy I can find? I’d GLADLY pay double what I am for a 90/10, no-deductable, drug coverage, etc. policy? I’m assuming the fact that I both qualify for the subsidy and already have coverage doesn’t automatically DQ me from eligibility for the subsidy. ---
**Author:** ![kayT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayt/32/3633_2.png) [@kayT](https://boards.straightdope.com/u/kayT)\ **Post date:** [March 23, 2010, 5:05am UTC](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305/40 "2010-03-23T05:05:44Z")
**Cyberhwk** your LA Times link is no good. Do you know if the article is just expired or? [Previous page](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305.md?page=1) [Next page](https://boards.straightdope.com/t/health-care-bill-what-does-it-entail/533305.md?page=3)