| Jamie Dupree |
Health Care Details
Since we don't see paper copies of bills too often anymore, there wasn't a thud when the 1,018 page health care bill from House Democrats landed in my Inbox on Tuesday afternoon.
But let me assure you, it's big. And it will probably get even bigger.
You can download the bill at http://bit.ly/nSL2A to check it out for yourself.
Some of you were nice enough to play "research team" for this correspondent, and search out a few things in the bill.
Jason read my mind by searching for provisions that would authorize spending "such sums" as may be necessary for certain sections of the bill.
There are a dozen of them:
* p. 120, to cover the start up costs of the government health insurance option
* p. 300, to pay for a study on why Medicare costs vary around the nation
* p. 404, to pay for a section on "Ensuring Effective Communication In Medicare"
* p. 610, for a study of large intrastate chains of nursing facilities
* p. 864, to increase funding for Community Health Centers between 2013-2019
* p. 869, to fund the National Health Service Corps Program for 2013-2019
* p. 892, to increase money for the Public Health Investment Fund
* p. 897, more on funding for the Public Health Investment Fund
* p. 931, "such sums" to fund a cryptic reference to public health law
* p. 1001, money to fund School Based Health Clinics for 2011-2014
* p. 1006, to fund the National Medical Device Registry
* p. 1018, to fund Grant Programs to Provide Education to Nurses
Since taxes are such a hot button issue, I thought I would also look at the tax hikes included in this bill, as a penalty for those not getting health care coverage.
You have to hand it to whoever wrote this bill, because they could have called these "penalties" or "fees" instead of taxes.
If you make $350,000-$500,000 in modified adjusted gross income, then you would be subjected to a 1% surtax;
If you make $500,000 to $1,000,000, you would be hit with a 1.5% surtax;
And if you make more than a million a year, you would see a 5.4% surtax.
After 2012, the 1% rate would go up to 2% and the 1.5% rate would double as well to 3%.
Then there is a section that is basically a "trigger" (or a gimmick as one of my colleagues labeled it) where if the feds say there has been a significant amount of savings in the health care system, those increases in the surtax rates would be waved off.
That would be made by the head of the Office of Management and Budget, which is basically the White House budget director.
They believe that recent deals cut by the White House to cut health care costs with the industry should be counted in this bill, while the Congressional Budget Office, which is the official budget arbiter, does not.
Burrowing into the bill, one interesting little section appears on what should be covered by a "qualified" health insurance plan. Here's the list:
MINIMUM SERVICES TO BE COVERED.--The items and services described in this subsection are the following:
(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department services.
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician's or a health professional's delivery of care in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.
How about who is going to be in charge of setting all of these parameters for this new government intervention into health care? That's up to the Health Benefits Advisory Committee in Section 123 of this new bill.
How many members are on that? I'm glad you asked!
- 9 members who are not federal employees appointed by the President
- 9 members who are not federal employees appointed by the Comptroller General
- An even number (not more than 8) of federal employees appointed by the President
That's no more than 26, if you are scoring at home. And they aren't on the payroll of the feds, but they do get per diem for travel and meetings.
As for the real organization in charge, that would be the newly created Health Choices Administration on page 41 of the bill, a new fully independent federal agency.
There would also be a "Health Insurance Ombudsman," who - and I'm not making up this quote - "shall, in a linguistically appropriate manner - receive complaints, grievances and requests."
Does "linguistically appropriate" mean that they guy doesn't drop the F-bomb or something in emails? Just wondering.
Then there is the section that basically has the feds subsidize the cost of providing health insurance to retirees before they are eligible for Medicare and Social Security.
One final thing on this bill for today, and that is there is not a concrete estimate on how much this measure will cost.
The estimate that was being floated was around $1.5 trillion over ten years, but there isn't anything official on that.
Stay tuned as we keep digging through this bill.
What others are saying
- NOT RIGHT!THIS SUMMARY IS WRONG!!!!!! The bill raises taxes above 350k regardless of whether the individual has health insurance to fund itself.
- THIS POSTING IS WRONG!!!!!!! The taxes are not if "you don't buy insurance", they are automatic to fund the bill and have nothing to do with whether they buy insurance
- Good JobGreat ideas researching the bill. Has this been the busiest six months of your life with the new adminstration and congress? Keep it going!
- Cost SavingsCould someone point out where the cost savings are in this bill?
- Cost SavingsCould someone point out how this bill actually saves money?
- Nice workI hear you're doing hourly hits these days and you still managed to scour this thing...kudos.
- AMT - rememberWhat happens when you are making 300,000 dollars flipping burgers because of the devalued dollar. I remember when you could by a house for $25,000.00, and now it's worth $250,000.00
So everyone in the future will have to pay for thier heath care,if things go true to form. - Linguistically AppropriateIs the phrase "linguistically appropriate" really code for "multilingual" -- to include people who don't speak English -- such as, oh, say, maybe illegal aliens?
- Huh?So, am I reading this right? If you DON'T purchase health insurance and you make over a certain amount of money, you will be subject to a tax? Where is the logic in that?
- Flow ChartHere is a link to a flow chart for the new health care bill that was put out by Congressman Kevin Brady.
http://docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf - health careKeep up the good work Jamie - I don't know what we'd do without you.
- *sigh*you could eliminate all this crap if they just handed out vouchers for the poor to purchase their own health care....
not my idea.... I just listen to Herman Cain.
bureaucracy run amok. - school based clinicsThat in itself would be like prison. I cringe as a mother that my child would have to be approved to get to the next level of medical care.
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