The open-backed medical gown

It's getting hot in here,
So take off all your clothes . . . and look to the left and cough.
Because now more of you can go get annual check-ups as part of your government-semi-mandated insurance coverage! :)

Ok. So, I have a total personal commentary blog about the health care debate, but I am going to post this one JUST in as simple terms as possible for my sister-in-law, Stacy, a self-proclaimed "not really into the political thing" person, for now, and then post my thoughts afterward. I'm going to type this like I was talking with Stacy.

Alright. According to the Congressional Budget Office, the numbers guys, there are approximately 32 million people living in America without health insurance (that's a little more than 10% of our population). With this new bill 25 million people will be required, by law, to carry some sort of minimal health insurance by the year 2014. By 2016, if you have elected to NOT have medical insurance, you will be fined ($2,085 or no more than 2.5% of your household income as your family's fee.) It's very similar to the idea of auto insurance. The money that the younger, healthier, haven't-really-needed-it-and-never-wanted-to-pay-for-it-unless-I-have-to-and-now-I-have-to generation of medical insured will help offset the costs for those who, under this new bill, CANNOT be denied health insurance because of pre-existing conditions, amongst other things.

So, out of those 25 million people who HAVE to have medical insurance, 19 MILLION of them will qualify for government subsidies (or financial aid). They figure whether you need a subsidy based on your family size and income (similar to how they figure your taxes.) If you make less money, you get more of a subsidy to help pay for your health insurance. If you make more money, you will get less of a subsidy. It's kinda like a sliding scale. As your income goes up, your help from the government to cover your medical insurance goes down. Now, if you make a bunch of money (over $250,000/year per couple) or are collecting interest and dividends on monies you have, you will pay more taxes on that sitting money AND you will have to pay more for Medicare (Part A [the hospital Medicare]). That's one reason people don't like the plan. If they make more money, they are definitely paying more money into the system for those who DON't make as much money.

The extra taxes and cutting of their Medicare for the wealthy, along with a bunch of other taxes and fees that have been enacted (i.e., new tax on expensive health insurance plans, drug manufacturers, insurance companies, and other smaller fee collections [like a 10% increase on indoor tanning tax. . . lol]) AND government monies that have been cut (like the Medicare Advantage, Home Health cuts, and certain payments to hospitals) will be where they get some of the monies they need to get this health care plan moving. IF you work full time for a company (that is over 50 employees) they must provide health insurance to you. If they don't they will be fined and if they do, but it's not enough and you qualify for a subsidy, then they have to pay into the government system $2000.00/employee for the year (first 30 employees they don't have to pay into the government system, but every full time employee after those 30, it's $2000 bucks into the system.) If they DO pay for some insurance, but it's more than 8% but less than 9.8%, this new bill would require businesses to give their employees insurance vouchers so they could go out into the marketplace to get their own insurance.

OK. SO. The marketplace is probably one of the more radical ideas of this whole concept. Shopping for medical insurance will take place in state-run EXCHANGES where individuals can shop for their family, and become part of a group (kinda like a co-op) that gets a better rate. If I understand right, it's how most of the government officials have gotten their insurance, because they have banded together and made their own bigger group. So, if you're self-employeed, or not making a ton of money, or work for a company with less than 50 employees, you can take your employer voucher or your government subsidy and check out the plans in the exchange and opt for a plan. At least a minimal plan, but each state will have 4 levels to choose from. (Bronze, Silver, Gold, Platinum). The insurance companies are now (well, in 2014) to allow the same rates for people inside a plan and for outside a plan and all plans must be "in the interest" of the people. The theory is this bill will inject competition into the medical insurance field, so even the average guy who's been paying for his own insurance can get a better deal on the exchange. The bill also expands the coverage of Medicaid so they can cover more people in the government's program if it's necessary. ALL of the subsidies and appeals about qualification as well as oversight of the state exchanges will be part of the Department of Health and Human Services. It's already a government department, they just got a whole bunch more responsibilities in their laps.

So, when is all this going to happen? Like, SHAZAM? No. The bill was passed by the House, and now the Senate and the House will go back and forth working out the terms. Plus, there's 2 more elections before it's supposed to go into action. One of the reasons people have been upset that this was being "pushed" through was because there's a Democratic majority and so, the chances of it passing were REALLY good, especially since, in these times, most all major decisions are decided by party lines [which I will get more into when I have my say on the next post.] Another reason for people getting more upset is that they're mandating that we HAVE to have insurance . . . [again, later I can talk about that.] There has been some issues (quite a lot, actually) about this new bill allowing money from the federal government to be used to fund abortions. It's one of the reasons why they weren't sure the bill would pass because several of the Democrat representatives wouldn't vote for it UNTIL President Obama signed an executive order specifically stating that no federal monies would be used to fund abortions. What we have now is that there canNOT be any lifetime caps OR annual caps on existing health coverage. SO, if you get really sick, you can't be kicked off your insurance for using up too much money. Children cannot be excluded from insurance coverage for pre-existing conditions and can stay on their parents insurance until they're 26, guaranteed by this bill. Until the "exchange" program is available (in 2014) there will be a temporary "high risk" National plan that's available for some, and a credit available to senior who fell into the "gap" of the Medicare prescription plans. Also, effective immediately, businesses that already offer insurance to their employees will recieve tax credits of up to 50% of their premium costs (that's a big plus to businesses.)

Is this the answer? I do not think it's the complete answer. I can see where there is a lot of wiggle room for the plan to work one way for the good of the people and another for the tighter control by government . . . but that gets all too personally motivated for me, to keep it simple, so I will have to talk about that next.

Hope this helps, Stac.