To help you all out, here is what was voted on:
http://docs.house.gov/rules/hr4872/111_hr3590_engrossed.pdf
It opens a 2,409 page PDF. I haven't read this.
Here is what I understand about this:
To start, how insurance
works worked in the US:
Currently, I can buy insurance through my employer so that my monthly premiums are paid for out of my pay check before taxes are taken out. In essence I get a tax bonus for having insurance through my employer. This pre-tax deal cannot be done if you buy insurance on your own. And you cannot buy insurance outside of your own state, or the state your employer resides in (my insurance comes from Blue Cross Blue Shield of New Jersey).
Now, I have options that can cover me from anywhere between 80% and 100% (what I have due to my heart condition). Which plan I take determines my monthly premiums. Mine is expensive, but it is far cheaper than paying 20% of any one of my heart procedures.
But, I also have a family. I can buy insurance that just covers me, or pay a little more to cover my wife and myself, or pay a more to cover any children. Upgrading from 1+spouse to a family plan is expensive, but it does not change if you have more kids.
When one of us sees a doctor we pay a copay of about $30, and something similar for prescription drugs, although I can get a 3 month supply of my heart medicines for as cheap as $4 per medicine.
My heart condition is covered because Kentucky law states that as long as the condition was covered without fail in the past it must be continued. So, I have not fallen victim to the pre-existing condition issues that many bring up. But then I have always made sure to have some kind of coverage, even if minimal. I know a lot of people at my work that failed to do this because either A) they didn't want to pay for it (their fault) or B) they didn't know diabetes (for example) was considered a pre-existing condition (duh).
I have little sympathy for those that did not know how the system works, or didn't research to see how they were affected. My knowing is why I had the paperwork to add my daughter filled out before she was born and just had to fax a copy of the birth certificate to my human resources department so they could fill in the birth date details. Essentially, if it wasn't discovered at her delivery check-up, it is covered. She was given a clean bill of health at birth.
I should also add that if it changed and the only way to cover my pre-existing condition was to pay more, I would understand and accept that.
How I understand things will change.
First, pre-existing conditions are no longer allowed to be denied coverage. This is why I should support this reform. My signature quote is why I do not.
Here is the rest of what the White House statement says will happen this year.
http://www.whitehouse.gov/blog/2010/03/21/reform-begins-now
This year, thousands of uninsured Americans with pre-existing conditions will have the opportunity to purchase quality, affordable health insurance. Beginning in 2010, small business owners will no longer be forced to choose between offering health care and hiring new employees because they’ll be offered tax credits of up to 35 percent of premiums to help insure their employees. Medicare beneficiaries will no longer wonder how they’ll afford their prescription drug bills because they’ll be given a rebate of $250 if they hit the prescription drug donut hole in 2010. And early retirees will be provided help through the creation of a temporary re-insurance program to help offset the costs of expensive premiums.
This year, you will now have the security of knowing that insurers cannot deny coverage to your child because of a pre-existing condition. You won’t have to live every day in fear of having your insurance taken away from you if you get sick. And for new plans, there won’t be lifetime or restrictive annual limits on the amount of care you receive from your insurance companies.
Of course, it leaves out that there are also tax increases this year on those making above a certain amount of money. In other words, any US members here that make above whatever the cut-off line is will cover my heart condition if I lose my job. I apologize to them. That is not your responsibility to bear.
Ongoing, there will be a mandate that unless you make below a certain amount each year (that is how the poor don't get hurt by the fine Famine) you have to have an insurance policy for yourself, and any dependents. So, if I covered myself, but not my perfectly healthy daughter, I still pay a fine. Also, employers who pay over so much in payroll every year have to provide a plan, which meets the new minimum standard of coverage, or also face a fine.
And insurance plans will have new regulations, requiring they cover so much, like the pre-existing coverage deal. I am unsure how they will do this and meet the promise of cheaper insurance without some form of price controls in place, so I have to assume that is there, or it is subsidized with taxes.
Either way, I am unsure how they are supposed to promise lower costs with better care unless there is a lot of subsidizing going on.
There is also a tax on what they are calling Cadillac tax plans. These are plans that have premiums, paid by employee and employer, over $8,500 for a single plan and $23,500 for a family plan. I believe I fall into this category, but I don't know since I can't see what my employer pays. But based on what I can see it looks like I might fall under that. That tax is supposedly going to be 40% of the exceeded amount. I don't get this. Well, I get that it punishes rich people for buying better insurance, but it is also a punishment for employers or employees who take an active roll in ensuring they have the best coverage.
As for deficit reduction, the Congressional Budget Office (CBO) predicts deficit reductions over 10 years, and can only say they expect similar reductions in the next decade, but note that it is too far out to assume the details and economic factors affecting how people buy insurance will change.
My personal thought is that the government won't quit tweaking the reform until it is more costly.
My overall opinion on this thing is that I will benefit from this, but it will be at a cost I am not willing to pay. This will reduce the freedom of those who are healthy, and force them to help pay for me. President Obama is correct, it is not fair to me that I was born with a heart defect. But that does not make it someone else's problem. It is one thing to provide coverage for those few who cannot take care of themselves at all, it is a wholly different thing to take care of me when I can drive to and from a middle management job every single day.
EDIT: I see Danoff's link has more updated information than I said above.
