Health Plan

Here is the President's health care plan. What do you think?



Health Care 101: A Primer On Obama’s Bill

It took lawmakers a year to shape President Obama’s health care bill. If it finally passes Congress, it’ll take a decade to write the user manual for consumers and doctors, employers and insurance companies. Some health insurance consumer protections would go into place immediately, while others would be phased in. The big expansion in coverage comes in four years. About 25 million people would sign up, with most getting tax credits to help pay premiums. But even if the 2,700-plus-page bill passes, it’s only the end of the beginning. The House is expected to vote on the final legislation this week, with the Senate to follow later. Here’s some things you should know about the bill.

Immediate Changes:
· Uninsured people with medical problems will have a workable alternative. The bill pumps $5 billion into high-risk insurance pools run by the states to provide coverage to those with preexisting conditions. Taxpayer-backed insurance won’t be free, but premiums should be much lower than what’s charged by private insurers.

· For people with private health insurance – about two-thirds of Americans – there would be some new safeguards. For example, insurers would be barred from placing lifetime dollar limits on coverage and from canceling policies except in cases of fraud. Children could stay on their parents’ coverage until age 26.

The Self-Employed:
· Starting in 2014, self-employed people and those whose employers don’t offer coverage would be able to pick a plan through a health insurance exchange. It’s modeled on the federal employee health program available to members of Congress, with a range of private plans. Small businesses could join also.

· About 25 million would buy coverage through state exchanges, and nearly 60% would be eligible for help with their premiums. The new tax credits would be computed according to income. The money would go straight to the insurer. For example, a family of four making $44,000 would pay $2,763 in premiums for a policy worth $9,345. But a similar family making $66,000 would have to pay $6,257 in premiums.

· People with employer-provided insurance would not see major changes. But if they lost their job, they’d be able to get coverage through the exchange.

Doctors:
· Primary care doctors and general surgeons practicing in underserved areas such as inner cities and rural communities would get a 10% bonus from Medicare. But the more significant changes for doctors would unfold slowly. The goal is to start rewarding doctors for keeping patients healthy, not just treating them when they get sick.

· The plan would use Medicare as a testing ground for new ways of coordinating care for patients and multiple chronic illnesses such as high blood pressure, diabetes and heart problems. Primary care doctors would become care managers for such patients, keeping close tabs on medications and basic health indicators.

Employers:
· Obama’s plan wouldn’t require employers to provide insurance to their workers, but it would hit them with a stiff fine if even one of their workers gets a federally subsidized coverage. Companies with 50 or fewer workers would be exempt, and those with 25 workers or less could get federal assistance.

· But the fines could turn into a big headache for many employers, particularly since they may not be able to tell if their workers are getting benefits from the government. For example, a company with 100 employees that fails to provide coverage could face a fine of $140,000 under the plan Obama unveiled on February 22nd.

Insurance Companies:
· Health insurance companies would face federal regulation and particularly close scrutiny of their bottom line. A lot of Americans were furious when they found out that CEOs of the country’s largest insurance companies made millions of dollars, while at the same time complaining about the company not profiting. Under Obama’s plan, a fixed percentage of income from premiums would have to go to medical care, otherwise insurers would be forced to provide rebates for consumers. That share is 85% for large group plans, and 80% for plans in the small group and individual markets.

· One of the central reforms of the bill won’t start until 2014, when the exchanges open. From then on, insurers will not be able to turn away people with medical problems or charge them more.