[Market-farming] questions about Obamacare

ecoponderosa 3cedarsfarm at gmail.com
Tue Oct 8 17:22:29 EDT 2013


> can someone direct me to a few factual, accurate,
> non-sensational websites where I can figure out what responsibilities I have
> as a small farm business owner, for complying with this new Obamacare stuff

Maybe some of this applies:

Help me understand Obamacare? (self.medicine)
http://www.reddit.com/r/medicine/comments/1nk5r4/help_me_understand_obamacare/ccjc556

Already in effect: It allows the Food and Drug Administration to
approve more generic drugs (making for more competition in the market
to drive down prices) ( Citation: An entire section of the bill,
called Title VII, is devoted to this, starting on page 747 )

It increases the rebates on drugs people get through Medicare (so
drugs cost less) ( Citation: Page 216, sec. 2501 )

It establishes a non-profit group, that the government doesn't
directly control, PCORI, to study different kinds of treatments to see
what works better and is the best use of money. ( Citation: Page 665,
sec. 1181 )

It makes chain restaurants like McDonalds display how many calories
are in all of their foods, so people can have an easier time making
choices to eat healthy. ( Citation: Page 499, sec. 4205 )

It makes a "high-risk pool" for people with pre-existing conditions.
Basically, this is a way to slowly ease into getting rid of
"pre-existing conditions" altogether. For now, people who already have
health issues that would be considered "pre-existing conditions" can
still get insurance, but at different rates than people without them.
( Citation: Page 30, sec. 1101, Page 45, sec. 2704, and Page 46, sec.
2702 )

It forbids insurance companies from discriminating based on a
disability, or because they were the victim of domestic abuse in the
past (yes, insurers really did deny coverage for that) ( Citation:
Page 47, sec. 2705 )

It renews some old policies, and calls for the appointment of various positions.

It creates a new 10% tax on indoor tanning booths. ( Citation: Page
923, sec. 5000B )

It says that health insurance companies can no longer tell customers
that they won't get any more coverage because they have hit a
"lifetime limit". Basically, if someone has paid for health insurance,
that company can't tell that person that he's used that insurance too
much throughout his life so they won't cover him any more. They can't
do this for lifetime spending, and they're limited in how much they
can do this for yearly spending. ( Citation: Page 14, sec. 2711 )

Kids can continue to be covered by their parents' health insurance
until they're 26. ( Citation: Page 15, sec. 2714 )

No more "pre-existing conditions" for kids under the age of 19. (
Citation: Page 45, sec. 2704 and Page 57, sec. 1255 )

Insurers have less ability to change the amount customers have to pay
for their plans. People in a "Medicare Gap" get a rebate to make up
for the extra money they would otherwise have to spend. ( Citation:
Page 379, sec. 3301 )

Insurers can't just drop customers once they get sick. ( Citation:
Page 14, sec. 2712 )

Insurers have to tell customers what they're spending money on.
(Instead of just "administrative fee", they have to be more specific).

Insurers need to have an appeals process for when they turn down a
claim, so customers have some manner of recourse other than a lawsuit
when they're turned down. ( Citation: Page 42, sec. 2719 )

Anti-fraud funding is increased and new ways to stop fraud are
created. ( Citation: Page 699, sec. 6402 )

Medicare extends to smaller hospitals. ( Citation: Starting on page
344, the entire section "Part II" seems to deal with this )

Medicare patients with chronic illnesses must be monitored more thoroughly.

Reduces the costs for some companies that handle benefits for the
elderly. ( Citation: Page 492, sec. 4202 )

A new website is made to give people insurance and health information.
(I think this is it: http://www.healthcare.gov/ ). ( Citation: Page
36, sec. 1103 )

A credit program is made that will make it easier for business to
invest in new ways to treat illness by paying half the cost of the
investment. (Note - this program was temporary. It already ended) (
Citation: Page 830, sec. 9023 )

A limit is placed on just how much of a percentage of the money an
insurer makes can be profit, to make sure they're not price-gouging
customers. ( Citation: Page 22, sec. 1101 )

A limit is placed on what type of insurance accounts can be used to
pay for over-the-counter drugs without a prescription. Basically, your
insurer isn't paying for the Aspirin you bought for that hangover. (
Citation: Page 800, sec. 9003 )

Employers need to list the benefits they provided to employees on
their tax forms. ( Citation: Page 800, sec. 9002 )

Any new health plans must provide preventative care (mammograms,
colonoscopies, etc.) without requiring any sort of co-pay or charge. (
Citation: Page 14, sec. 2713 ) 1/1/2013

If you make over $200,000 a year, your taxes go up a tiny bit (0.9%).
Edit: To address those who take issue with the word "tiny", a change
of 0.9% is relatively tiny. Any look at how taxes have fluctuated over
the years will reveal that a change of less than one percent is
miniscule, especially when we're talking about people in the top 5% of
earners. ( Citation: Page 818, sec. 9015 )

1/1/2014 This is when a lot of the really big changes happen.

No more "pre-existing conditions". At all. People will be charged the
same regardless of their medical history. ( Citation: Page 45, sec.
2704, Page 46, sec. 2701, and Page 57, sec. 1255 )

If you can afford insurance but do not get it, you will be charged a
fee. This is the "mandate" that people are talking about. Basically,
it's a trade-off for the "pre-existing conditions" bit, saying that
since insurers now have to cover you regardless of what you have, you
can't just wait to buy insurance until you get sick. Otherwise no one
would buy insurance until they needed it. You can opt not to get
insurance, but you'll have to pay the fee instead, unless of course
you're not buying insurance because you just can't afford it. (Note:
On 6/28/12, the Supreme Court ruled that this is Constitutional, as
long as it's considered a tax on the uninsured and not a penalty for
not buying insurance... nitpicking about wording, mostly, but the long
and short of it is, it looks like this is accepted by the courts) (
Citation: Page 145, sec. 5000A, and here is the actual court ruling
for those who wish to read it. )

Small businesses get some tax credits for two years. (It looks like
this is specifically for businesses with 25 or fewer employees) (
Citation: Page 138, sec. 1421 )

Businesses with over 50 employees must offer health insurance to
full-time employees, or pay a penalty.

Insurers now can't do annual spending caps. Their customers can get as
much health care in a given year as they need. ( Citation: Page 14,
sec. 2711 )

Limits how high of an annual deductible insurers can charge customers.
( Citation: Page 62, sec. 1302 )

Cut some Medicare spending

Place a $2500 limit on tax-free spending on FSAs (accounts for medical
spending). Basically, people using these accounts now have to pay
taxes on any money over $2500 they put into them. ( Citation: Page
801, sec. 9005 )

Establish health insurance exchanges and rebates for the lower and
middle-class, basically making it so they have an easier time getting
affordable medical coverage. Congress and Congressional staff will
only be offered the same insurance offered to people in the insurance
exchanges, rather than Federal Insurance. Basically, we won't be
footing their health care bills any more than any other American
citizen. ( Citation: Page 81, sec. 1312 )

A new tax on pharmaceutical companies.

A new tax on the purchase of medical devices.

A new tax on insurance companies based on their market share.
Basically, the more of the market they control, the more they'll get
taxed.

The amount you can deduct from your taxes for medical expenses increases.

1/1/2015 Doctors' pay will be determined by the quality of their care,
not how many people they treat.

1/1/2017 If any state can come up with their own plan, one which gives
citizens the same level of care at the same price as the PPACA, they
can ask the Secretary of Health and Human Resources for permission to
do their plan instead of the PPACA. So if they can get the same
results without, say, the mandate, they can be allowed to do so.
Vermont, for example, has expressed a desire to just go straight to
single-payer (in simple terms, everyone is covered, and medical
expenses are paid by taxpayers). ( Citation: Page 98, sec. 1332 )

2018 All health care plans must now cover preventative care (not just
the new ones). A new tax on "Cadillac" health care plans (more
expensive plans for rich people who want fancier coverage).

2020 The elimination of the "Medicare gap"


More information about the Market-farming mailing list