Doghouse(caution Politics)

By: auburn, 2:41 PM GMT on March 27, 2010

Seems the last blog got a little out of hand...so lets give this another try...pleas no personal attacks...lets try to learn from one another on here


Welcome to da Doghouse...right Clem?

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1 The Upside: If you are 26 or younger, you may be able to get insurance through your parents' policy. If you buy coverage on your own in the exchanges, you will have access to cheaper catastrophic coverage. If you buy a traditional benefits package, you will pay less than those who are older.

The Downside: Traditional insurance purchased in the exchanges may cost more than what you can buy now, but you'll have to stay covered unless you qualify for an exemption.

30 percent of Americans ages 19 to 29 are now uninsured

2 The Upside: You will receive free preventive services under Medicare. If you have Medicare prescription-drug coverage, you will pay less if you reach the coverage gap known as the doughnut hole.

The Downside: If you have a Medicare Advantage plan, your insurer may cut extra benefits or increase co-payments. Until 2019, Medicare beneficiaries earning $85,000 or more will pay higher Part B premiums.

10 million seniors are now in Medicare Advantage plans

3 The Upside: Beginning this year, if you have 25 or fewer workers, you may be eligible for a tax credit to help you buy coverage for them. By 2017, you'll be able to buy insurance for your employees through new insurance marketplaces.

The Downside: After 2014, you may be eligible for only two years of tax credits to help purchase coverage. If you employ more than 50 people, you'll have to provide benefits or pay a penalty.

50 employees is the maximum number a company can have without providing benefits and paying a penalty

4 The Upside: Companies with more than 50 employees will be required to provide coverage or face a fine, so your benefits are secure. Existing benefits packages will be grandfathered, but new plans will have to meet minimum requirements. Limits on out-of-pocket spending may keep your costs down.

The Downside: Premiums may continue to go up, and if you don't qualify for subsidies or entrance into exchanges, you may be stuck with the plan your employer chooses for you.

5 The Upside: If you are among the lowest wage earners — even if you don't have children or a disability — you will become eligible for Medicaid. And if you earn less than 400% of the poverty level — about $88,000 in 2009 — you will be eligible for subsidies to help you buy coverage.

The Downside: Even with subsidies, buying insurance may strain your budget. But you'll have to maintain coverage unless you qualify for a hardship waiver or the cheapest plans available exceed 8% of your total income.

6 The Upside: If you are among the lowest wage earners — even if you don't have children or a disability — you will become eligible for Medicaid. And if you earn less than 400% of the poverty level — about $88,000 in 2009 — you will be eligible for subsidies to help you buy coverage.

The Downside: Even with subsidies, buying insurance may strain your budget. But you'll have to maintain coverage unless you qualify for a hardship waiver or the cheapest plans available exceed 8% of your total income.

Here is a year by year list of when and what.


2010

Adults who can't get coverage because of a pre-existing medical condition can join a high-risk insurance pool (this is an interim step pending the launch in 2014 of competitive health insurance marketplaces and premium subsidies).

Insurance companies will have to issue policies for children with pre-existing conditions. They will not be allowed to revoke existing policies if people get sick. Lifetime limits on coverage will be banned in new coverage and annual limits will be restricted. Preventive services will be fully covered, with no co-pays or deductibles. Coverage will be available for dependent children until they turn 26.
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PD toolbar!

People in the Medicare prescription drug program will receive a $250 rebate as the first step in closing the coverage gap, or "doughnut hole," that requires them to pay full freight after they have spent $2,700 on drugs. The gap would be phased out entirely by 2020.

Certain small businesses will start getting tax credits to offset up to 35 percent of the cost of insuring their employees. That will rise to 50 percent in 2014.

Plans must have "an effective appeals process" for decisions and claims. States will get grants to set up programs that help consumers with complaints or questions about health insurance. The federal government will set up a website to help people in different states figure out their insurance options.

The first tax increase kicks in: A 10 percent tax on indoor tanning services.

2011

Medicare changes will include free annual wellness visits; little to no cost-sharing for preventive care, like immunizations and cancer screenings; bonuses to primary care doctors and general surgeons; a new Center for Medicare and Medicaid Innovation to test ways to provide better, more efficient care; and, the start of a phase-out of overpayments to private Medicare Advantage insurers. People in the prescription "doughnut hole" will receive discounts on prescriptions.

2012

There will be new money for primary care services and new incentives to encourage doctors to join together in "accountable care organizations." The government will track re-admission rates at hospitals and impose penalty fees on hospitals with the highest rates.

2013

This is when higher taxes will begin for households with income above $250,000 and individuals above $200,000. The Medicare payroll tax on earnings above those amounts will rise from 1.45 percent to 2.35 percent. Unearned income above those amounts, such as dividends, will now be subject to a 3.8 percent tax.

In addition, maximum contributions to pre-tax Flexible Savings Account contributions will be limited to $2,500 a year (down from the current $3,050 for individuals).

There will be a new 2.9 percent excise tax on medical devices.

Medicare will sponsor a national pilot program on "payment bundling" -- paying hospitals, doctors and other providers based on patient outcome, not services provided.

2014

More consumer protections begin. Insurance companies will not be able to deny policies to anyone based on their health status or to refuse coverage of a treatment based on pre-existing health conditions. Their ability to charge higher rates to people based on age, geography, family size or tobacco use will be limited. Annual limits on coverage will be abolished.

Each state will open a health insurance exchange, or marketplace, for individuals and small businesses without coverage. People will be able to comparison shop for standardized health packages. There will be a multistate private plan available nationwide, supervised by the U.S. Office of Personnel Management. Tax credits will be available to make insurance and care affordable for people who make too much to qualify for Medicaid, but have incomes below 400 percent of poverty.

Most people will be required to buy insurance coverage or pay penalties that start at $95 in 2014 and rise to $695 or 2.5 percent of income in 2016. Employers with 50 or more workers who do not offer coverage will have to pay annual fees.

Medicaid eligibility will increase to 133 percent of the poverty level ($14,404 for individuals) for everyone under 65 (when they qualify for Medicare).

2015

A new Independent Payment Advisory Board will be formed to come up with ways to lower Medicare costs and promote better care. The recommendations will go to Congress and private insurers.

2018

This is when the most controversial new tax begins, a 40 percent excise tax on insurance companies and plan administrators for any family plan that costs more than $27,500. The tax applies to the cost above that threshold. There are higher thresholds for retirees over 55 and plans that cover workers in high-risk jobs.

2019

The new system will have reduced the number of uninsured people by 32 million, according to the nonpartisan Congressional Budget Office. That will leave an estimated 23 million uninsured, one-third of them illegal immigrants. Coverage of legal residents too young for Medicare (under age 65) will be 94 percent, up from 83 percent now.


Here are other big winners and losers in the new era of health care:

WINNERS: College students. Within six months, college students will be able to stay on their parents' insurance until they are 26 years old.

LOSERS: People who don't want to carry insurance. These people will be big losers, because they'll need to pay a tax penalty starting January 1, 2014. That penalty will be $695 per year up to a maximum of $2,085 per family or 2.5% of household income. The penalty will be phased in gradually over three years, starting with $95 in 2014. The penalty could go as high as $750 if the reconciliation bill doesn't pass the Senate.

WINNERS: Children with pre-existing conditions, such as diabetes or asthma. They can get coverage within six months.

LOSERS: Taxpayers who make more than $200,000 individually or $250,000 as a married couple. These taxpayers will foot part of the cost of the reform. They will need to pay 0.9% more in Medicare taxes. The total Medicare payroll tax rate will be 2.35%. The current rate is 1.45%. The tax rate will apply to unearned income, such as dividends and capital gains, if the reconciliation bill is passed.

WINNERS: Middle class families that can't afford to buy insurance and fall below 400% of the Federal Poverty Level. They will get tax credits to help reduce their costs. For example, if you earn at 100% to 200% of the FPL, your out-of-pocket limits will be $1,983 for an individual and $3,967 for a family.

LOSERS: Taxpayers who get high premium insurance plans from their employers. They will need to pay a "Cadillac Tax." If your employer plan exceeds $8,500 for a single person or $23,000 for a family in premiums per year, you could be stuck with that tax.

WINNERS: Seniors who have Medicare Part D (drug coverage). They will see the doughnut hole diminish from the loss of 100% coverage for drugs when they enter the doughnut hole to a co-pay of 25% by 2020. Beginning in 2011, seniors will see the costs of brand-name drugs cut by 50% when they reach the doughnut hole. Also, there will be a $250 rebate to Medicare beneficiaries when they reach the doughnut hole coverage gap in 2010 to help with their prescription drugs expenses this year.

LOSERS: Young adults. They'll likely be losers in the amount they'll pay in monthly premiums. That's because there is a three to one limit on how much insurers can charge older people. Insurers can't charge seniors more than three times the amount younger people pay. That will likely increase premiums for younger people, but since the insurance pools will be much larger, the increase may not be that great.

Some health care players are winners and losers:

WINNERS/LOSERS: Drug companies. They agreed to contribute $84.8 billion over 10 years to help pay for the health care legislation and agreed to the 50% reduction in costs for drugs when seniors reach the doughnut hole. But they got some big wins in exchange. The government will not be able to negotiate the prices of drugs sold through Medicare Part D, and they got protection for 12 years against generic drugs competing with biotech drugs. Also, the law doesn't bar pharmaceutical companies from paying a fee to generic drug companies to delay the launch of these less expensive alternatives.

WINNERS/LOSERS: Insurance industry. When health care reform is full in place in 2014, the industry will likely have 32 million new customers from which they can collect premiums. They are expected to pay about $70 billion in new taxes over 10 years on health insurance premiums beginning in 2014. But they will have to make major changes in the way they do business, since they will no longer be able to deny coverage based on pre-existing conditions. They also can no longer limit coverage based on annual or lifetime caps (new policies will remove lifetime limits within six months; by 2014, lifetime limits, as well as annual caps, must be removed from existing policies). Right now, there is no regulation on how much premiums can go up each year, but Sen. Diane Feinstein (D-Calif.) told viewers on CNN yesterday that she would get a bill passed to regulate premium increases.

The law does establish a process for reviewing increases in health plan premiums and will require plans to justify increases. States will be required to report on trends in premium increases. The states can recommend that a plan be excluded from the the state-based exchanges, from which people will buy individual insurance, if insurers seek unjustified premium increases.

Insurers will also face a profit cap. Insurers will be required to spend 85% of premiums collected in the group marketplace and 80% of premiums collected from individuals and and small group markets on clinical services and quality or provide rebates to customers. They will need to report their medical loss ratio beginning in 2010 and be required to provide rebates if they make too much money starting on January 1, 2011.

WINNERS/LOSERS: Hospitals. They will likely benefit from the fact that 32 million more people have insurance, and the losses they incur to treat uninsured individuals will go down. They also will benefit from the ban on yearly and lifetime coverage caps. But in exchange, they will end up with a cut in annual increases to Medicare reimbursement rates. They will also see cuts in federal aid for treating indigent people beginning in 2014.

WINNERS/LOSERS: Doctors. They will see their patient loads increase dramatically with all the new insured patients -- how they handle this new load will help determine whether they are winners or losers. Doctors who effectively make use of physician's assistants and nurse practitioners will probably fare better under the new load. The law does increase reimbursement rates for doctors who take Medicaid patients, but did not eliminate the reduction in Medicare reimbursements permanently. That will still be a yearly decision for Congress to make. Doctors are also concerned with the creation of an independent payment advisory board that will oversee Medicare.

Those are the key winners and losers, but it's not an all inclusive list.

Permalink

Doghouse(caution Politics)

By: auburn, 5:31 PM GMT on March 26, 2010

Welcome to da Doghouse...right Clem?

" alt="" />


1 The Upside: If you are 26 or younger, you may be able to get insurance through your parents' policy. If you buy coverage on your own in the exchanges, you will have access to cheaper catastrophic coverage. If you buy a traditional benefits package, you will pay less than those who are older.

The Downside: Traditional insurance purchased in the exchanges may cost more than what you can buy now, but you'll have to stay covered unless you qualify for an exemption.

30 percent of Americans ages 19 to 29 are now uninsured

2 The Upside: You will receive free preventive services under Medicare. If you have Medicare prescription-drug coverage, you will pay less if you reach the coverage gap known as the doughnut hole.

The Downside: If you have a Medicare Advantage plan, your insurer may cut extra benefits or increase co-payments. Until 2019, Medicare beneficiaries earning $85,000 or more will pay higher Part B premiums.

10 million seniors are now in Medicare Advantage plans

3 The Upside: Beginning this year, if you have 25 or fewer workers, you may be eligible for a tax credit to help you buy coverage for them. By 2017, you'll be able to buy insurance for your employees through new insurance marketplaces.

The Downside: After 2014, you may be eligible for only two years of tax credits to help purchase coverage. If you employ more than 50 people, you'll have to provide benefits or pay a penalty.

50 employees is the maximum number a company can have without providing benefits and paying a penalty

4 The Upside: Companies with more than 50 employees will be required to provide coverage or face a fine, so your benefits are secure. Existing benefits packages will be grandfathered, but new plans will have to meet minimum requirements. Limits on out-of-pocket spending may keep your costs down.

The Downside: Premiums may continue to go up, and if you don't qualify for subsidies or entrance into exchanges, you may be stuck with the plan your employer chooses for you.

5 The Upside: If you are among the lowest wage earners — even if you don't have children or a disability — you will become eligible for Medicaid. And if you earn less than 400% of the poverty level — about $88,000 in 2009 — you will be eligible for subsidies to help you buy coverage.

The Downside: Even with subsidies, buying insurance may strain your budget. But you'll have to maintain coverage unless you qualify for a hardship waiver or the cheapest plans available exceed 8% of your total income.

6 The Upside: If you are among the lowest wage earners — even if you don't have children or a disability — you will become eligible for Medicaid. And if you earn less than 400% of the poverty level — about $88,000 in 2009 — you will be eligible for subsidies to help you buy coverage.

The Downside: Even with subsidies, buying insurance may strain your budget. But you'll have to maintain coverage unless you qualify for a hardship waiver or the cheapest plans available exceed 8% of your total income.

Here is a year by year list of when and what.


2010

Adults who can't get coverage because of a pre-existing medical condition can join a high-risk insurance pool (this is an interim step pending the launch in 2014 of competitive health insurance marketplaces and premium subsidies).

Insurance companies will have to issue policies for children with pre-existing conditions. They will not be allowed to revoke existing policies if people get sick. Lifetime limits on coverage will be banned in new coverage and annual limits will be restricted. Preventive services will be fully covered, with no co-pays or deductibles. Coverage will be available for dependent children until they turn 26.
Get the new
PD toolbar!

People in the Medicare prescription drug program will receive a $250 rebate as the first step in closing the coverage gap, or "doughnut hole," that requires them to pay full freight after they have spent $2,700 on drugs. The gap would be phased out entirely by 2020.

Certain small businesses will start getting tax credits to offset up to 35 percent of the cost of insuring their employees. That will rise to 50 percent in 2014.

Plans must have "an effective appeals process" for decisions and claims. States will get grants to set up programs that help consumers with complaints or questions about health insurance. The federal government will set up a website to help people in different states figure out their insurance options.

The first tax increase kicks in: A 10 percent tax on indoor tanning services.

2011

Medicare changes will include free annual wellness visits; little to no cost-sharing for preventive care, like immunizations and cancer screenings; bonuses to primary care doctors and general surgeons; a new Center for Medicare and Medicaid Innovation to test ways to provide better, more efficient care; and, the start of a phase-out of overpayments to private Medicare Advantage insurers. People in the prescription "doughnut hole" will receive discounts on prescriptions.

2012

There will be new money for primary care services and new incentives to encourage doctors to join together in "accountable care organizations." The government will track re-admission rates at hospitals and impose penalty fees on hospitals with the highest rates.

2013

This is when higher taxes will begin for households with income above $250,000 and individuals above $200,000. The Medicare payroll tax on earnings above those amounts will rise from 1.45 percent to 2.35 percent. Unearned income above those amounts, such as dividends, will now be subject to a 3.8 percent tax.

In addition, maximum contributions to pre-tax Flexible Savings Account contributions will be limited to $2,500 a year (down from the current $3,050 for individuals).

There will be a new 2.9 percent excise tax on medical devices.

Medicare will sponsor a national pilot program on "payment bundling" -- paying hospitals, doctors and other providers based on patient outcome, not services provided.

2014

More consumer protections begin. Insurance companies will not be able to deny policies to anyone based on their health status or to refuse coverage of a treatment based on pre-existing health conditions. Their ability to charge higher rates to people based on age, geography, family size or tobacco use will be limited. Annual limits on coverage will be abolished.

Each state will open a health insurance exchange, or marketplace, for individuals and small businesses without coverage. People will be able to comparison shop for standardized health packages. There will be a multistate private plan available nationwide, supervised by the U.S. Office of Personnel Management. Tax credits will be available to make insurance and care affordable for people who make too much to qualify for Medicaid, but have incomes below 400 percent of poverty.

Most people will be required to buy insurance coverage or pay penalties that start at $95 in 2014 and rise to $695 or 2.5 percent of income in 2016. Employers with 50 or more workers who do not offer coverage will have to pay annual fees.

Medicaid eligibility will increase to 133 percent of the poverty level ($14,404 for individuals) for everyone under 65 (when they qualify for Medicare).

2015

A new Independent Payment Advisory Board will be formed to come up with ways to lower Medicare costs and promote better care. The recommendations will go to Congress and private insurers.

2018

This is when the most controversial new tax begins, a 40 percent excise tax on insurance companies and plan administrators for any family plan that costs more than $27,500. The tax applies to the cost above that threshold. There are higher thresholds for retirees over 55 and plans that cover workers in high-risk jobs.

2019

The new system will have reduced the number of uninsured people by 32 million, according to the nonpartisan Congressional Budget Office. That will leave an estimated 23 million uninsured, one-third of them illegal immigrants. Coverage of legal residents too young for Medicare (under age 65) will be 94 percent, up from 83 percent now.


Here are other big winners and losers in the new era of health care:

WINNERS: College students. Within six months, college students will be able to stay on their parents' insurance until they are 26 years old.

LOSERS: People who don't want to carry insurance. These people will be big losers, because they'll need to pay a tax penalty starting January 1, 2014. That penalty will be $695 per year up to a maximum of $2,085 per family or 2.5% of household income. The penalty will be phased in gradually over three years, starting with $95 in 2014. The penalty could go as high as $750 if the reconciliation bill doesn't pass the Senate.

WINNERS: Children with pre-existing conditions, such as diabetes or asthma. They can get coverage within six months.

LOSERS: Taxpayers who make more than $200,000 individually or $250,000 as a married couple. These taxpayers will foot part of the cost of the reform. They will need to pay 0.9% more in Medicare taxes. The total Medicare payroll tax rate will be 2.35%. The current rate is 1.45%. The tax rate will apply to unearned income, such as dividends and capital gains, if the reconciliation bill is passed.

WINNERS: Middle class families that can't afford to buy insurance and fall below 400% of the Federal Poverty Level. They will get tax credits to help reduce their costs. For example, if you earn at 100% to 200% of the FPL, your out-of-pocket limits will be $1,983 for an individual and $3,967 for a family.

LOSERS: Taxpayers who get high premium insurance plans from their employers. They will need to pay a "Cadillac Tax." If your employer plan exceeds $8,500 for a single person or $23,000 for a family in premiums per year, you could be stuck with that tax.

WINNERS: Seniors who have Medicare Part D (drug coverage). They will see the doughnut hole diminish from the loss of 100% coverage for drugs when they enter the doughnut hole to a co-pay of 25% by 2020. Beginning in 2011, seniors will see the costs of brand-name drugs cut by 50% when they reach the doughnut hole. Also, there will be a $250 rebate to Medicare beneficiaries when they reach the doughnut hole coverage gap in 2010 to help with their prescription drugs expenses this year.

LOSERS: Young adults. They'll likely be losers in the amount they'll pay in monthly premiums. That's because there is a three to one limit on how much insurers can charge older people. Insurers can't charge seniors more than three times the amount younger people pay. That will likely increase premiums for younger people, but since the insurance pools will be much larger, the increase may not be that great.

Some health care players are winners and losers:

WINNERS/LOSERS: Drug companies. They agreed to contribute $84.8 billion over 10 years to help pay for the health care legislation and agreed to the 50% reduction in costs for drugs when seniors reach the doughnut hole. But they got some big wins in exchange. The government will not be able to negotiate the prices of drugs sold through Medicare Part D, and they got protection for 12 years against generic drugs competing with biotech drugs. Also, the law doesn't bar pharmaceutical companies from paying a fee to generic drug companies to delay the launch of these less expensive alternatives.

WINNERS/LOSERS: Insurance industry. When health care reform is full in place in 2014, the industry will likely have 32 million new customers from which they can collect premiums. They are expected to pay about $70 billion in new taxes over 10 years on health insurance premiums beginning in 2014. But they will have to make major changes in the way they do business, since they will no longer be able to deny coverage based on pre-existing conditions. They also can no longer limit coverage based on annual or lifetime caps (new policies will remove lifetime limits within six months; by 2014, lifetime limits, as well as annual caps, must be removed from existing policies). Right now, there is no regulation on how much premiums can go up each year, but Sen. Diane Feinstein (D-Calif.) told viewers on CNN yesterday that she would get a bill passed to regulate premium increases.

The law does establish a process for reviewing increases in health plan premiums and will require plans to justify increases. States will be required to report on trends in premium increases. The states can recommend that a plan be excluded from the the state-based exchanges, from which people will buy individual insurance, if insurers seek unjustified premium increases.

Insurers will also face a profit cap. Insurers will be required to spend 85% of premiums collected in the group marketplace and 80% of premiums collected from individuals and and small group markets on clinical services and quality or provide rebates to customers. They will need to report their medical loss ratio beginning in 2010 and be required to provide rebates if they make too much money starting on January 1, 2011.

WINNERS/LOSERS: Hospitals. They will likely benefit from the fact that 32 million more people have insurance, and the losses they incur to treat uninsured individuals will go down. They also will benefit from the ban on yearly and lifetime coverage caps. But in exchange, they will end up with a cut in annual increases to Medicare reimbursement rates. They will also see cuts in federal aid for treating indigent people beginning in 2014.

WINNERS/LOSERS: Doctors. They will see their patient loads increase dramatically with all the new insured patients -- how they handle this new load will help determine whether they are winners or losers. Doctors who effectively make use of physician's assistants and nurse practitioners will probably fare better under the new load. The law does increase reimbursement rates for doctors who take Medicaid patients, but did not eliminate the reduction in Medicare reimbursements permanently. That will still be a yearly decision for Congress to make. Doctors are also concerned with the creation of an independent payment advisory board that will oversee Medicare.

Those are the key winners and losers, but it's not an all inclusive list.

Updated: 5:34 PM GMT on March 26, 2010

Permalink

time for me to move on.

By: auburn, 4:24 PM GMT on March 26, 2010

I guess I should remove my blog again...I really have this blog for information purposes...and I see very little hate and discontent in it...but I guess you guys are right...this is a weather site and I am trespassing with my off topic blog...might be time for me to move on.

Sorry to intrude...when I have something weather I may even post again...but about all I understand about weather is rain is wet...

Permalink

Ups and downs of HCR

By: auburn, 4:09 PM GMT on March 22, 2010

1 The Upside: If you are 26 or younger, you may be able to get insurance through your parents' policy. If you buy coverage on your own in the exchanges, you will have access to cheaper catastrophic coverage. If you buy a traditional benefits package, you will pay less than those who are older.

The Downside: Traditional insurance purchased in the exchanges may cost more than what you can buy now, but you'll have to stay covered unless you qualify for an exemption.

30 percent of Americans ages 19 to 29 are now uninsured

2 The Upside: You will receive free preventive services under Medicare. If you have Medicare prescription-drug coverage, you will pay less if you reach the coverage gap known as the doughnut hole.

The Downside: If you have a Medicare Advantage plan, your insurer may cut extra benefits or increase co-payments. Until 2019, Medicare beneficiaries earning $85,000 or more will pay higher Part B premiums.

10 million seniors are now in Medicare Advantage plans

3 The Upside: Beginning this year, if you have 25 or fewer workers, you may be eligible for a tax credit to help you buy coverage for them. By 2017, you'll be able to buy insurance for your employees through new insurance marketplaces.

The Downside: After 2014, you may be eligible for only two years of tax credits to help purchase coverage. If you employ more than 50 people, you'll have to provide benefits or pay a penalty.

50 employees is the maximum number a company can have without providing benefits and paying a penalty

4 The Upside: Companies with more than 50 employees will be required to provide coverage or face a fine, so your benefits are secure. Existing benefits packages will be grandfathered, but new plans will have to meet minimum requirements. Limits on out-of-pocket spending may keep your costs down.

The Downside: Premiums may continue to go up, and if you don't qualify for subsidies or entrance into exchanges, you may be stuck with the plan your employer chooses for you.

5 The Upside: If you are among the lowest wage earners — even if you don't have children or a disability — you will become eligible for Medicaid. And if you earn less than 400% of the poverty level — about $88,000 in 2009 — you will be eligible for subsidies to help you buy coverage.

The Downside: Even with subsidies, buying insurance may strain your budget. But you'll have to maintain coverage unless you qualify for a hardship waiver or the cheapest plans available exceed 8% of your total income.

6 The Upside: If you are among the lowest wage earners — even if you don't have children or a disability — you will become eligible for Medicaid. And if you earn less than 400% of the poverty level — about $88,000 in 2009 — you will be eligible for subsidies to help you buy coverage.

The Downside: Even with subsidies, buying insurance may strain your budget. But you'll have to maintain coverage unless you qualify for a hardship waiver or the cheapest plans available exceed 8% of your total income.

Here is a year by year list of when and what.


2010

Adults who can't get coverage because of a pre-existing medical condition can join a high-risk insurance pool (this is an interim step pending the launch in 2014 of competitive health insurance marketplaces and premium subsidies).

Insurance companies will have to issue policies for children with pre-existing conditions. They will not be allowed to revoke existing policies if people get sick. Lifetime limits on coverage will be banned in new coverage and annual limits will be restricted. Preventive services will be fully covered, with no co-pays or deductibles. Coverage will be available for dependent children until they turn 26.
Get the new
PD toolbar!

People in the Medicare prescription drug program will receive a $250 rebate as the first step in closing the coverage gap, or "doughnut hole," that requires them to pay full freight after they have spent $2,700 on drugs. The gap would be phased out entirely by 2020.

Certain small businesses will start getting tax credits to offset up to 35 percent of the cost of insuring their employees. That will rise to 50 percent in 2014.

Plans must have "an effective appeals process" for decisions and claims. States will get grants to set up programs that help consumers with complaints or questions about health insurance. The federal government will set up a website to help people in different states figure out their insurance options.

The first tax increase kicks in: A 10 percent tax on indoor tanning services.

2011

Medicare changes will include free annual wellness visits; little to no cost-sharing for preventive care, like immunizations and cancer screenings; bonuses to primary care doctors and general surgeons; a new Center for Medicare and Medicaid Innovation to test ways to provide better, more efficient care; and, the start of a phase-out of overpayments to private Medicare Advantage insurers. People in the prescription "doughnut hole" will receive discounts on prescriptions.

2012

There will be new money for primary care services and new incentives to encourage doctors to join together in "accountable care organizations." The government will track re-admission rates at hospitals and impose penalty fees on hospitals with the highest rates.

2013

This is when higher taxes will begin for households with income above $250,000 and individuals above $200,000. The Medicare payroll tax on earnings above those amounts will rise from 1.45 percent to 2.35 percent. Unearned income above those amounts, such as dividends, will now be subject to a 3.8 percent tax.

In addition, maximum contributions to pre-tax Flexible Savings Account contributions will be limited to $2,500 a year (down from the current $3,050 for individuals).

There will be a new 2.9 percent excise tax on medical devices.

Medicare will sponsor a national pilot program on "payment bundling" -- paying hospitals, doctors and other providers based on patient outcome, not services provided.

2014

More consumer protections begin. Insurance companies will not be able to deny policies to anyone based on their health status or to refuse coverage of a treatment based on pre-existing health conditions. Their ability to charge higher rates to people based on age, geography, family size or tobacco use will be limited. Annual limits on coverage will be abolished.

Each state will open a health insurance exchange, or marketplace, for individuals and small businesses without coverage. People will be able to comparison shop for standardized health packages. There will be a multistate private plan available nationwide, supervised by the U.S. Office of Personnel Management. Tax credits will be available to make insurance and care affordable for people who make too much to qualify for Medicaid, but have incomes below 400 percent of poverty.

Most people will be required to buy insurance coverage or pay penalties that start at $95 in 2014 and rise to $695 or 2.5 percent of income in 2016. Employers with 50 or more workers who do not offer coverage will have to pay annual fees.

Medicaid eligibility will increase to 133 percent of the poverty level ($14,404 for individuals) for everyone under 65 (when they qualify for Medicare).

2015

A new Independent Payment Advisory Board will be formed to come up with ways to lower Medicare costs and promote better care. The recommendations will go to Congress and private insurers.

2018

This is when the most controversial new tax begins, a 40 percent excise tax on insurance companies and plan administrators for any family plan that costs more than $27,500. The tax applies to the cost above that threshold. There are higher thresholds for retirees over 55 and plans that cover workers in high-risk jobs.

2019

The new system will have reduced the number of uninsured people by 32 million, according to the nonpartisan Congressional Budget Office. That will leave an estimated 23 million uninsured, one-third of them illegal immigrants. Coverage of legal residents too young for Medicare (under age 65) will be 94 percent, up from 83 percent now.





strong>Welcome to da Doghouse...right Clem? " alt="" />

Here are other big winners and losers in the new era of health care:

WINNERS: College students. Within six months, college students will be able to stay on their parents' insurance until they are 26 years old.

LOSERS: People who don't want to carry insurance. These people will be big losers, because they'll need to pay a tax penalty starting January 1, 2014. That penalty will be $695 per year up to a maximum of $2,085 per family or 2.5% of household income. The penalty will be phased in gradually over three years, starting with $95 in 2014. The penalty could go as high as $750 if the reconciliation bill doesn't pass the Senate.

WINNERS: Children with pre-existing conditions, such as diabetes or asthma. They can get coverage within six months.

LOSERS: Taxpayers who make more than $200,000 individually or $250,000 as a married couple. These taxpayers will foot part of the cost of the reform. They will need to pay 0.9% more in Medicare taxes. The total Medicare payroll tax rate will be 2.35%. The current rate is 1.45%. The tax rate will apply to unearned income, such as dividends and capital gains, if the reconciliation bill is passed.

WINNERS: Middle class families that can't afford to buy insurance and fall below 400% of the Federal Poverty Level. They will get tax credits to help reduce their costs. For example, if you earn at 100% to 200% of the FPL, your out-of-pocket limits will be $1,983 for an individual and $3,967 for a family.

LOSERS: Taxpayers who get high premium insurance plans from their employers. They will need to pay a "Cadillac Tax." If your employer plan exceeds $8,500 for a single person or $23,000 for a family in premiums per year, you could be stuck with that tax.

WINNERS: Seniors who have Medicare Part D (drug coverage). They will see the doughnut hole diminish from the loss of 100% coverage for drugs when they enter the doughnut hole to a co-pay of 25% by 2020. Beginning in 2011, seniors will see the costs of brand-name drugs cut by 50% when they reach the doughnut hole. Also, there will be a $250 rebate to Medicare beneficiaries when they reach the doughnut hole coverage gap in 2010 to help with their prescription drugs expenses this year.

LOSERS: Young adults. They'll likely be losers in the amount they'll pay in monthly premiums. That's because there is a three to one limit on how much insurers can charge older people. Insurers can't charge seniors more than three times the amount younger people pay. That will likely increase premiums for younger people, but since the insurance pools will be much larger, the increase may not be that great.

Some health care players are winners and losers:

WINNERS/LOSERS: Drug companies. They agreed to contribute $84.8 billion over 10 years to help pay for the health care legislation and agreed to the 50% reduction in costs for drugs when seniors reach the doughnut hole. But they got some big wins in exchange. The government will not be able to negotiate the prices of drugs sold through Medicare Part D, and they got protection for 12 years against generic drugs competing with biotech drugs. Also, the law doesn't bar pharmaceutical companies from paying a fee to generic drug companies to delay the launch of these less expensive alternatives.

WINNERS/LOSERS: Insurance industry. When health care reform is full in place in 2014, the industry will likely have 32 million new customers from which they can collect premiums. They are expected to pay about $70 billion in new taxes over 10 years on health insurance premiums beginning in 2014. But they will have to make major changes in the way they do business, since they will no longer be able to deny coverage based on pre-existing conditions. They also can no longer limit coverage based on annual or lifetime caps (new policies will remove lifetime limits within six months; by 2014, lifetime limits, as well as annual caps, must be removed from existing policies). Right now, there is no regulation on how much premiums can go up each year, but Sen. Diane Feinstein (D-Calif.) told viewers on CNN yesterday that she would get a bill passed to regulate premium increases.

The law does establish a process for reviewing increases in health plan premiums and will require plans to justify increases. States will be required to report on trends in premium increases. The states can recommend that a plan be excluded from the the state-based exchanges, from which people will buy individual insurance, if insurers seek unjustified premium increases.

Insurers will also face a profit cap. Insurers will be required to spend 85% of premiums collected in the group marketplace and 80% of premiums collected from individuals and and small group markets on clinical services and quality or provide rebates to customers. They will need to report their medical loss ratio beginning in 2010 and be required to provide rebates if they make too much money starting on January 1, 2011.

WINNERS/LOSERS: Hospitals. They will likely benefit from the fact that 32 million more people have insurance, and the losses they incur to treat uninsured individuals will go down. They also will benefit from the ban on yearly and lifetime coverage caps. But in exchange, they will end up with a cut in annual increases to Medicare reimbursement rates. They will also see cuts in federal aid for treating indigent people beginning in 2014.

WINNERS/LOSERS: Doctors. They will see their patient loads increase dramatically with all the new insured patients -- how they handle this new load will help determine whether they are winners or losers. Doctors who effectively make use of physician's assistants and nurse practitioners will probably fare better under the new load. The law does increase reimbursement rates for doctors who take Medicaid patients, but did not eliminate the reduction in Medicare reimbursements permanently. That will still be a yearly decision for Congress to make. Doctors are also concerned with the creation of an independent payment advisory board that will oversee Medicare.

Those are the key winners and losers, but it's not an all inclusive list.

Updated: 4:09 PM GMT on March 26, 2010

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219 to 212 Yes we can!!

By: auburn, 5:18 PM GMT on March 15, 2010

strong>Welcome to da Doghouse...right Clem? " alt="" />

Updated: 2:49 AM GMT on March 22, 2010

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Read This b4U Buy Iams Pet food

By: auburn, 3:25 PM GMT on March 10, 2010

Beneath the wholesome image of the dog- and cat-food manufacturer, a 10-month PETA undercover investigation into an Iams contract laboratory revealed a dark and sordid secret: routine neglect and misery.


Abuses include the following:

• Dogs dumped on cold concrete flooring after huge chunks of muscle were cut from their thighs—27 of the 60 dogs were killed, and two others were later found dead in their cages

• Dogs and cats gone stir-crazy from confinement in windowless, dungeon-like buildings

• A procedure in which tubes were stuck down dogs' throats to force them to ingest vegetable oil

• Dogs with such severe tartar build-up on their teeth that it was painful for them to eat

• Vet technicians with inadequate training and experience performing invasive procedures






Welcome to da Doghouse...right Clem? " alt="" />

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DogHouse

By: auburn, 7:36 PM GMT on March 04, 2010

img src="Welcome to da Doghouse...right Clem? " alt="" />

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Coffee Party Moment

By: auburn, 5:22 PM GMT on March 03, 2010

img src="Welcome to da Doghouse...right Clem? " alt="" />
MISSION: The Coffee Party Movement gives voice to Americans who want to see cooperation in government. We recognize that the federal government is not the enemy of the people, but the expression of our collective will, and that we must participate in the democratic process in order to address the challenges that we face as Americans. As voters and grassroots volunteers, we will support leaders who work toward positive solutions, and hold accountable those who obstruct them.

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About auburn

Hi,I am from Beauregard Al(outskirts of Auburn)I dont know much about weather but I enjoy it just the same. I have made lots of great friends on WU! UR3

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