By: Dale J. Buchberger, PT, DC, CSCS, DACBSP
At first most of us were relieved that Congress averted the so called “fiscal cliff. That was of course until we all got our first pay check of 2013 and found out that it was on the “light” side. Since the members of the Supreme Court decided to leave the human race and become jelly fish, President Obama was able to sign into law the regulation that has adopted his name; ObamaCare or the Patient Protection and Affordable Care Act (ACA). Many of us are growing increasingly tired of hearing about it, but nonetheless it is here to stay in some form. It will unquestionably affect everyone either positively or negatively, but it will affect all of us. To follow are a few notes to try and simplify a few aspects of ObamaCare. It is impossible to reduce 900 pages to 800 words but here goes nothing!
According to the Washington Post the average household pays $15,000 or more for what some people continue to refer to as “health Insurance”. In fact this number would dictate that almost 20% of household income is dedicated to health insurance. New York State ranks as the state with the fourth highest health insurance premiums.
One thing the Affordable Care Act did immediately was require health insurance companies to cover preventive care at no additional cost, allow parents to keep their kids on their plans up to age 26 and prevent denial of patients with preexisting conditions. Sounds good right? Well as my dad once said, “there is no free lunch”. He was right. We all pay anywhere from 5-15% extra in premiums. You see the insurance industry just passes the cost on to us. I think the term in sales is called “bait and switch”. But the Supreme Court calls it “Shared responsibility”.
Once ObamaCare was signed into law in March of 2010 a timetable of sorts went into affect. In 2011, the Medicare prescription “donut hole” began to close but won’t fully disappear until 2020. Over-the-counter medications can no longer be purchased with your HSA or FSA funds. Starting in 2013, the income tax deduction threshold for medical expenses rises from 7.5% to 10%. Looking ahead to 2014, for people who can’t afford health insurance, the Federal government will pay the states to add them to Medicaid. The income requirement is expanded up to 133% of the Federal Poverty Level; roughly $29,000 for a family of four. Those who don’t qualify for the expanded Medicaid will receive tax credits if their income is below 400% of the poverty level ($88,000 for a family of four). States will be required to set up insurance exchanges to make it easier to shop for private health insurance coverage.
Those who don’t purchase insurance, and don’t qualify for Medicaid or subsidies, will be assessed a tax of $95 (or 1% of income, whichever is higher) in 2014. It increases to $325 (or 2% of income) in 2015, and $695 (or 2.5% of income) in 2016. About 4 million people, or 1.2% of the population, will wind up paying the tax rather than purchase health insurance. The Congressional Budget Office estimates this will total $54 billion. Pharmaceutical companies will pay an extra $84.8 billion in fees over the next ten years to pay for closing the “donut hole” in Medicare Part D. This will most likely raise drug costs as the pharmaceutical industry passes the additional cost onto the backs of consumers.
This is merely a list of ObamaCare regulations by timetable. Over the next four years the “winners” and “losers” in ObamaCare will be dictated by which group you fall into and how you define winning and losing. Generally speaking most people will define it by how much more they pay versus how much more or less they receive in benefits. If ObamaCare stays as it is, the biggest winners are the uninsured that receive a benefit with little or no cost. The biggest losers are Medicare recipients who are on the receiving end of approximately $455 billion in spending cuts.
For Medicare recipients, ObamaCare has renamed the term Health Maintenance Organization (HMO) from the 1990’s and now calls it an Accountable Care Organization (ACO) who’s main purpose is to “cut costs” which in the 1990’s was accomplished by rejecting claims and services for patients who needed testing or treatment. The ACO will be coupled with an Independent Payment Advisory Board (IPAB) that will have absolute power to cut Medicare spending. This in and of itself sets healthcare back 20-years.
In the past The Citizen has published my three part series regarding healthcare. In the series, I provided thoughts and ideas on healthcare that are far more cost effective than ObamaCare. I still believe that. To access the series you can go to the following link http://www.activeptsolutions.com/articles.asp.