Healthcare Bill Question: Do subsidies only cover premiums?

[Oregone]

So, the subsidy plan for the health care bill looks really great, to leave the expense 1.5% to 10% of ones income.

A quick question....do these subsidies also cover the co-pays/deductibles on the way up to the $5000 dollar "cost-sharing"?

Or, are the premiums basically going to be taken care of, and you are privately responsible for the cost-sharing deductible?

[babylonsister]

1. I don't know if this answers your question as

co-pays/deductibles are specifically mentioned.

http://voices.washingtonpost.com/ezra-klein/2009/07/the_house_releases_its_health-.html

snip//

Affordability and Subsidies: The House bill has subsidies up to 400 percent of poverty, which is equal to $43,320 for an individual and $88,200 for a family of four. At the bottom end -- 133 percent if income, as below that, you're eligible for Medicaid -- the subsidies limit your health premiums to 1.5 percent of income. At the top end -- 400 percent -- it's no more than 11 percent of income. Speaking of the out-of-pocket cap, all of the benefit packages -- from the "basic" plan on upward -- cap total costs for members. So if you're not eligible for subsidies, you're still going to be protected from catastrophic health-care costs.

[Oregone]

2. Ok, so the subsidies sound to be different than the out-of-pocket cap

"Speaking of the out-of-pocket cap, all of the benefit packages -- from the "basic" plan on upward -- cap total costs for members."


What is the out-of-pocket cap? Is that the $5000 per person?

[babylonsister]

4. Lots of info here, with an interactive thingie on the bottom...

http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/07/14/breaking-house-bill-good-wish-it-could-happen-quicker.aspx

[Oregone]

5. I guess, all Im trying to find is the maximum amount, period, people will have to pay at certain

income ranges, premium + out-of-pocket - subsidy.

What is the average and max people will be paying in the second quintile for health care? Its tough finding that.

[babylonsister]

6. Here's another source, from the House website:

http://www.speaker.gov/blog/?p=1864

Read issue specific fact sheets about America’s Affordable Health Choices Act of 2009:

The Health Insurance Exchange>>

Public Health Insurance Option>>

Shared Responsibility>>

Guaranteed Benefits>><

Making Coverage Affordable>>

Consumer Protections and Insurance Market Reforms>>

Employers and Health Reform>>

Strengthening the Nation’s Health Workforce>>

Delivery System Reform>>

Protecting Program Integrity by Preventing Waste, Fraud and Abuse>>

Strengthening Medicare>>

Improving the Medicare Part D Drug Program>>

Maintaining and Improving Medicaid>>

Preventing Disease and Improving the Public’s Health>>

Controlling Health Care Costs>>

[babylonsister]

7. It's not easy finding answers, at least not yet. Thought you'd get

a kick out of how 'easy' this all is:

[lindisfarne]

8. A lot of the answers people are requesting, however, aren't too difficult to find though. Many have

been answered on DU, or at the house.gov site you provided. Obviously, the legislation is complex. But that's to be expected. That's why the House provided nice little PDF summary sheets, and they also have somewhat more complex summaries at the link you provide (or just go here:
http://www.speaker.gov/newsroom/legislation?id=0327 )

Ezra Klein tries to summarize, too:
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=222x64708

================
Some other info from http://www.speaker.gov/newsroom/legislation?id=0327

# Expands Medicaid. Individuals and families with incomes at or below 133 percent of the federal poverty level will be eligible for an expanded and improved Medicaid program. Recognizing the budget challenges in many states, this expansion will be fully federally financed. To improve provider participation in this vital safety net – particularly for low-income children, individuals with disabilities and people with mental illnesses – reimbursement rates for primary care services will be increased with new federal funding.
# Improves Medicare. Senior citizens and people with disabilities will benefit from provisions that fill the donut hole over time in the Part D drug program, eliminate cost-sharing for preventive services, improve the low-income subsidy programs in Medicare, fix physician payments, and make other program improvements. The bill will also address future fiscal challenges by improving payment accuracy, encouraging delivery system reforms and extending solvency of the Medicare Trust Fund.

[Bluenorthwest]

3. All I know is that it is a further codification of the discrimination

against my family that seems to be needed to please the heterosexual community. A bigoted law that will be unfair to millions of families.