AARP Bulletin To Members - "Health Care Reform and You: Here’s how the legislation would affect you"

[TomCADem]

Here's an AARP Bulletin to members discussing both the House Bill and the Senate Bill, and its impact on seniors, including the Medicare "doughnut" hole:

http://bulletin.aarp.org/yourhealth/policy/articles/_health_care_reform.html

If you don’t have insurance

About 46 million Americans—15 percent of the population—lack health insurance. The number of uninsured people ages 50 to 64 has grown 36 percent since 2000, to 7.1 million. Men and women in this group face higher premiums because they are older and usually have some health issues.

• House bill:

Anyone without health insurance must pay a fine -- 2.5 percent of income. People could purchase insurance through a health insurance exchange, where choices include competing private companies and a government option. Poor families’ premiums would be subsidized depending on income. Premiums for those over 60 could only be twice as high as those under 60. Both the House and Senate bill would cover about 94 percent of Americans.

• Senate bill:

People who don’t purchase coverage must pay a penalty of between $750 or 2 percent of income. People could purchase insurance through a health insurance exchange, where choices include private companies and a government option.

If you’re covered by Medicare

Some 44 million people—more than 11 percent of the population—are over age 65 and covered by Medicare.

• House bill:

The HHS Secretary would be authorized to negotiate drug prices. Costs of brand-name prescription drugs in the drug plan’s coverage gap—the doughnut hole—would be cut in half and the gap closes completely by 2019. The life of the Medicare trust fund is extended by five years. The bill aims to eliminate $170 billion in overpayments to Medicare Advantage programs, which currently make the cost of those plans 14 percent higher than traditional Medicare. It would provide $15 billion in payments to skilled nursing homes and rehabilitation centers; and provide Medicare coverage for doctors giving end-of-life counseling.

• Senate bill:

Prices in the brand-name prescription drug coverage gap are cut in half starting in 2014. Also, starting in 2010, the Medicare doughnut hole would start to be narrowed. The bill would extend the life of the Medicare Trust Fund by at least five years. It also would eliminate the overpayment, or subsidies, to Medicare Advantage programs; cut $15 billion in payments to skilled nursing homes and rehabilitation centers; and provide Medicare coverage for doctors giving end-of-life counseling.

If you’re insured by Medicaid

New plans would expand Medicaid by an estimated 11 million to 15 million people.

• House bill:

Medicaid expands. Families of four with income under $33,000 would be eligible. Families of four earning $88,000 would pay no more than 12 percent of their income for health insurance. Government subsidies would pay the rest.

• Senate bill:

Medicaid expands. Families of four with income under $29,326 (133 percent of poverty) would be eligible.

Financing the plan

• House bill:

Total cost: $1.05 trillion over 10 years. Individuals with income over $500,000 and families with incomes over $1 million would pay a 5.4 percent surtax. Costs would be financed by $400 billion in cuts to Medicare and Medicare Advantage.

• Senate bill:

Total cost: $871 billion over 10 years. Costs would be partially funded by about $420 billion in savings from future Medicare and Medicaid spending and $118 billion from Medicare Advantage. In addition, nearly $300 billion would come from new taxes and fees on health care insurers, clinical laboratories and manufacturers of health care devices. The payroll tax for Medicare would rise from 1.45 to 1.95 percent for those earning over $200,000 and a 10 percent excise tax on indoor tanning salons. The Senate also proposes an independent Medicare Advisory Committee authorized to impose Medicare cuts directly.

[FreakinDJ]

1. I don't understand - it says senate bill has Public Option

Senate bill:

People who don’t purchase coverage must pay a penalty of between $750 or 2 percent of income. People could purchase insurance through a health insurance exchange, where choices include private companies and a government option.

Is this wishful thinking or what

[TomCADem]

3. AARP - Here is the December 24th Post-Passage Update Re Public Option

Updated as of December 24th:

http://bulletin.aarp.org/yourhealth/policy/articles/senate_approves_bill.html

Rocky road to passage

The road to legislative reform hasn’t been easy. Along the way, Senate Democrats pieced together a delicate consensus that required changes in the bill: dropping a government-run public insurance option, which is still in the House bill; scrapping a Medicare buy-in provision for people 55 to 64 years old; and adding language prohibiting the use of government health insurance subsidies for plans that cover most abortion procedures.

Key provisions

The Senate bill would strengthen Medicare by requiring insurance companies to competitively bid to offer private Medicare Advantage plans, a move that is estimated to save $118 billion from 2010 to 2019. Currently Medicare beneficiaries are subsidizing enrollees in these plans, which cost an average of 14 percent more than traditional Medicare.

The bill also would:

• provide bonus payments for plans that provide top-quality service.

• encourage states to develop more choices of long-term care services, to enable older people to live in their own homes instead of more expensive nursing homes.

• improve health care and provide better care by, for example, giving bonus payments to hospitals with low rates of patient readmission.

• crack down on fraud and waste in the system.

• raise payments to primary care physicians and surgeons in areas where there is a shortage.

How the two final bills compare

The Senate and House bills differ on how to pay for health care reform. The Senate bill, estimated to cost $871 billion over 10 years, would finance its changes by raising the Medicare payroll tax for the wealthy, taxing high-cost health care plans offered by employers, taxing indoor tanning services, and reducing Medicare spending. The House legislation, estimated to cost $1 trillion over 10 years, would pay for reforms primarily by taxing the wealthy (individuals with incomes above $500,000 and families with incomes above $1 million) and also trimming nearly $450 billion in Medicare spending.

Under the Senate bill, those who lack employer health insurance could purchase coverage from an insurance company that would be negotiated by the federal Office of Personnel Management, which currently negotiates policies on behalf of federal government employees and members of Congress. The House bill contains the public option, a government-run insurance plan.

The Senate bill does not require employers to offer coverage, as the House does, but businesses with 50 or more employees would pay a penalty of $750 for each employee who receives a government subsidy. The House bill requires larger employers to offer health insurance or face fines.

In addition to the differences over the public option and the employer mandate, the House and Senate disagree on how far to expand Medicaid and on language forbidding the use of public subsidies to purchase health care plans that cover abortion. (The House bill would not allow any plans to cover abortion if they enroll subsidized members, whereas the Senate would allow plans to cover abortion but states would be able to ban such plans.)

Subsidies for low-income people

The Senate legislation would open Medicaid, the government health care program for low-income people, to millions more by raising the income eligibility limit to an annual income of $14,404 in 2009 for an individual and $29,327 for a family of four. The House bill is more generous, raising the income limit to an annual income of $16,245 in 2009 for an individual and $33,075 for a family of four.

Both bills would create insurance exchanges—a one-stop marketplace for health insurance for those not covered by employer insurance. Those who cannot afford to buy health insurance on their own or do not qualify for the expanded Medicaid coverage would be eligible for government subsidies to help them purchase insurance through the exchanges. Both bills offer subsidies for families with annual income of up to $88,200 in 2009 for a family of four.

If individuals don’t get insurance, the Senate bill would force them to pay a penalty as would the House bill.

Whether the different provisions in the bills can be reconciled remains to be seen. Controversy over the public plan alone could prove fatal for health care reform. Some supporters in the House have said they would not vote for a bill without it. Senate opponents say they would not support health care reform that included a public option. And because both bills passed with few or no votes to spare, some Washington observers warn that there may not be much room for compromise.

[nvme]

2. whats up with that?

There is NO PUBLIC OPTION IN SENATE BILL! WHY DO YOU THINK EVERYONE WHO IS NOT IN THE SENATE IS PISSED.

[eridani]

4. Maybe they should change their name to reflect the fact that they

--don't give a shit about retirees 50-64 and the fucking outrageous age rating that this shitty "reform" is mandating.