So, what's in the reconciliation bill?
Posted on March 23rd, 2010 by Jason Rosenbaum in Solutions that Work
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The President signed the Senate health care bill into law at noon today.
This year, over 4 million small businesses will get tax credits worth up to 35% of their health care costs. This year, seniors will get $250 towards closing their coverage donut hole. This year, young Americans will be able to stay on their parent's insurance plan until they are 26. This year, lifetime caps on benefits will be a thing of the past. And this year, the people with pre-existing conditions who can't get health care now at any price will be able to buy into high-risk pools until the exchanges are set up in 2014.
But we are not done. Right after the House passed the health care bill on Sunday, they passed a package of improvements that now head to the Senate for an up-or-down vote.
The fixes heading to the Senate are mostly focused on making health care affordable to middle class families.
First, the package vastly improves the excise tax on "Cadillac" insurance plans, raising the threshold at which a plan will be affected to $10,200 for individual plans and $27,500 for family coverage. It also delays the implementation of the tax until 2018. As a result, the burden on middle tax families will be dramatically reduced.
To make up for the loss in revenue, the fixes broaden the Medicare payroll tax on on rich investors, taxing net investment income for those who make more than $250,000 per year.
And second, the package increases the subsidies available in the exchanges for middle class families and lowers their cost sharing. With the package, a lower percentage of a family's income will be spent on health care costs - both premiums and out of pocket.
And there are more provisions in the package that would help broad swaths of the American public:
- The package fully closes the donut hole for seniors over time
- It freezes Medicare Advantage overpayments to private insurers and requires private insurers to pay 85% of money in to benefits in Medicare Advantage, to match the levels for all insurance plans in the health care bill
- It strikes the deals Senators like Ben Nelson received and replaces them with increased Medicaid funding to all states
- And it funds student loans for millions of young Americans
The Senate, after a string of favorable parliamentary rulings, is expected to take up the improvements under budget reconciliation rules today, with the goal of a final vote at the end of this week before the Easter recess.
How great it is that America has the Democrats and President Obama to do the hard work and fight the hard fight to improve health care in America. I am so proud and so thankful for everything that has been accomplished.
This was one bet I was happy to lose — although I don't like to lose. Being a pessimist (I prefer realist), I bet a friend who was more potimistic than I, that the House wouldn't have the guts to adopt the Senate, the only thing they could have done to keep the Health Reform momentun on track. We bet a dinner for four (our wives were included in the bet). I'm happy to say I will pay off that bet this weekend. And now that the ball is rolling and the die is cast and the brave Democrats who bucked the obnoxious, loud-mouthed leaders of the right (Rush, Glenn, Michael, Sean et al), they can't stop here. They must see it through and make recnciliation a done deal. I'm proud to be a Democrat — for a long time, I wouldn't dare say that much less feel it.
You know, I made a bet with a friend a while back about the public option. Being an optimist, I said we would get one. I owe him a party. But it's ok, we've still got something to be proud of here.
I am not happy to hear that doctors may have to take pay cuts for Medicare patient cases. There is likely NO basis for that!
But, I am very happy that we have re-shuffled the deck, in making it clear, we would MUCH rather allocate precious resources to medical care for every American, than continue to squander trillions in the military-industrial complex. How does the health care reforms get paid for? But letting go of the innane notion that there always have been wars and so there always will be wars. The main reason for wars is our insepid insistence that everyone adopt US culture, public policy and beliefs. We are not the most advanced culture in the world, but tell that to the idiots on the far right!
From my understanding the doctors are getting a raise on Medicaid patients to bring them up to Medicare pay. Never read anything about a cut in the bill and I read most of it.
Yep, you're right.
This HCR is a godsend. Thanks to all Democrats and the organisations backing them for making this possible. Now, my two oldest children who couldn't afford healthcare prior to Pres Obama signing HCR into law, can now afford healthcare.
It seems the bill has nothing immediate for those that are too poor to afford insurance. I guess they just keep dying till 2014…
Not true, subsidized high risk pools will be set up within six months so people can have insurance until the Exchanges are up and running in 2014.
I'm all for Health Care Reform, but what does student lending have to do with this? Shouldn't that be part of a higher education bill?
The improvements to the health care bill are passed using budget reconciliation, which is a legislative process that needs only 50 votes in the Senate. It's used a lot for a grab-bag of items. This year, it's being used for both health care fixes and student loans.
I, too am very proud to be a Democrat. But we have a lot of work ahead. We must all get togather and make sure all Democrats vote in upcoming election or everything we have worked so hard for will disappear. We must not allow the U.S. to fall into the hands of the people that are talking about a civil war over health care. These people have gone over the deep end. To deny over 30 million of their fellow citizens health care isn't even human. It distrubs me to see our brave congress people being threatened just for doing their job. So we must stick together to make sure these crazy people never get control.
I couldn't agree with you more. The fact that not even one Republican voted for health care for all Americans screams volumes about who they really represent!
The Health Care reform law is a good start, but it does not go far enough. President Obama's plan covered much more. Too many of the benefits provided by the new law take much too
long to go into effect. People need help now! The republicans apparently don't know what it's like to have to struggle when your resources, despite your best efforts, are not sufficient to cover basic necessities such as health insurance. Let them have to make the painful choice between seeing a doctor, paying the mortgage or rent, or providing enouh food and clothing for your family.
They, (members of Congress and the Senate) will never have to make those choices. Their health care has always been provided by TAXPAYER DOLLARS. And if they run a little short for groceries (not likely), they can always call the health insurance companies or the pharmaceutical companies who will be happy to take them and their family out to dinner. Who is really running this country? The health Ins. co's. & big pharma. It is painfully clear when one compares the cost of drugs in the USA to the cost of drugs in Canada. Our leaders do not care about us, they only care about their own pockets being lined.
Not anymore! The bill says Members of Congress have to have the same plans we have.
I was happy to hear the bill passed especially since myself and family members have been denied health care because of pre-existing conditions, however, will they cap the amount we would have to pay for "high risk" insurance? right now in South Dakota, you can only get high risk, if you completed cobra if you have it and never missed a payment on an insurance premium, and the cost is so high, its more then most SD people make on a paycheck with a deductable, so high you,d never meet the deductable, and yet the govenor brags about(because he's connected to the insurance industry). So it sounds like I'll be paying the gov. penalty rather then being able to have insurance and our State is foolishly challeging the Health bill even though more then a 1/4 or more people have no insurance. So I am worried, its not over yet….Pat
Not over yet, to be sure. Under the new provisions, insurers will have to offer good health plans, not just high-risk plans, rates will be monitored, and subsidies offered so it's affordable.
I too am having a problem understanding how this may help someone in my position. I am among the working poor, don't qualify for medicaid but can't afford to buy insurance. Can somone clarify this for me? It seems like it is more geared toward business owners, and people who make more money than me.
It depends what you make per year. Under the new law, in 2014, if you make less than 133% of the federal poverty level you can get Medicaid. That's a large increase in the threshold.
If you make more than that, you'll be able to buy insurance on the new exchange in your state and the government will provide you tax credits so you can afford it.
So either way, there's a lot for you.
It's hard to believe, but we did it! Elected Barack AND kept his vision for America on track in Congress, depite every scummy obstructionist trick the Rethuglicans and renegade lobby-bought Democrat could pull.
WE CAN DO IT- WE DID IT- AND WE'LL DO IT AGAIN! By the way -Rush the Flaming Nazi gasbag has promised to leave the country if the health care reform bill passes- let's help his 300-lbs of felony-lawbreaking-narcotic-addict whimpering along with our boot, shall we? Ahh- why bother. Just another Right-wing antiprogressive, antiDemocratic LIE… tunes to the classical music station (oh wait, that's "libbrul"). Sounding shallow and shrill these days, these Repubs. Not even the Bush-lice could fool ALL the People ALL the Time!