What does the bill mean for you? Who are the winners and losers?
Obama is a political winner and, depending on how popular the reform proves, the Democrats could be winners too.
If you are uninsured and have not been able to afford a policy, you are probably a winner. The subsidies are fairly generous.
The insurance companies must be counted among the big winners. They are going to get tens of millions of new customers, with their premiums subsidized by taxpayers. And many of those new customers will be winners too, as will people who have been unable to get insurance because of a pre-existing condition.
Insurers will have to offer coverage to people with pre-existing conditions in 2014; there will eventually be some review of premium increases; and there will be limits on how much they can spend on administration and profits (15 percent of premiums for large group plans, 20 percent for individuals and small group plans — but this is still many times higher than the administrative overhead for Medicare).
Medicare Advantage plans will get subsidized rather less by taxpayers. (The media have been calling this “cuts to Medicare” but old-fashioned Medicare won’t be affected.) The Medicare “donut hole” will be eliminated in 2020.
The state-run insurance exchanges through which individuals and small businesses can buy insurance won’t be up and running till 2014. But people with pre-existing conditions who have been uninsured for six months or more can sign up in 90 days for a high-risk program.
If you are a young woman not covered by a group plan and you might get pregnant, you are a winner. Currently, most individual plans don’t cover pregnancy. But the standard benefits to be provided by the insurance exchange will include pregnancy coverage — but wait! Not till 2014.
Want an abortion? Not so fortunate. You are on your own.
People who lose their jobs (or choose to leave them) after 2014 will, of course, still lose their employers’ coverage, but will be able to get insurance right away through the exchange.
More people will be covered by Medicaid (those with family incomes up to 133 percent of federal poverty level).
If your family income is $250,000, you’ll be asked to contribute more to Medicare funding and to pay a small tax on your investment income.
Now you may be thinking that this is all horribly complicated, and that it would have been a lot simpler to just cover everyone. We at HCAO would agree with you.
There is more information about the overhaul on the Federal Legislation page.