Obamacare as seen by CRS

There has been so much conversation about what will actually happen when Obamacare kicks in I thought you might want to see what their plans are. This is from CRS without any interpretation from me.

Effective by January 1, 2014

Maximum Out-of-Pocket Premium Payments Under PPACA by Family Size and federal poverty level.[13] (Source: CRS)
▪ Insurers are prohibited from discriminating against or charging higher rates for any individuals based on gender or pre-existing medical conditions.[97]
▪ Impose an annual penalty of $95, or up to 1% of income over the filing minimum,[98] whichever is greater, on individuals who are not covered by an acceptable insurance policy; this will rise to a minimum of $695 ($2,085 for families), or 2.5% of income over the filing minimum,[98] by 2016.[19][99] Exemptions to the mandatory coverage provision and penalty are permitted for religious reasons or for those for whom the least expensive policy would exceed 8% of their income.[100]
▪ Insurers are prohibited from establishing annual spending caps.[42]
▪ In participating states, Medicaid eligibility is expanded; all individuals with income up to 133% of the poverty line qualify for coverage, including adults without dependent children.[19][101] As written, PPACA withheld all Medicaid funding from states declining to participate in the expansion. However, the Supreme Court ruled, in National Federation of Independent Business v. Sebelius, that this withdrawal of funding was unconstitutionally coercive, and that individual states had the right to opt out of the Medicaid expansion without losing pre-existing Medicaid funding from the federal government. As of July 10, 2012, the governors of five states: Texas, Florida, Mississippi, Louisiana, and South Carolina, had announced that they would decline to participate in the Medicaid expansion.[102]
▪ Two years of tax credits will be offered to qualified small businesses. In order to receive the full benefit of a 50% premium subsidy, the small business must have an average payroll per full-time equivalent (“FTE”) employee of no more than $25,000 and have no more than 10 FTEs. For the purposes of the calculation of FTEs, seasonal employees, and owners and their relations, are not considered. The subsidy is reduced by 3.35 percentage points per additional employee and 2 percentage points per additional $1,000 of average compensation. As an example, a 16 FTE firm with a $35,000 average salary would be entitled to a 10% premium subsidy.[103]
▪ Impose a $2,000 per employee penalty on employers with more than 50 employees who do not offer health insurance to their full-time workers (as amended by the reconciliation bill).[30]
▪ For employer sponsored plans, set a maximum of $2,000 annual deductible for a plan covering a single individual or $4,000 annual deductible for any other plan (see 111HR3590ENR, section 1302). These limits can be increased under rules set in section 1302.
▪ The CLASS Act provision would have created a voluntary long-term care insurance program, but in October 2011 the Department of Health and Human Services announced that the provision was unworkable and would be dropped, although an Obama administration official later said the President does not support repealing this provision.[104][105][106][107]
▪ Pay for new spending, in part, through spending and coverage cuts in Medicare Advantage, slowing the growth of Medicare provider payments (in part through the creation of a new Independent Payment Advisory Board), reducing Medicare and Medicaid drug reimbursement rate, cutting other Medicare and Medicaid spending.[44][108]
▪ Revenue increases from a new $2,500 limit on tax-free contributions to flexible spending accounts (FSAs), which allow for payment of health costs.[109]
▪ Establish health insurance exchanges, and subsidization of insurance premiums for individuals in households with income up to 400% of the poverty line. To qualify for the subsidy, the beneficiaries cannot be eligible for other acceptable coverage.[101][110][111][112] Section 1401(36B) of PPACA explains that the subsidy will be provided as an advanceable, refundable tax credit[113] and gives a formula for its calculation.[114] Refundable tax credit is a way to provide government benefit to people even with no tax liability[115] (example: Earned Income Credit). The formula was changed in the amendments (HR 4872) passed March 23, 2010, in section 1001. According to DHHS and CRS, in 2014 the income-based premium caps for a “silver” healthcare plan for family of four would be the following:
Health Insurance Premiums and Cost Sharing under PPACA for average family of 4.[13][116][117][118][119]
Income % of federal poverty level
Premium Cap as a Share of Income Income $ (family of 4)a Max Annual Out-of-Pocket Premium Premium Savingsb Additional Cost-Sharing Subsidy
133% 3% of income $31,900 $992 $10,345 $5,040
150% 4% of income $33,075 $1,323 $9,918 $5,040
200% 6.3% of income $44,100 $2,778 $8,366 $4,000
250% 8.05% of income $55,125 $4,438 $6,597 $1,930
300% 9.5% of income $66,150 $6,284 $4,628 $1,480
350% 9.5% of income $77,175 $7,332 $3,512 $1,480
400% 9.5% of income $88,200 $8,379 $2,395 $1,480
a.^ Note: In 2016, the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four.[120][121] See Subsidy Calculator for specific dollar amount.[122] b.^ DHHS and CBO estimate the average annual premium cost in 2014 to be $11,328 for family of 4 without the reform.[116]

It’s About Today and Tomorrow

There’s much that the politicians can learn about the recent election. I think it is amply clear to most Republicans that they need to rethink their goals and objectives. Probably the most important thing they need to do as the GOP is drop the Grand Old Party title and encourage the far right religiously driven voting contingent to form their own party. They would probably have to side with the new Republican Party on most voting issues with the possible exception of some financial issues where the Libertarians would best reflect their beliefs. Of course they couldn’t vote as a block with the Libertarians because of the party’s liberal position on most social issues.

The far right would be very much like the black electorate that voted 97% with the democrat party because they had no other option. I know that some say the heavy vote for the democrats by the black population was because the President is partially black. My point is that if the President had been Mexican American and a democrat the blacks would have to vote for him and the other democrats running because they have no other practical option. Now I’m certain that some on the liberal side will say my observations are a racist comment but I don’t think that will fly in the face of realities of the voting history of the black community. Further the observations by some in the black community that Obama isn’t really black, he is just half black and the black community won’t be happy until a “real” black is elected as President of this country frees my comments from being racist.

On a financial consideration basis one of my liberal friends have made some suggests that a global tax be applies to U.S. basis corporations to lessen our national debt. The examples he has offered are complex, very difficult to police if not impossible. The truth is that any good international accountant or CFO can find ways around this kind of tax. In my friends example he uses Star Bucks as a corporation we can tax on a global basis. In fact in using Star Bucks he shows how a smart organization circumvents the taxes in various countries by buying a commodity cheap in one country then processing it cheaply in another country, we presumed by favored business practices to make the end product tax free in the UK. He hasn’t but he may suggest that our government could track down the many steps involved in this kind of a transaction. He may well suggest that since our government can identify every mad cow in this country they can follow a complex financial trial. I on the other hand I might offer our countries inability to find and capture eleven million immigrants as an example of their incompetence.

In order to address the financial debt we face and will face in the next four years I ask my liberal friend to first acknowledge that a democrat controlled Senate in power for the last two years of the Bush administration endorse and encourage the over expenditures by the Bush management team. Then I ask him to stop using Bush as the basis for every defense he makes of the Obama expenditures that drive the national debt up daily and weaken the social security and Medicare financial stability. Instead find a way just as Obama will with immigration to bring illegal immigrants into citizenship, bring our corporations funds back to the country without excessive penalties or taxes, off shore corporate funds that can be used to start new businesses.

Is it Real?

Is it Real?

We have heard for over a year that as a country we are in debt to the tune of 16 trillion dollars. My question is; does the average citizen really understand that we individually as well as collective owe16 trillion dollars in debt? It is very hard to comprehend this amount of debt even when it is expressed as $51,600 an individual or $141,622 as a family. The point of this blog is that the national debt seems totally out of our realm of thinking, of digesting as a real threat to our family. Rather most of our citizens think it is a theoretical problem to be solved by the government. The government’s job is to address these large problems and solve the issues without materially affecting our citizen’s lives. The truth is that the debt is real and we as individuals and families are responsible. If you question my statement look at what is happening in Greece today. The unemployment rate is over 25%, currency is being devalued, have you tried to change Euros for dollars recently, administrative services such as waste management and education are being reduced dramatically and the debt will not be reduced for seven years. My message is; take the debt as a real obligation that the government cannot negotiate our way out of it. In the final analysis we the citizens are going to be responsible for and have to pay it back in terms of reduced administrative services, higher taxes and a huge debt passed on to our children and grand children.

Is it True?

Is it Real?

We have heard for over a year that as a country we are in debt to the tune of 16 trillion dollars. My question is; does the average citizen really understand that we individually as well as collective owe16 trillion dollars in debt? It is very hard to comprehend this amount of debt even when it is expressed as $51,600 an individual or $141,622 as a family. The point of this blog is that the national debt seems totally out of our realm of thinking, of digesting as a real threat to our family. Rather most of our citizens think it is a theoretical problem to be solved by the government. The government’s job is to address these large problems and solve the issues without materially affecting our citizen’s lives. The truth is that the debt is real and we as individuals and families are responsible. If you question my statement look at what is happening in Greece today. The unemployment rate is over 25%, currency is being devalued, have you tried to change Euros for dollars recently, administrative services such as waste management and education are being reduced dramatically and the debt will not be reduced for seven years. My message is; take the debt as a real obligation that the government cannot negotiate our way out of it. In the final analysis we the citizens are going to be responsible for and have to pay it back in terms of reduced administrative services, higher taxes and a huge debt passed on to our children and grand children.