Key details of the bill The plan, according to CBO projections, will cut budget deficits by more than $1 trillion in its second decade. It will subsidize insurance for a family of four making up to about $88,000 annually, or 400 percent of the federal poverty level. It also creates a series of health insurance exchanges designed to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage. Medicaid will be significantly expanded, ensuring coverage to those earning up to 133 percent of the poverty level, or just over $29,000 for a family of four. The bill cuts projected Medicare spending by roughly $500 billion, in part through reductions in the Medicare Advantage program. Democratic leaders have promised the reductions will not affect service to Medicare recipients. The bill hikes Medicare payroll taxes on families making more than $250,000. Starting in 2013, it also imposes a 40 percent tax on insurance companies providing "Cadillac" health plans valued at more than $8,500 for individuals and $23,000 for families. Proponents of the tax on high-end plans say it's one of the most effective ways to curb medical inflation. However, many Democrats oppose taxing such policies because it would hurt union members who traded higher salaries for more generous health benefits. If the compromise bill becomes law, the threshold for imposing the Cadillac tax will be raised to health plans valued at more than $10,200 for individuals and $27,500 for families. The tax won't kick in until 2018. Buy insurance or pay a fine Under the plan now headed to Obama, individuals are required to purchase health insurance coverage or face a fine of up to $750 or 2 percent of their income -- whichever is greater. It includes a hardship exemption for poorer Americans. Companies with more than 50 employees that don't provide coverage are required to pay a fee of $750 per worker if any of its employees rely on government subsidies to purchase coverage. The compromise package would drop the individual fine to $695 or 2.5 percent of income, whichever is greater. The fine on companies failing to provide coverage would jump to $2,000 per employee. Federally funded abortion coverage for people purchasing insurance through the exchanges will be banned under the bill now passed by Congress. Exceptions will be made in cases of rape, incest, or danger to the life of the woman. Individuals receiving federal assistance who want abortion coverage will have to purchase the coverage using private funds. Illegal immigrants will be barred from buying insurance in the health insurance exchanges. Parents, however, will be entitled to keep their children on their health care plans until age 26. While passage of the Senate bill is a major win for Democrats on a major party priority, Pelosi had to take a number of steps in recent weeks to assuage House members unhappy with the measure. A deeply unpopular special exemption for the state of Nebraska from all new Medicaid expenses -- known as the "Cornhusker kickback" -- would be eliminated under the compromise plan. The federal government will instead assist every state by picking up 100 percent of the costs of expanded Medicaid coverage between 2014 and 2016, and 90 percent starting in 2020. The speaker also tried to sweeten the deal for some progressive members of her caucus partly by adding additional subsidies and a major student loan overhaul measure to the compromise plan. The measure -- a priority for Obama -- would end the practice of having private banks offer student loans and would expand direct lending from the government. source-cnn.com Last edited: 22-Mar-10 07:23 AM

kukur · Mar 22, 2010 7:22 AM

The republicans aren't so much against health care reform as they are against anything the democrats do. They are terrified of allowing the democrats to actually accomplish anything. The polarization in politics has gotten to the point where the government is practically crippled (some would say this is a good thing) Really, its gotten to the point that if the democrats said "puppies are cute" that the republicans would launch an anti-puppy campaign. If the democrats were to state that "Satan is evil" I'm pretty sure that there are at least a few of the neo-cons that would feel compelled to speak out in favor of the Price of Lies (and no..I'm talking about Cheney...)  

kukur · Mar 22, 2010 7:25 AM

with America going broke, wonder how can we afford this?

novaguy83 · Mar 22, 2010 7:43 AM

thanks for the input kukur ji (nice name though) , So how will the bill affect international students like us?? or the americans with lower level income, since everyone has to buy the insurance??

shrek431 · Mar 22, 2010 10:04 AM

WITHIN THE FIRST YEAR OF ENACTMENT Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted. Insurers will be barred from excluding children for coverage because of pre-existing conditions. Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college. Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014. A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014. Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent. A tax credit becomes available for some small businesses to help provide coverage for workers. A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1. WHAT HAPPENS IN 2011 Medicare provides 10 percent bonus payments to primary care physicians and general surgeons. Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients. A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care. Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare. Employers are required to disclose the value of health benefits on employees' W-2 tax forms. An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less. WHAT HAPPENS IN 2012 Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care. An incentive program is established in Medicare for acute care hospitals to improve quality outcomes. The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions. WHAT HAPPENS IN 2013 A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care. The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016. The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group. A 2.9 percent excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax. WHAT HAPPENS IN 2014 State health insurance exchanges for small businesses and individuals open. Most people will be required to obtain health insurance coverage or pay a fine if they don't. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange. Health plans no longer can exclude people from coverage due to pre-existing conditions. Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine. Health insurance companies begin paying a fee based on their market share. WHAT HAPPENS IN 2015 Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services. WHAT HAPPENS IN 2018 An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions. (Reporting by Donna Smith; Editing by David Alexander and Eric Beech) Source: http://www.reuters.com/article...

ananta09 · Mar 22, 2010 1:57 PM

This rule sucks for H1 B and F1 and such status. It will take 10% of your income so if you are making 100 K then 10,000 will go for this .. which really really suck . If you really understand the really what they are trying to get from this is only political control over people ....

BetterNepal · Mar 22, 2010 2:11 PM

Oh really??? "It will take 10% of your income so if you are making 100 K then 10,000 will go for this" What is the source for this information?

ananta09 · Mar 22, 2010 2:15 PM

Hope this helps Part I Part II Part III

Lahure Kancha · Mar 22, 2010 2:31 PM

BetteNepal is funded by GOP. Where the heck u read it would go up by 10%? Tetteikai. The biggest change might be that health insurance would be mandatory. This probably extends to students too but I am not positive on that. U have to either get insurance or pay about 300 dollars roughly. I say this is still good since u now will have a choice to chose between various insurers and nepalese don't always have to chip in whenever someone is seiorsly sick or dies.

Stiffler · Mar 22, 2010 2:47 PM

BetterNepal is not only funded by GOP, but also married to TEA PARTY member.

Sexy In Sari · Mar 22, 2010 3:07 PM

I am always with "Universal Health Care for all" like in many other countries. But this reform is better than status quo. If you think doing nothing was a good idea, and you are worried that your medicare taxes will go up 0.9 %  if you make over $ 200,000 then you are with fox news and all the rich people out there, who do not care about rest of the people except their idiotic racist ideologies and their own money.

ananta09 · Mar 22, 2010 7:18 PM