I'm reading here on the details
http://www.gather.com/viewArticle.action?articleId=281474978120546
It seems all the taxes kick in this year and actual benefits don't start till 2014 strangly. My guess to generate cash now my feeling is benefit will never arrive looking at government almost in bankruptcy right now.
http://market-ticker.denninger.net/archives/2104-How-Far-Down-The-Rabbit-Hole-Must-We-Go.html
Starting in 2014, require that most Americans have a minimum level of health insurance or else pay a penalty.
Senate bill
Penalty: In 2014, $95 a year or 0.5 percent of a household’s income, whichever is greater; in 2015, $495 or 1 percent of income; in 2016, $750 or 2 percent of income (with a maximum of $2,250 for a family). The penalty would be adjusted for inflation after 2016.
Exemptions: American Indians; people with religious objections; people who can show financial hardship; people without coverage for less than three months; households with income below 100 percent of the poverty level ($22,050 for a family of four in 2009); households that would pay more than 8 percent of their income on premiums for the cheapest available health plan.
Reconciliation bill
Would revise the penalty for some years: In 2014, $95 a year or 1 percent household’s income; in 2015, $325 or 2 percent of income; in 2016, $695 or 2.5 percent of income (with a maximum of $2,085 for a family).
Instead of using the poverty threshold to exempt low-income people, the bill would exempt households with incomes below the tax-filing threshold — $9,350 for individuals and $18,700 for couples in 2009.
Within six months, require health plans, including employer-sponsored plans, to cover children of policyholders up to a certain age.
Senate bill
Would allow children to stay on their parents’ insurance plans through age 26. Currently, states set the age at which adults can no longer be covered by their parents’ insurance.
Reconciliation bill
Would apply the requirement to cover children to all existing plans within six months, not just new plans.
Before 2014, only children who do not have a choice of coverage from an employer can stay on their parents’ plan.
Starting in 2014, provide tax credits to low- and middle-income people to help them buy insurance through the exchange.
Senate bill
Would provide tax credits, on a sliding scale, to people with incomes up to 400 percent of the federal poverty level ($88,200 for a family of four) to help pay insurance premiums and out-of-pocket costs like co-payments and deductibles.
Households in the lowest income group — those below 150 percent of the poverty level ($33,075 for a family of four) — would pay 2 percent to 4.6 percent of their income on premiums. Health plans would cover 90 percent of the cost of the benefits.
Households in the highest income group eligible for subsidies — those between 350 percent and 400 percent of the poverty level ($77,175 to $88,200 for a family of four) — would pay 9.8 percent of their income on premiums. Health plans would cover 70 percent of the cost of the benefits.
Subsidies would increase at the same rate as the increase in premium contributions from the previous year.
The proposal would limit out-of-pocket spending at $5,950 a year for individuals and $11,900 for families.
Reconciliation bill
Would offer more generous subsidies to lower income groups. Households below 150 percent of the would pay 2 percent to 4 percent of their income on premiums. Health plans would cover 94 percent of the cost of benefits.
Starting in 2019, the subsidies would grow at a slower rate than under the Senate bill.
Would not explicitly require employers to offer coverage. Starting in 2014, penalize some employers if low- and middle-income workers use federal subsidies to buy insurance.
Senate bill
Employers with 50 or more full-time workers would pay a penalty if they do not offer health benefits and if any of the workers obtain subsidized coverage through the new health insurance exchanges.
Penalty: $750 for each full-time worker in the company.
Employers with more than 50 workers that offer coverage would also pay a penalty if any of the workers obtain subsidies to buy insurance. In this case, the penalty would be $3,000 for each employee who receives subsidized coverage, or $750 for each full-time worker in the company, whichever is lesser.
Employers who offer coverage would be required to provide vouchers — equal to what the employer would have paid under the company’s plan — to low- and middle income workers to obtain insurance on their own through the exchanges. These firms would not be subject to penalties if any of the employees receive subsidies. People with incomes up to 400 percent of the federal poverty level ($88,200 for a family of four) would be eligible for the vouchers if they spend between 8 and 9.8 percent of their income on premiums.
Reconciliation bill
Would increase the penalty to $2,000 for each full time worker in the company, but would exempt the first 30 employees while calculating the penalty. For example, an employer with 53 workers would pay the penalty for 23 workers, or $46,000.
Starting in 2010, provide tax credits to small businesses that want to offer coverage. Subsidize employer plans that cover early retirees ages 55 to 64.
Senate bill
Employers with 25 or fewer workers and average wages of $50,000 or less could qualify for tax credits. Employers with 10 or fewer workers and average wages of less than $25,000 can get the full credit — up to 35 percent of premium costs between 2010 and 2013 and 50 percent thereafter. The credit would phase out as firm size and average wage increases.
The federal government would cover 80 percent of the cost of a retiree’s medical claims of more than $15,000 through 2013, with a cap at $90,000 — at which point the employer’s plan would pay the rest.
Reconciliation bill
No major changes.
Prohibit insurers from denying coverage or charging higher premiums because of a person’s medical history or health condition.
Senate bill
People with pre-existing conditions who have been turned down for health insurance could sign up for a high-risk insurance pool that would be available within 90 days and remain available until 2014. Within six months, insurers would be prohibited from denying coverage to children based on pre-existing medical conditions, from placing lifetime dollar limits on coverage and from rescinding coverage when a person becomes sick or disabled. The ban on exclusion based on pre-existing conditions would be extended to every one when the exchanges are operational in 2014.
Premiums for older people cannot be more than three times the premium for young adults.
Insurers competing in the new exchanges would be required to justify rate increases and those who raise prices excessively could be barred from the exchanges.
Insurers would be required to spend more of their premium revenues — between 80 to 85 cents of every dollar — on medical claims. According to a recent Senate Commerce Committee analysis, the largest for-profit insurance companies spend about 74 cents out of every dollar on medical care in the individual market.
Reconciliation bill
Would extend the ban on lifetime limits and rescission of coverage to all existing health plans within six months.
Would extend the ban on exclusion based on medical condition and annual limits to all employer-sponsored health plans by 2014.
Impose new fees and taxes. Curb Medicare payments to hospitals and many other health care providers.
Senate bill
TAX ON HIGH-COST HEALTH PLANS: Starting in 2014, would impose a 40 percent excise tax on high-cost employer-sponsored group health plans with premiums over $8,500 for individual coverage and $23,000 for family. The thresholds would rise each year by the inflation rate plus one percentage point. The bill would provide a special dispensation to police officers, firefighters, miners and construction workers, who have high premiums because they work in high-risk occupations.
MEDICARE PAYROLL TAX: Starting in 2013, would increase tax rate — from 1.45 percent to 2.35 percent – for individuals earning more than $200,000 a year and families earning more than $250,000.
FEES FROM HEALTH CARE SECTOR: Would impose annual fees, allocated by market share, on health care companies. Starting in 2010, drug makers would pay $2.3 billion a year. Manufacturers of medical devices would pay $2 billion in 2011 and $3 billion after 2017. For insurance companies, the fee would start at $2 billion in 2011 and gradually increase to $10 billion a year in 2017. Nonprofit insurance companies could be exempt if they spent a large share of their premiums on medical care rather than administrative costs.
FLEXIBLE SPENDING ACCOUNTS: Starting in 2011, would place a $2,500 annual limit on what people can set aside from their paychecks before paying taxes to use for health care expenses.
TANNING TAX: Would impose a 10 percent tax on indoor tanning services starting in 2010.
MEDICARE SAVINGS: Squeeze roughly $500 billion out of the projected growth in Medicare over 10 years, including $116 billion in cuts to federal subsidies for privately offered Medicare Advantage plans.
Reconciliation bill
TAX ON HIGH-COST HEALTH PLANS: Would delay the application of the tax until 2018 and would increase the thresholds to $10,200 for individual coverage and $27,500 for family. Beginning in 2020, the thresholds would be rise by the inflation rate.
MEDICARE PAYROLL TAX: Would impose an additional 3.8 percent tax on capital gains, dividends, interest and other “unearned income.”
FEES FROM HEALTH CARE SECTOR: Would delay the implementation of all fees by one to three years. Drug makers would pay $2.5 billion in 2011, $3 billion from 2012 to 2016, $3.5 billion in 2017, $4.2 billion in 2018, and $2.8 billion in 2019 and thereafter. For insurance companies, the fee would start at $8 billion in 2014 and rise to $14.3 billion in 2018, after which point the fee would rise yearly by the rate of premium growth. Medical device manufacturers would pay 2.9 percent excise tax on devices sold (excluding eyeglasses, contact lenses, and hearing aids).
FLEXIBLE SPENDING ACCOUNTS: Would delay the provision until 2013.
MEDICARE SAVINGS: Would imposes an additional $16 billion in cuts to Medicare Advantage plans, which now cost the government more on average than traditional Medicare, for a total of $132 billion in reductions.