Nearly 4M to pay health insurance penalty by 2016 Apr 22 02:16 PM US/Eastern By STEPHEN OHLEMACHER
WASHINGTON (AP) - Nearly 4 million Americans—the vast majority of them middle class—will have to pay the new penalty for not getting health insurance when President Barack Obama's health care overhaul law kicks in, according to congressional estimates released Thursday.
The penalties will average a little more than $1,000 apiece in 2016, the Congressional Budget Office said in a report.
Most of the people paying the fine will be middle class. Obama pledged in 2008 not to raise taxes on individuals making less than $200,000 a year and couples making less than $250,000.
Republicans have criticized the penalties, even though the idea for a mandate was originally proposed by the GOP in the 1990s and is part of the Massachusetts health care plan signed into law in 2006 by then Gov. Mitt Romney, a Republican. Attorneys general in more than a dozen states are working to challenge the mandate in federal court as unconstitutional.
"The individual mandate tax will fall hardest on Americans who can least afford to pay it, many of whom were promised subsidies by the Democrats and who the president has promised would not pay higher taxes," said Rep. Dave Camp of Michigan, the top Republican on the tax-writing House Ways and Means Committee.
Democrats argue the mandate and the penalties are a necessary part of a massive overhaul designed to expand coverage to millions who now lack it. They point out that getting young, healthy Americans in the insurance pool will reduce costs for others.
Americans who don't get qualified health insurance will be required to pay penalties starting in 2014, unless they are exempt because of low income, religious beliefs, or because they are members of American Indian tribes. The penalties will be fully phased in by 2016.
About 21 million nonelderly residents will be uninsured in 2016, according to projections by the CBO and the Joint Committee on Taxation. Most of those people will be exempt from the penalties.
Under the new law, the penalties will be phased in starting in 2014. By 2016, those who must get insurance but don't will be fined $695 or 2.5 percent of their household income, whichever is greater.
After 2016, the penalties will be increased by annual cost-of-living adjustments. People will not be required to get coverage if the cheapest plan available costs more than 8 percent of their income.
The penalties will be collected by the Internal Revenue Service through tax returns. However, the IRS will not have the authority to bring criminal charges or file liens against those who don't pay.
About 3 million of those required to pay fines in 2016 will have incomes below $59,000 for individuals and $120,000 for families of four, according to the CBO projections. The other 900,000 people who must pay the fine will have higher incomes.
The government will collect about $4 billion a year in fines from 2017 through 2019, according to the report.
Report: Health Overhaul Will Increase Nation's Tab
Associated Press
A report by economic experts at the Health and Human Services Department said the new health care law will expand insurance but won't reduce runaway costs
Mar. 30: President Barack Obama shakes hands after signing the Health Care and Education Reconciliation Act in Alexandria, Va. WASHINGTON -- President Barack Obama's health care overhaul law will increase the nation's health care tab instead of bringing costs down, government economic forecasters concluded Thursday in a sobering assessment of the sweeping legislation.
A report by economic experts at the Health and Human Services Department said the health care remake will achieve Obama's aim of expanding health insurance -- adding 34 million Americans to the coverage rolls.
But the analysis also found that the law falls short of the president's twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, however, since the report also warned that Medicare cuts in the law may be unrealistic and unsustainable, forcing lawmakers to roll them back.
The mixed verdict for Obama's signature issue is the first comprehensive look by neutral experts.
In particular, the warnings about Medicare could become a major political liability for Democratic lawmakers in the midterm elections. The report projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, "possibly jeopardizing access" to care for seniors. The report from Medicare's Office of the Actuary carried a disclaimer saying it does not represent the official position of the Obama administration. White House officials have repeatedly complained that such analyses have been too pessimistic and lowball the law's potential to achieve savings.
The report acknowledged that some of the cost-control measures in the bill -- Medicare cuts, a tax on high-cost insurance and a commission to seek ongoing Medicare savings -- could help reduce the rate of cost increases beyond 2020. But it held out little hope for progress in the first decade.
"During 2010-2019, however, these effects would be outweighed by the increased costs associated with the expansions of health insurance coverage," wrote Richard S. Foster, Medicare's chief actuary. "Also, the longer-term viability of the Medicare ... reductions is doubtful." Foster's office is responsible for long-range costs estimates.
Republicans said the findings validate their concerns about Obama's 10-year, nearly $1 trillion plan to remake the nation's health care system.
"A trillion dollars gets spent, and it's no surprise -- health care costs are going to go up," said Rep. Dave Camp, R-Mich., a leading Republican on health care issues. Camp added that he's concerned the Medicare cuts will undermine care for seniors. Congress in the past has enacted deeper Medicare cuts without disrupting service, and HHS Secretary Kathleen Sebelius issued a statement that sought to highlight some positive findings for seniors. For example, the report concluded that Medicare monthly premiums would be lower than otherwise expected, due to the spending reductions.
"The Affordable Care Act will improve the health care system for all Americans and we will continue our work to quickly and carefully implement the new law," the statement said.
Passed by a divided Congress after a year of bitter partisan debate, the law would create new health insurance markets for individuals and small businesses. Starting in 2014, most Americans would be required to carry health insurance except in cases of financial hardship. Tax credits would help many middle-class households pay their premiums, while Medicaid would pick up more low-income people. Insurers would be required to accept all applicants, regardless of their health.
A separate Congressional Budget Office analysis, also released Thursday, estimated that 4 million households would be hit with tax penalties under the law for failing to get insurance.
The U.S. spends $2.5 trillion a year on health care, far more per person than any other developed nation, and for results that aren't clearly better when compared to more frugal countries. At the outset of the health care debate last year, Obama held out the hope that by bending the cost curve down, the U.S. could cover all its citizens for about what the nation would spend absent any reforms. The report found that the president's law missed the mark, although not by much. The overhaul will increase national health care spending by $311 billion from 2010-2019, or nine-tenths of 1 percent. To put that in perspective, total health care spending during the decade is estimated to surpass $35 trillion.
Administration officials argue the increase is a bargain price for guaranteeing coverage to 95 percent of Americans. They also point out that the law will decrease the federal deficit by $143 billion over the 10-year period, even if overall health care spending rises.
The report's most sober assessments concerned Medicare.
In addition to flagging the cuts to hospitals, nursing homes and other providers as potentially unsustainable, it projected that reductions in payments to private Medicare Advantage plans would trigger an exodus from the popular program. Enrollment would plummet by about 50 percent, as the plans reduce extra benefits that they currently offer. Seniors leaving the private plans would still have health insurance under traditional Medicare, but many might face higher out-of-pocket costs.
In another flashing yellow light, the report warned that a new voluntary long-term care insurance program created under the law faces "a very serious risk" of insolvency.
New coverage for young adults will raise premiums Published - May 10 2010 04:01PM EST By RICARDO ALONSO-ZALDIVAR - Associated Press Writer
WASHINGTON— Letting young adults stay on their parents' health insurance until they turn 26 will nudge premiums nearly 1 percent higher for employer plans, the government said in an estimate released Monday.
The coverage requirement, effective starting later this year, is one of the most anticipated early benefits of President Barack Obama's new health care law. Many insurers have already started offering extended coverage to families who purchase their coverage directly. And employers say parents have flooded their benefits departments with questions.
The Health and Human Services Department released estimates of the costs and benefits of the requirement as part of a regulation directing employers and insurers how to carry it out.
The new benefit will cost $3,380 for each dependent, raising premiums by 0.7 percent in 2011 for employer plans, according to the department's mid-range estimate. Some 1.2 million young adults are expected to sign up, more than half of whom would have been uninsured.
Extended coverage will be required starting this fall, for health plan years beginning on or after Sept. 23.
That premium increase will come on top of hikes employers already expect for next year. Large companies forecast that premiums will rise between 6.5 percent and 7 percent without the impact of the health care overhaul, according to an early survey by the National Business Group on Health and benefits consultant Towers Watson.
Family coverage through the workplace now averages about $13,400 a year_ counting both the shares paid by the employer and worker. Many employers allow workers to keep college students on the company health plan until they graduate. But under the new law, staying in school would no longer be required..................>>>>..............>>>>.......http://www.rr.com/news/topic/a....._will_raise_premiums
Texas doctors opting out of Medicare at alarming rate By TODD ACKERMAN HOUSTON CHRONICLE May 17, 2010, 11:02PM photo Eric Kayne For the Chronicle Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.
Two years after a survey found nearly half of Texas doctors weren't taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.
“This new data shows the Medicare system is beginning to implode,” said Dr. Susan Bailey, president of the Texas Medical Association. “If Congress doesn't fix Medicare soon, there'll be more and more doctors dropping out and Congress' promise to provide medical care to seniors will be broken.”
More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010, according to data compiled by the Houston Chronicle. Texas Medical Association officials, who conducted the 2008 survey, said the numbers far exceeded their assumptions.
The largest number of doctors opting out comes from primary care, a field already short of practitioners nationally and especially in Texas. Psychiatrists also make up a large share of the pie, causing one Texas leader to say, “God forbid that a senior has dementia.”
The opt-outs follow years of declining Medicare reimbursement that culminated in a looming 21 percent cut in 2010. Congress has voted three times to postpone the cut, which was originally to take effect Jan. 1. It is now set to take effect June 1. Not cost-effective
The uncertainty proved too much for Dr. Guy Culpepper, a Dallas-area family practice doctor who says he wrestled with his decision for years before opting out in March. It was, he said, the only way “he could stop getting bullied and take control of his practice.”
“You do Medicare for God and country because you lose money on it,” said Culpepper, a graduate of the University of Texas Medical School at Houston. “The only way to provide cost-effective care is outside the Medicare system, a system without constant paperwork and headaches and inadequate reimbursement.”
Ending Medicare participation is just one consequence of the system's funding problems. In a new Texas Medical Association survey, opting out was one of the least common options doctors have taken or are planning as a result of declining Medicare funding — behind increasing fees, reducing staff wages and benefits, reducing charity care and not accepting new Medicare patients.
In 2008, 42 percent of Texas doctors participating in the survey said they were no longer accepting all new Medicare patients. Among primary-care doctors, the percentage was 62 percent.
The impact on doctors has not been lost on their patients. Kathy Sweeney, a Houston retiree, twice has been turned away by specialists because they weren't accepting new Medicare patients. She worries her doctors might have to drop her if Medicare cuts go through and they can't afford to continue in the program.
“I've talked to them about the possibility,” said Sweeney, who sent her legislators a letter calling on them to fix Medicare. “They're hanging in there as long as there's not a severe cut, but just thinking I couldn't continue doctor-patient relationships I built up over years is disturbing. Seniors should be able to see the doctors they want.”
The problem dates back to 1997, when Congress passed a balanced budget law that included a Medicare payment formula aimed at reining in spending. The formula, which assumed low growth rates, called for payment cuts if spending exceeded goals, a scenario that occurred year after year as health care costs grew. The scheduled cuts, expected to be modest, turned out to be large.
Congress would overturn the cuts, but their short-term fixes didn't keep up with inflation. The Texas Medical Association says the cumulative effect since 2001 already amounts to an inflation-adjusted cut of 20.9 percent. In 2001, doctors receiving a $1,000 Medicare payment made roughly $410, after taking out operating expenses. In 2010, they'll net $290. If the scheduled 21.2 percent cut goes through, they'd net $72, effectively an 83 percent cut since 2001.
The issue caused the Texas Medical Association to break ranks with the American Medical Association and oppose health care reform efforts throughout 2009. Then TMA President Dr. William Fleming said “reform is doomed to failure” without Medicare reform and called Congress' failure to devise a rational payment plan “an insult to seniors, people with disabilities and military families.” No surprise to senator
U.S. Sen. John Cornyn, R-Texas, said he isn't surprised by the new opt-out numbers, allowing that Congress' inability to reform Medicare is leaving “seniors without access and breaking the promise we made to them.”
“The problem has been how to eliminate the cuts without running up the deficit,” said Cornyn, responding to blame U.S. Rep. Gene Green, D-Houston, placed on the Senate for not passing a House bill that would have provided a longer-term Medicare fix. “There hasn't been the political will, but we really have no choice but to fix it.”
Cornyn acknowledged the task is daunting. The Congressional Budget Office recently estimated that eliminating scheduled Medicare payment cuts through 2020 would cost $276 billion.
The growth in Texas Medicare opt-outs began in earnest in 2007, when 70 doctors notified Trailblazer Health Enterprises, the state's Medicare carrier, they would no longer participate, up from seven in 2006. The numbers jumped to 151 in 2008, fell back to 135 in 2009 and are on pace for 200 in 2010. From 1998 to 2002, by contrast, no more than three a year opted out.
Now, according to a Texas Medical Association new poll, more than four in 10 doctors are considering the move.
“I've been in practice 24 years, and a lot of my patients got old right along with me,” Culpepper said. “It's stressful to tell them you're leaving Medicare and they're responsible for payments if they want to stay with you. You feel like you're abandoning them.”
The problem dates back to 1997, when Congress passed a balanced budget law that included a Medicare payment formula aimed at reining in spending. The formula, which assumed low growth rates, called for payment cuts if spending exceeded goals, a scenario that occurred year after year as health care costs grew. The scheduled cuts, expected to be modest, turned out to be large. Who was President in 1997 Stein?
You're starting to sound like Chris Mathews or Rachael Maddow a real liberal who can accept no responsibility for what your party does and the defense to every discussion is to blame someone else. It's not working for Obama either.
Doesn't make sense to blame the last person to touch it? How long do you want to go back blaming people for it? The system was made to save money, and it is for tax payers. If some doctor's don't want to accept it fine.
Stein the CBO has adjusted it's report and now says that the health-care bill as it's currently written won't save us any money and in fact will cost us more money than projected. The whole purpose for passing this bill was to save us money or was it.
Stein the CBO has adjusted it's report and now says that the health-care bill as it's currently written won't save us any money and in fact will cost us more money than projected. The whole purpose for passing this bill was to save us money or was it.
Costing more money means restrictive health care! Exactly what we have been saying all along. Either the health care will go broke just like SS or it gets 'restricted'. So there ya go liberals....pick your poison.
And congrats on your loses in the elections!!!
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
On March 20, 2010, CBO released its final cost estimate for the reconciliation act, which encompassed the effects of both pieces of legislation. Table 1 (on page 5) provides a broad summary and Table 2 offers a detailed breakdown of the budgetary effects of the two pieces of legislation. CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting both pieces of legislation will produce a net reduction in federal deficits of $143 billion over the 2010-2019 period. About $124 billion of that savings stems from provisions dealing with health care and federal revenues; the other $19 billion results from the education provisions. Those figures do not include potential costs that would be funded through future appropriations (those are discussed on pages 10-11 of the cost estimate).
Let's get a bigger picture here....back in the day the nurse was 'free'...a student or nun.....it was considered woman's work......it still kind of is now....we guess what it costs $$ and no one saw this coming??? yeah, some MD's might have fancy cars but most dont......but the fact remains that once the surgery is done which is a fraction(albeit difficult) time as compared to the recovery/nursing.....recovery also used to be done at home.....when most women were home and stayed home.....NEWSFLASH-----Mary Tyler Moore happened........if anyone thinks national healthcare without a gigantic union is sadly mistaken....
BTW if they tax the health insurance that I have already paid for via my time/energy/education etc....kiss my F'EN butt.......
the cost is in the 'service'....we looooooooove service.....we loooooove nice service.....we looooooove to be the righteous customer....and that costs $$$$$$.....national healthcare will not have room for that.. although to swallow that pill there maybe some sugar coating before the taxpayers demand it be reigned in......
YOU CANT AFFORD ME AND I CANT AFFORD YOU
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
WASHINGTON (AP) - Republicans are pointing to a leaked administration document as evidence President Barack Obama has broken his promise that Americans who like their health plans can keep them under his new overhaul law.
An early draft of an Obama administration regulation says that many employers will be forced to make changes to their health plans under the new law. The draft says in just three years, a majority of workers—51 percent—will be in plans subject to new federal requirements.
Employers say it's another sign that the law will drive up costs. Republicans say Obama did not keep his word. But some experts believe the increased regulation will lead to improved benefits for consumers.
Health overhaul to force changes in employer plans Jun 11 03:42 PM US/Eastern By RICARDO ALONSO-ZALDIVAR Associated Press Writer Comments (66) Email to a friend Share on Facebook Tweet this Bookmark and Share WASHINGTON (AP) - Over and over in the health care debate, President Barack Obama said people who like their current coverage would be able to keep it.
But an early draft of an administration regulation estimates that many employers will be forced to make changes to their health plans under the new law. In just three years, a majority of workers—51 percent—will be in plans subject to new federal requirements, according to the draft. Employers say it's more evidence that the law will drive up costs. Republicans say Obama broke his promise. But some experts believe increased regulation will lead to improved benefits for consumers.
"On the face of it, having consumer protections apply to all insurance plans could be a good thing for employees," said Alex Vachon, an independent health policy consultant. "Technically, it's actually improved coverage."
The types of changes that employers would be forced to make include offering preventive care without copayments and instituting an appeals process for disputed claims that follows new federal guidelines. The law already requires all health plans to extend coverage to young adult children until they turn 26. But such changes also nudge costs up.
The Obama administration said the draft regulation is an early version undergoing revision. Nonetheless, the leaked document was getting widespread interest Friday in lobbying firms that represent employers and insurance companies and on Capitol Hill.
"What we are getting here is a clear indication that most plans will have to change," said James Gelfand, health policy director for the U.S. Chamber of Commerce. "From an employer's point of view that's a bad thing. These changes, whether or not they're good for consumers, are most certainly accompanied by a cost."
Senate Republican Leader Mitch McConnell of Kentucky said it showed that Obama's assurance that Americans would be able to keep the plans they currently have was "a myth" all along.
"Since its passage, Republican arguments against the bill have been repeatedly vindicated, even as the administration's many promises about the bill have been called into question again and again," McConnell said. "So Democrats may have passed this bill, but the debate is far from over."
An administration official, speaking on condition of anonymity because the rules are still being written, said the final version will uphold Obama's promise, accommodating employers' desire for flexibility while protecting consumers from runaway costs.
Employer provided coverage is the mainstay of the nation's health insurance system and is expected to remain so even after the new health care law is fully phased in.
The main issue in the 83-page regulation is how to deal with what the government calls "grandfathered" health plans.
Those are plans that predated the health care law and are exempt from many, but not all, of its consumer protections. Lawmakers created the special category to deliver on Obama's promise that people can keep the coverage they have if they like it.
But health plans change frequently. Premiums and copayments keep rising. Coverage is expanded for some services and restricted for others. Lawmakers asked regulators to spell out how much an employer can change a plan and still claim it to be grandfathered, exempting it from closer federal regulation.
Employers say the draft rules are too inflexible. Generally plans can lose their protected status by increasing copayments and deductibles above certain limits. Gelfand said medical inflation alone would push many employers over the line.
How employers react to the final rules will be critical. If major companies start dropping health care benefits, opting instead to pay the government a penalty, Democrats would face a political backlash.
Stronger consumer protections can mean higher costs for employers. But whether there's a tipping point ahead is still unclear.
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