Nancy Pelosi, the Speaker of the House of
Representatives who shepherded the Patient Protection and Affordable Care Act
through her chamber in 2009 and 2010, once famously said that we need to pass
the bill so that we can find out what’s in it. Fair enough; now that it has
passed, here’s a sample of what’s in it:
·
The HHS now
has authority over all physicians and their decisions, even if they are
treating patients in private practice and/or under private insurance plans
having nothing to do with Medicare or Medicaid.
·
Citizens who
fail to enroll in a health insurance plan approved
by the Secretary of the Department of Health and Human Services (HHS) will
be fined: $285 in 2014; $975 in
2015; $2,085 in 2016. Your current plan may not qualify for approval,
especially if it is a low-premium, high-deductible plan. See Section 1501 of
the law.
·
The IRS will
withhold income tax refunds from taxpayers who fail to prove that they are
enrolled in an HHS-approved plan.
·
Employers of
50 or more full-time employees must provide an HHS-approved health plan or pay
a fine of $2000 for each employee beyond the thirtieth.
·
$716 billion
will be siphoned out of Medicare to pay for Obamacare.
·
Capital gains
taxes (like the one that hits you when you sell your house after a lifetime of
paying your mortgage on time) go up 3.8 percent on gains over $200,000.
·
A 40% tax on
high-end ‘Cadillac’ health care plans.
·
No more
low-premium, high-deductible plans allowed. Mini-Med plans such as the ones
offered by McDonald’s to entry-level workers, are now history.
·
New limits on
tax deductions for medical expenses. The threshold is now 10 percent of your
income instead of 7.5 percent.
·
The law creates
the Independent Payment Advisory Board, or IPAB. The Board’s decisions may only
be overruled by Congress with a 60 percent supermajority in the Senate. Until
the board is seated, the Secretary of the Department of Health and Human
Services (Kathleen Sibelius) wields the board’s authority.
·
You will have
to tell your boss how much money your spouse and children earn. Your employer
is required by law to collect information about your total household income in order to classify you in the right
‘affordability’ category.
·
Tax-free
contributions to Flexible Spending Accounts or FSAs are capped at $2,500.
Likewise, the use of Health Savings Accounts (HSAs) is restricted and
deductibles are capped at $2,000 for individuals, $4,000 for families. These
accounts may no longer be used to pay for over-the-counter drugs. Tax penalties
for non-allowable purchases made through these accounts increase from 10 to 20
percent.
·
The Medicare
Part A payroll tax is hiked for taxpayers (like job-creating small business
owners) who earn more than $200,000 individually or $250,000 as a couple.
·
Funding for
Medicare Advantage is to be cut 27%. Each of its 7 million currently covered
seniors will get on average $3,700 less allowance per year.
·
Spending to
staff the government health care bureaucracy is expected to more than double to
over $70 billion by the year 2020.
·
Waivers: 1600
(and counting) special privileges of exemption from compliance with Obamacare’s
mandates have been awarded disproportionately to unions and groups that
supported Obama’s political agenda. The waivers weren’t written in the law, but
they have become part of the policy implementation since the law passed. So
finding out what’s in it includes finding out that privileges, prejudices and
enforcement will be arbitrary and based on political favoritism.
·
People who
don’t get health coverage from their employer or from traditional government
programs like Medicare and Medicaid are expected to shop for it at subsidized
rates on ‘exchanges’ sponsored by the law, starting in 2014. Half of the states
have so far refused to do the federal government’s bidding, so presumably the
federal government will set up them on its own in those states. Companies that
offer health insurance to their employees will nevertheless be fined for
failing to provide adequately if their employees opt for shopping on the
exchanges.
·
…and a whole
lot of other stuff contained in its 2,500+ pages that none of the congressmen
who voted on it read in its entirety.
Even though the law itself is comprised of over
2,500 pages of legalese, administrative departments like HHS still have the
task of interpreting the law and writing the derived regulations that
companies, individuals, patients and doctors are supposed to comply with. That
will multiply the volume several times over.
Many of the nicest people you will ever meet
supported the bill with the best of intentions, including most of this author’s
family and social circle. But if every senator and representative in
Congress – and the citizens who voted for them – had known that all of the
above was in the bill, would it have passed?
---------------------------------
This article is excerpted from ‘Pull
the Plug on Obamacare’, available in Kindle
and paperback
editions from Amazon.com.