Sam Bauman: Thousands of pages, in one column
For the Nevada Appeal
The Patient Protection and Affordable Care Act – thousands of pages long and written in Congress-speak – is the law of the land. It’s difficult not to get technical when writing about the law; it’s something most of us find confusing. I’ve been studying the law for a couple of weeks and I’ve learned much, but not enough. We’ll go into the individual mandate at a future date. Much of what follows is from Internet pieces; some is mine.
• First off, ACA is not the “biggest tax hike in recent years”; in terms of percentage of Gross Domestic Product, it falls between the boosts of Presidents George H.W. Bush and Bill Clinton.
• Second, most seniors will not be greatly affected – except for those with Medicare Advantage, which will be phased out by 2020. No need to panic.
• There are immediate benefits for some. More than 5.2 million American seniors and those with disabilities will have saved millions on prescription drugs. And 750,000 of those on Medicare in the “doughnut hole” saved $450 million on drugs. People in the “doughnut hole” receive a 7 percent discount on all generic brands. Once they reach their yearly limit, the coverage gap ends and their Medicare plan pays for their covered drugs again.
• The ACA has given seniors free annual checkups and free preventive services like chronic-disease screenings.
• Once people reach the coverage gap in their Part D coverage, they will automatically get a 50 percent discount on covered brand name drugs and a 14 percent discount on generic drugs. The percentage of discounts will continue to increase until 2020, when the coverage gap is closed.
• Insurers are prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays, in new policies issued.
• Dependents may stay on their parents’ insurance plan until their 26th birthday, and regulations under ACA include dependents who no longer live with their parents, are not declared as a dependent on a parent’s tax return, are no longer a student, or are married.
• Insurers are prohibited from barring pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.
• Insurers are prohibited from charging co-payments, co-insurance, or deductibles for Level A or Level B preventive care and medical screenings on all new insurance plans.
• Insurance companies’ enforced annual spending caps will be restricted, and completely prohibited by 2014.
• Insurance firms are prohibited from dropping people and must reveal administrative and executive expenditures.
• Enhanced methods of fraud detection are implemented.
• Medicare is expanded to small, rural hospitals and facilities.
• Medicare patients with chronic illnesses must be monitored or evaluated on a three-month basis for coverage of the medications for treatment of such illnesses.
• Small-business owners with 50 or fewer employees will be able to get a tax credit that will almost match the cost of furnishing those employees health insurance.
Here’s what a Reuters-Ipsos poll of Americans during June 2012 found:
• Fifty-six percent of Americans overall were against the law, with 44 percent supporting it. By party affiliation, 75 percent of Democrats, 27 percent of independents and 14 percent of Republicans favored the law overall.
• Eighty-two percent favored banning insurance companies from denying coverage to people with pre-existing conditions.
• Sixty-one percent favored allowing children to stay on their parents’ insurance until age 26.
• Sam Bauman is a regular contributor to the Nevada Appeal.