The Facts about Obamacare

The recent Supreme Court ruling upholding the Patient Protection Affordable Health Care Act is a step in the right direction for health care in America.  No longer will individuals be denied coverage due to a pre-existing condition nor will they be cancelled by their insurance company for being high risk.  Young adults will also be allowed to remain on their parent’s health care plan up to the age of twenty-six.  Most Americans agree these are good ideas.  The following is a timeline of benchmarks that will be implemented under this new health care plan.  This information was extracted from the website  Costs vary depending on who is interpreting the plan. 


New Consumer Protections

7/1/10 – Putting information online for consumers to compare health coverages.

7/1/10 – Provide access to insurance for those Americans with pre-existing conditions.

9/23/10 – Prohibit insurance companies from denying coverage to kids under 19.

9/23/10 – Prohibit insurance companies from rescinding coverage due to errors on application.

9/23/10 – Eliminate lifetime limits on coverage.

9/23/10 – Regulate Annual limits on coverage.

9/23/10 – Consumer can appeal insurance company decision by going through an external review process.

9/23/10 – Establish consumer assistance program to help navigate through health care selection process.  States must apply for federal funding for this project.

9/23/10 – First phase of tax credits available for small businesses.  Company eligible for up to 35% of the employers contribution to employee health insurance.  Non profit rate is 25%.

9/23/10 – Extend coverage to young adults under 26 by allowing them to stay on parents policy.

9/23/10 – Expand coverage for early retirees by preserving employer coverage.  Employers must apply for this program.  For more info go to Early Retiree Insurance Program (

9/23/10 – Expand number of primary doctors, nurses, and physician assistants available for consumer.

9/23/10 – Hold insurance company’s accountable for any unreasonable rate hikes in excess of 10%.

9/23/10 – Allow states to cover more people on Medicaid through a federal fund matching program.

9/23/10 – Increase payments to rural health care providers.

9/23/10 – One time rebate check of $250.00 for seniors to cover prescription medicine and help cover donut hole.  Donut hole is gap when you and insurance provider have spent the cap allowed under          plan.  Individual is responsible for all costs after that threshold is met.  Donut hole will be gradually reduced until it no longer exists in 2020.    


Provide free preventive care for seniors, annual wellness visits, and personalized prevention plans with no charge to the deductible.

Improve after hospital care for seniors to avoid readmissions. (Community Care Transitions Program).

Strengthen Medicare by reviewing and removing excess waste in the system.


Improve quality and lower costs by implementing a link to quality outcomes.  Value Based Purchasing Program for Medicaire.

Provide incentives to physicians to join together to form Accountable Care Organizations.  Should they provide quality care, help prevent disease, and reduce hospital admissions, they will get to keep a percentage of the money saved.

Reduce paperwork and administrative costs.  All hospital and physician records digitized.


Improve preventive health coverage by expanding coverage to state Medicaid programs that choose to cover preventive services at little or no costs.  Includes physicals, colonoscopies, and mammograms.

Expand authority to bundle payments.  Have hospitals, doctors and providers bill Medicare in one flat rate for one episode of care rather than billing separately.

Insure Medicaid payments at 100% to primary physician paid by states, fully funded by the federal government.


Prohibit discrimination due to pre-existing conditions or gender.

Eliminate annual limits on coverage.

Offer tax credits for those with incomes near the poverty line.

Establish affordable insurance exchange.  If employer does not have insurance, employee can go into competitive exchange market.  Members of Congress will also be in this pool.

Increase small business tax credit.  50% of employers contribution in for profit company’s, 35% for non-profit.

Increase access to Medicaid.  Those earning %133 under the poverty line will qualify.

Insurers can shop for less expensive insurance than what employers provide.

Must buy insurance or be assessed a tax.  Tax credits may be available to those who are near or below poverty line.

The Affordable Health Care Act should reduce costs for the end user.  The federal government will pick up many of the costs previously incurred by the consumer.  There is a peace of mind for those concerned about insurance coverage limits or cancellation.  Those that opposed this new law suggest that the Affordable Health Care Act, does not do enough to lower the costs of the entire system.  The mandate or tax is $95.00/person, $235.00/family of four.  This is hardly an incentive to go out and purchase insurance and increase the insurance pool.  Those that can afford health insurance but choose not to will likely pay the tax.  The fees assessed amount to less than one month of health insurance for most families.  Should the number of people acquiring insurance increase, it will likely be as a result of small businesses hiring more people and taking advantage of the tax credit.  In addition, the federal government will pay %100 of the primary physician’s bill after Medicaid.  Great news for the end user and the doctor, but will it be an incentive for the doctor to reduce his rate?  In the end, it may bring an increase to the federal debt which hurts us all.

Libertarians, those who are largely represented by the Tea Party candidates want as little government as possible.  Their argument is that the capital system, the laws of supply and demand will bring costs down.  This has already occurred under the health care balloon with cosmetic and eye surgery.  Insurance companies do not typically cover these procedures the consumer being forced to pay the entire costs of the operation.  As a result, the expense of these procedures has dropped considerably and cosmetic surgery has become a booming industry.  Realistically though, health care expenses are usually not voluntary and often procedures must be done right away without negotiation.   

Opposition to this new plan should not attempt to repeal the new law.  Rather, they should recognize that costs could be prohibitive and come up with solutions to reign in those costs.  The talking points about the Affordable Health Care Act are appealing to many Americans.  Bashing “ObamaCare” may be politically counterproductive.