Thursday, December 31, 2009

The ghost of health care reform future

Via Heritage, here's what Americans can expect with the new health care legislation. Sounds expensive for everybody.

2010: Physician Medicare payments decrease 21% effective March 1, 2010
2011: “Annual Fee” tax on health insurance, allocated according to share of total premiums. Begins at $2 billion in 2011, then increases to $4 billion in 2012, $7 billion in 2013, $9 billion in the years 2014, 2015, and 2016, and eventually $10 billion for 2017 and every year thereafter. Two insurers in Nebraska and one in Michigan are exempt from this tax.
2012: Medicare payment penalties for hospitals with the highest readmission rates for selected conditions.
2013: Medicare tax increased from 2.9% to 3.8% for incomes over $250,000 (joint filers) or $200,000 (all others). (This is stated as an increase of 0.9 percentage points, to only the employee’s share of the FICA tax.)
2014: Individual mandate begins: Tax penalties for not having insurance begin at $95 or 0.5% of income, whichever is higher, rising to $495 or 1% of income in 2015 and $750 or 2% of income thereafter (indexed for inflation after 2016). These penalties are per adult, half that amount per child, to a maximum of three times the per-adult amount per family. The penalty is capped at the national average premium for the “bronze” plan.
2015: Establishment of Independent Medicare Advisory Board (IMAB) to recommend cuts in Medicare benefits; these cuts will go into effect automatically unless Congress passes, and the President signs, an override bill.
2016: Individual mandate penalty rises to $750 per adult ($375 per child), maximum $2,250 per family, or 2% of family income, whichever is higher (capped at the national average premium for the “bronze” plan). After 2016, the penalty will be increased each year to adjust for inflation.
2017: Itemized deduction for out-of-pocket medical expenses is limited to expenses over 10% of AGI for those over age 65.
Keep in mind that nobody but nobody believes that Congress will reduce reimbursement rates to Medicare doctors by 21%. The political pressure to counteract these cuts will be intense meaning that Washington will depend on even more deficit spending. And suddenly I'm a big fan of "the trigger option." Why not wait until next year to see if Washington holds firm to their own legislation? If Congress can't find the fortitude to cut Medicare payments by one-fifth, let's call the whole thing off.

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