Sunday, March 21, 2010

Health Care Reform Passes -- What's in the Bill?

Cost:

* $940 billion over ten years.

Deficit:

*

Would reduce the deficit by $143 billion over the first ten years. That is an updated CBO estimate. Their first preliminary estimate said it would reduce the deficit by $130 billion over ten years. Would reduce the deficit by $1.2 billion dollars in the second ten years.

Read more on the CBO Report

Coverage:

* Would expand coverage to 32 million Americans who are currently uninsured.

Health Insurance Exchanges:

* The uninsured and self-employed would be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level.
* Separate exchanges would be created for small businesses to purchase coverage -- effective 2014.
* Funding available to states to establish exchanges within one year of enactment and until January 1, 2015.

Subsidies:

* Individuals and families who make between 100 percent - 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.

Federal Poverty Level for family of four is $22,050

Paying for the Plan:

* Medicare Payroll tax on investment income -- Starting in 2012, the Medicare Payroll Tax will be expanded to include unearned income. That will be a 3.8 percent tax on investment income for families making more than $250,000 per year ($200,000 for individuals).
* Excise Tax -- Beginning in 2018, insurance companies will pay a 40 percent excise tax on so-called "Cadillac" high-end insurance plans worth over $27,500 for families ($10,200 for individuals). Dental and vision plans are exempt and will not be counted in the total cost of a family's plan.
* Tanning Tax -- 10 percent excise tax on indoor tanning services.

Medicare:

* Closes the Medicare prescription drug "donut hole" by 2020. Seniors who hit the donut hole by 2010 will receive a $250 rebate.
* Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade.

Medicaid:

* Expands Medicaid to include 133 percent of federal poverty level which is $29,327 for a family of four.
* Requires states to expand Medicaid to include childless adults starting in 2014.
* Federal Government pays 100 percent of costs for covering newly eligible individuals through 2016.
* Illegal immigrants are not eligible for Medicaid.

Insurance Reforms:

* Six months after enactment, insurance companies could no longer denying children coverage based on a preexisting condition.
* Starting in 2014, insurance companies cannot deny coverage to anyone with preexisting conditions.
* Insurance companies must allow children to stay on their parent's insurance plans through age 26.

Abortion:

* The bill segregates private insurance premium funds from taxpayer funds. Individuals would have to pay for abortion coverage by making two separate payments, private funds would have to be kept in a separate account from federal and taxpayer funds.
* No health care plan would be required to offer abortion coverage. States could pass legislation choosing to opt out of offering abortion coverage through the exchange.

**Separately, anti-abortion Democrats worked out language with the White House on an executive order that would state that no federal funds can be used to pay for abortions except in the case of rape, incest or health of the mother. (Read more here)

Individual Mandate:

* In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.

Employer Mandate:

* Technically, there is no employer mandate. Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance. Fines applied to entire number of employees minus some allowances.

Immigration:

* Illegal immigrants will not be allowed to buy health insurance in the exchanges -- even if they pay completely with their own money.

Monday, March 15, 2010

Governor Pawlenty ‘Line Item Vetoes’ Bonding Bill

Perspective

The governor originally called for a bonding bill not to exceed $725 million. The DFL legislature passed two bonding bills this session but through procedural maneuvering only sent the most recent on for presentment, the process that allows a Governor to formally act on legislation.

Governor Pawlenty delivered, as expected, on a promise to cut back the bonding bill by exercising his ‘line-item veto’ authority. As an aside, this is one gubernatorial authority that nobody questions as opposed to another battle that begins today—unallotment authority. But I digress, as this is an issue for another day. The bill as presented was larger than $1 Billion and the Governor has paired the bill down to $680, below even his threshold limit. The Governor cut from infrastructure projects in areas such as Community Colleges, Coon Rapids Dam, Public Housing, Trails, and other projects of regional significance. Not to be missed was the Governor’s ability to successfully implore the legislature to re-insert some of his own priorities including funding for sex offender lock-up facilities.

Proponents of each project will likely decry the lack of commitment to certain priorities by offering the proverbial “This is the time to bond and build,” indicating a preference for spending while the cost of borrowed money is cheapest. Additionally, expect post line item veto rhetoric to include quips about “lost opportunities on shovel ready projects.” Meanwhile, the republican responsorial will be “living within your means” and having the fiscal discipline to say no. The often invoked mantra is “it’s like charging up your credit cards, when you are flat broke.” Democrats will contend the Governor unfairly retaliated on projects in key Democratic strongholds. Though, Republicans will point out that Democrats loaded the bill with “Christmas presents” for those same constituencies.

As is often the case, the truth lies somewhere in between. No one can deny that bonding is relatively inexpensive in today’s economic environment. Yet, fiscal prudence requires restraint and an eye towards maintaining Minnesota’s bonding rating and not burdening future budgets with excess debt service obligations. So ultimately it comes down to balancing these competing priorities. Might I suggest that despite all the maneuvering, grandstanding, and political showmanship, an unfortunate side effect much like any modern era legend drug, the process actually worked as intended? How refreshing?

For a complete listing of vetoed items SEE LINK

http://www.leg.state.mn.us/lrl/Vetoes/veto_results.asp?veto_id=529

Tuesday, March 2, 2010

The Ultimate Bailout!

So let me get this straight Congressman Hoyer. Congress and the Administration dig themselves a 12 trillion hole and then want the American Taxpayer to fill the gap?

Talk about the ultimate bailout!

Is there any wonder why Congress has the lowest approval rating of all time?

Hoyer: Raising taxes a realistic option - TheHill.com

Hoyer: Raising taxes a realistic option - TheHill.com