Posted tagged ‘health insurance’

New Health Care Bill Has a Tax for Everyone

October 30, 2009

From HotAir:

Americans for Tax Reform has culled the 1990-page Pelosi health-care overhaul bill to find the taxes that will supposedly collect over $540 billion in revenue over 10 years.  It’s quite an impressive list of new burdens on Americans and their health-care providers and producers — but that’s redundant.  After all, who do you think will end up paying for the medical-device taxes?  It won’t be insurers or doctors:

  • Employer Mandate Excise Tax (Page 275): If an employer does not pay 72.5 percent of a single employee’s health premium (65 percent of a family employee), the employer must pay an excise tax equal to 8 percent of average wages.  Small employers (measured by payroll size) have smaller payroll tax rates of 0 percent (<$500,000), 2 percent ($500,000-$585,000), 4 percent ($585,000-$670,000), and 6 percent ($670,000-$750,000).
  • Individual Mandate Surtax (Page 296): If an individual fails to obtain qualifying coverage, he must pay an income surtax equal to the lesser of 2.5 percent of modified adjusted gross income (MAGI) or the average premium.  MAGI adds back in the foreign earned income exclusion and municipal bond interest.
  • Medicine Cabinet Tax (Page 324)
  • Cap on FSAs (Page 325)
  • Increased Additional Tax on Non-Qualified HSA Distributions (Page 326)
  • Denial of Tax Deduction for Employer Health Plans Coordinating with Medicare Part D (Page 327)
  • Surtax on Individuals and Small Businesses (Page 336)
  • Excise Tax on Medical Devices (Page 339)
  • Corporate 1099-MISC Information Reporting (Page 344)
  • Delay in Worldwide Allocation of Interest (Page 345)
  • Limitation on Tax Treaty Benefits for Certain Payments (Page 346)
  • Codification of the “Economic Substance Doctrine” (Page 349)
  • Application of “More Likely Than Not” Rule (Page 357)

See the ATR post for detailed descriptions of each new tax. 

Calling the Obamacare Line

October 28, 2009

Fact-Checking the Obama Health Speech

September 10, 2009

o-youlieReason magazine editor-in-chief Matt Welch has the best post-speech fact-check I’ve seen so far. Going beyond just the basic true/false of what Obama said about the (nonexistant) health reform plan, Welch takes measure of the president’s character and how willing we should be to trust his promises.

 

A brief excerpt:

Again and again last night, the president’s numbers didn’t add up. “There may be those—particularly the young and healthy—who still want to take the risk and go without coverage,” he warned, in a passage defending compulsory insurance. “The problem is, such irresponsible behavior costs all the rest of us money. If there are affordable options and people still don’t sign up for health insurance, it means we pay for those people’s expensive emergency room visits.” No, it means that, on balance, the healthy young don’t pay for the unhealthy old. The whole point of forcing vigorous youth to buy insurance is using their cash and good actuarials to bring down the costs of covering the less fortunate.

Such fudges reveal a politician who, for whatever reason, feels like he can’t be honest about the real-world costs of expanding health care. “Add it all up, and the plan I’m proposing will cost around $900 billion over ten years,” he said, trying hard to sound like those numbers weren’t pulled out of Joe Biden’s pants, and won’t be dwarfed by actual costs within a year or two. “We’ve estimated that most of this plan can be paid for by finding savings within the existing health care system–a system that is currently full of waste and abuse,” he said, making him at least the eighth consecutive president to vaguely promise cutting Medicare “waste” (a promise, it should be added, that could theoretically be fulfilled without drastically overhauling the health care system). Any government-run “public option,” he claimed, somehow “won’t be” subsidized by taxpayers, but instead would “be self-sufficient and rely on the premiums it collects.”

Read the rest

Health Care Reform Is Not About Health, Care, or Reform

August 22, 2009

lego_ambulanceI have come to the conclusion that health care reform is not about health, care, or reform. And this is why.

We already have a government run health care plan in this country – it is called Medicaid. If Medicaid doesn’t cover enough of the people who can’t afford private health insurance or those who can’t get private health insurance at any price, why aren’t we talking about Medicaid reform?

If the reason is because Medicaid is a broken system that is almost out of funds and is rife with fraud at all levels, then why should we believe that a new public health plan would fare any better?

Any real reform of the health care system in America would need to focus on four key issues:

  • Medicaid reform
    Fix what is broken and expand it to cover more of those who need it.
  • Tort reform
    I find the idea of health courts which would be similar to workers’ compensation courts very intriguing.
  • Tax reform
    Employers are allowed to deduct 100% of the health insurance premiums they pay for their employees. Individuals who purchase their own private health insurance should also be allowed to deduct 100% of their premiums on their income tax returns.
  • Regulation reform
    Allow insurance companies to do business across state lines. At the very least, allow them to offer high-deductible, HSA-qualifying plans nationwide.

By giving little, if any, attention to these key points, the federal government is telling us that health care reform is not really the purpose of the various bills currently floating around Congress. The true purpose is to increase tax revenues because government spending is at historic highs while income (in the form of tax revenues) is at historic lows.

This is why the plans, the House bill in particular, have far more sticks than carrots. Revenue will increase through several measures including:

  • New penalty taxes on individuals who do not have health insurance.
  • New penalty taxes on small businesses that do not offer health insurance to employees.
  • Implied increase in corporate taxes on insurance companies will benefit from the plan by picking up millions of new customers who don’t want to get stuck paying the above penalty taxes.
  • New income taxes on the wealthiest citizens.

Will all that money be spent on health care? Does the Social Security Trust Fund contain any actual money? No. Do seriously wounded veterans get their disabilty checks in a timely manner? No.

Again, why should we believe that an enormous new federal social program and its attendant bureaucracy function any better?

Don’t be fooled by all the rhetoric on either side of the ongoing, heated debate. It’s never been about anything but the money.

If It Sounds Too Good to Be True…

August 17, 2009

Silly me. I almost dared to, ahem, hope yesterday that the Obama administration might really be backing away from a government-run health insurance option. It was a guarded hope at best because as Edmund Haislmaier pointed out a few weeks ago at The Foundry:

If by health care “co-op,” Congress means allowing private associations to collectively buy health insurance for their members or operate a health insurance exchange, or allowing people to buy health insurance from a non-profit, member-owned private insurer, then those would be positive, pro-consumer developments.

However, simply slapping the word “cooperative” onto a new “insurer,” but then specifying that the government — not the policyholders — picks the board of directors (as Sen. Schumer wants), or that taxpayers will subsidize it, or that it has to pay doctors and hospitals at Medicare rates, would just be an exercise in trying to disguise a “public plan.”

But today it appears to have been nothing but a mis-statement or a trial balloon. It figures. Washington hasn’t been listening to we the people for a long time. Why start now?

The Whole Foods Alternative to ObamaCare

August 12, 2009

I’ve been jotting down notes for a few days now of the ways I think health care reform could be done effectively as opposed to the half-baked horror currently circulating in Congress.

So I was quite pleased to find the following op-ed in yesterday’s WSJ. Not only is it almost everything I’ve been thinking, it is a case study in how these ideas are actually working in real life.

Your thoughts?

The Whole Foods Alternative to ObamaCare
Eight things we can do to improve health care without adding to the deficit.

By John Mackey

With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people’s money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.

Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.

• Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.

• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.

• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.

• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.

• Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?

• Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.

• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.

Continue reading

Sadly, I don’t expect to see any of these excellent ideas implemented by the federal government and not just because of partisan politics either.

The unfinished plans in Congress now are heavy on sticks and light on carrots. Why? Because tax revenues have fallen off a cliff.

Sebelius Says Health Reform Will Empower Families

August 7, 2009

In an op-ed from July 28, Health and Human Services Secretary Kathleen Sebelius says “health reform will empower families against market constraints”. She goes on to say that it’s all about just four things.

So what will reform actually look like?

First, to provide Americans with more affordable choices, we’ll set up a marketplace where you can compare plans and pick the one that’s right for you. None of the plans would be allowed to deny you coverage because of a pre-existing condition. And one of the options should be a public plan that would increase competition and keep private insurance companies honest.

Second, we have to align incentives for doctors and hospitals so that they’re rewarded based on the quality of care they provide, not on how many tests or procedures they prescribe.

Third, we need to move from a sickness system to a wellness system. By investing in prevention and emphasizing healthy lifestyles, we can save money while improving health.

Finally, reform must not add to our deficit over the next ten years. To that end, we have already identified hundreds of billions of dollars in savings – savings from money that’s already being spent on health care, but is funding waste and overpayments to insurance companies.

Uh-huh. Just one question Secretary Sebelius – if that’s really all it’s about, why is the House bill over a thousand pages long?

Stop Obamacare Now

July 26, 2009

Picture-5

(Via Campaign For Liberty)

Stop Obamacare Now!
By David McKalip, M.D.

Congress is foolishly basing its health system reform proposals on the same approach used in Massachusetts. The state has failed to achieve “universal coverage” with about 200,000 (2.6%) of their state still uninsured. In fact, most of the newly insured were covered by receiving heavily subsidized insurance from the state — not due to the mandate to buy private insurance out of pocket. Due to budget overruns, they recently voted to remove coverage from 30,000 legal aliens for a $130 million savings and last year released others who couldn’t afford costly coverage from the mandate. Health care costs are rising much faster than nationally with spending up by 23 percent. Insurance premiums have increased 10-12 percent per year, nearly double the national average. The state is facing $1.5 billion this year in health spending and now is considering cost control programs that will limit care doctors provide to patients. There are too few providers for the increased demand – due to price fixing of doctor pay for decades by the federal government. Thus patients are waiting long periods to see doctors — especially in primary care. Congressional proposals to fix this included allowing nurse practitioners to be designated primary care “providers”, negating the years of training doctors receive and discouraging more doctors from entering the profession to compete against nurses for the same business.

Fortunately there are good Congressional proposals to address these problems and to allow American to escape from the government’s medical cage. Congressman Ron Paul has authored HR 2630, the “Protect Patients and Physician’s Privacy Act”. The bill states that all individuals shall have the ability to opt out of any federally mandated, created, or funded electronic system for maintaining health care information. He also is offering HR 2629 the “Coercion is Not Health Care Act'” which forbids the Federal Government from forcing any American to purchase health insurance, and from conditioning participation in any federal program, or receipt of any federal benefit, on the purchase of health insurance.

Read the rest

Congressman Paul himself was in Michigan yesterday at a private reception for conservatives. He was speaking about Obama’s “monstrous” health care reform plans.

Former Republican presidential candidate Ron Paul has a frank prescription for the health care plan making its way through Congress: Scrap it.

“I think it’s monstrous,” Paul said.

“I don’t think it will improve medical care in this country. I think it’s very, very costly and we don’t have any money. And they don’t have any way of paying for it.”

Continue reading

CBO Says Reform Will Increase – Not Decrease – Federal Health Care Spending

July 16, 2009

In the relentless stream of bad news about health care “reform”, this comes in from The Washington Post (emphasis mine): 

CBO Chief Criticizes Democrats’ Health Reform Measures
Director Says Proposed Changes Would Increase Health Care Spending

 Instead of saving the federal government from fiscal catastrophe, the health reform measures being drafted by congressional Democrats would increase rather than reduce public spending on health care, potentially worsening an already bleak budget outlook, the director of the nonpartisan Congressional Budget Office said this morning.

 Under questioning by members of the Senate Budget Committee, CBO director Douglas Elmendorf said bills crafted by House leaders and the Senate health committee do not propose “the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.”

 “On the contrary,” Elmendorf said, “the legislation significantly expands the federal responsibility for health-care costs.”

 Though President Obama and Democratic leaders have said repeatedly that reining in the skyrocketing growth in spending on government health programs such as Medicaid and Medicare is their top priority, the reform measures put forth so far would not fulfill their pledge to “bend the cost curve” downward, Elmendorf said. Instead, he said, “The curve is being raised.”

 Continue reading

Health Care Reform Is Making Me Sick

July 16, 2009

o-laughThe House of Representatives passed their health reform bill and the Senate Health, Education, Labor and Pensions Committee passed a $600 billion version today – a version that will require individuals to get health insurance and require employers to contribute to the cost as well.

And what if an individual does not buy a health insurance plan? For about 8 million of us, it means we will pay a new tax of 2.5% – and still not have health insurance.

Keith Hennessey lays it out:

As expected, the House bill would mandate that individuals and families have or buy health insurance.

But what if they don’t buy it?

Then Section 401 kicks in.  Any individual (or family) that does not have health insurance would have to pay a new tax, roughly equal to the smaller of 2.5% of your income or the cost of a health insurance plan. …

I assume the bill authors would respond, “But why wouldn’t you want insurance?  After all, we’re subsidizing it for everyone up to 400% of the poverty line.”

That is true.  But if you’re a single person with income of $44,000 or higher, then you’re above 400% of the poverty line.  You would not be subsidized, but would face the punitive tax if you didn’t get health insurance.  This bill leaves an important gap between the subsidies and the cost of health insurance.  CBO says that for about eight million people, that gap is too big to close, and they would get stuck paying higher taxes and still without health insurance.

Continue reading

Wondering where your income falls in terms of the federal poverty line? The numbers are on the Health and Human Services web site. Here is the chart for the 48 contiguous states and DC:

Persons in family Poverty guideline
1 $10,830
2 14,570
3 18,310
4 22,050
5 25,790
6 29,530
7 33,270
8 37,010
For families with more than 8 persons, add $3,740 for each additional person.

You can do your own math. With figures as ridiculously low as those, even multiplying the appropriate number by 4 isn’t going to give you an income that would have you living in the lap of luxury.

But if you do happen to be among the so-called wealthy with an income of $250K or more, you may end up paying even more – a 5.4% “surtax” whether you have your own health insurance or not. Interestingly, the “surtax” would be mostly charged to… doctors.

Good plan there – make the doctors angry about having to pay a big new tax and then force them to take on a boatload of new patients. What could go wrong?

Yet all of this for “reform” would enroll less than 5% of Americans and will very likely surpass the $1 trillion price tag currently attached to it according to the Congressional Budget Office.

On a preliminary basis … the proposal’s provisions affecting health insurance coverage would result in a net increase in federal deficits of $1,042 billion for fiscal years 2010 through 2019,” the report said, citing additional expenses for Medicaid and other federal subsidies. One Democratic aide said the bill would add up to $1.5 trillion over the next decade. But the CBO estimate showed that even if the price tag holds to $1 trillion, more than 80 percent of the costs will hit in the last five years. This indicates that after 2019, taxpayers could be hit with a rising tidal wave of health care expenses resulting from the shift in health care coverage from the private to public sector. 

Continue reading

So, what will health care “reform” look like? According to House Republicans, it will look like this:

But this is a crisis and we can’t do nothing, right, Mr. President? We need to get this thing going before the end of the year!

So buck up, America. Hey, it’s for your own good. Don’t you want top-quality health care like military women get from the VA, like wounded soldiers get from Walter Reed or like Indian Health Services?

Then again, on second thought, no. Universal health care just isn’t worth our freedom.

 

More links on this topic – if you’re feeling up to it:

Health care reform still has a long way to go before passage
Committee: Health care overhaul a yes
Concern grows that healthcare overhaul won’t cut costs
House Democrats would have us believe that the rich can pay for it all
9 reasons Pelosi’s healthcare surtax is disastrous
Small Business Faces Big Bite
What if Obamacare Fails?