Opinion

Health care reform, part 3

Wednesday, June 9, 2010

The Affordable Care Act was passed by Congress and signed by President Obama in March, even with the polls showing that most people were against the legislation. Many of the law makers were not aware of what the act contained, even when voting for it.

Many people are now trying to determine what is included in the health care reform. Insurance companies and insurance agencies are positive about the changes that are being made.

This week it has been announced that the president is going to meet with seniors to sell them on the advantages of the health bill and the advantages it offers to them. He is still trying to sell the reform as many remain against it. The latest polls indicate that 58 percent favors repeal of the recently passed health care law.

Those on the Medicare Prescription Drug program who are in the "donut hole" should have received $250 from the government, or will soon receive the $250. Others, as they enter the "donut hole," will receive the special funds.

Recently, special information was sent out to all Medicare Beneficiaries by Centers for Medicare and Medicaid Services, "Medicare and the New Health Care Law -- What it means for you." It cost $18 million to send the brochure out, which one senator referred to as propaganda.

The brochure was sent to Medicare beneficiaries by CMS to provide information that tells how good the law is, and what it will do for families now and in the future. If you have not read it, you will want to read it to get the information that it contains.

Recently, I told you that those entering the Part D "donut hole" were receiving $250 this year. What I had understood from information about the health bill was that beginning in 2014 the cost during the "donut law" would be reduced by 50 percent -- instead of 100 percent as it is now. I was wrong in that information.

The information in the brochure sent by CMS says: "Next year, if you reach the coverage gap, you will receive a 50 percent discount when buying Part D - covered brand name prescription drugs.

"Over the next 10 years, you will receive additional savings until the coverage gap is closed in 2020."

At the present time, those who qualify for a low income subsidy will have support on their Plan D. If they have full LIS, they do not pay premiums and they pay low co-pays, and are not affected by the "donut hole." This is a major advantage for those who qualify. The ones who get hurt are those a few dollars above the guidelines.

All beneficiaries are encouraged to apply for LIS at Social Security. Many qualify for some help and do not realize it. I previously had the false impression that once a person qualified for LIS that also took care of it for future years. I have learned that it is not automatic, but you must apply annually.

In the future, as the "donut hole" goes away, you can bet that it will not be free. Someone will be paying for it. Most likely the Plan D premiums and co-pays will be increased for everyone on Plan D, and also by an increased cost to tax payers.

In the last column the impact on individuals and families that will occur this year was discussed. One of the items that in the reform is designed to help small businesses with 25 or fewer employees to provide health insurance is a federal tax credit. I suggest that small employers check with their account on how this tax credit will work for them.

A recent article on www.moneynews.com was titled, "Obamacare Tax Cut for Small Business Has Big Loophole." An owner of an office furniture company found that assistance would not be provided for the 24 employees paid $79,200. According to the article -- lost in the small print is the stipulation that the credit drops off sharply once a company gets above 10 workers and $25,000 average annual wages.

The owner of the furniture company had a 15 percent increase in premiums and is having difficulty in continuing to provide insurance for his employees. To get the most out of the new federal tax credit the workforce would need to be reduced to 10 employees and also slash their wages.

The ones that will benefit are small companies paying lower wages. In those cases it will benefit small employers.

The law makers who supported the Affordable Care Act and the administration won the battle, but with the majority of citizens remaining opposed to it, the war is not over.

There is much more that can be said about the new health care law. The brochure sent by CMS suggests that for additional information about the new health law, visit www.medicare.gov. For questions, call (800) MEDICARE, (800) 633-4227, or your state health assistant program.