Senate Health Care Reform Plan (H.R. 3590), Part the Tenth

Tuesday, 16 March 2010, 15:37 | Category : Healthcare, Politics
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Starting around page 1760, there is an act within an act – the Elder Justice Act, which has the goal of preventing, detecting, and treating abuse of the elderly. I certainly don’t make light of it, but I’m not going to delve into that part of the act. This is followed by a section on “Improving Access to Innovative Medical Therapies”. This seems to be all about “biosimilar biological products”. If I’m understanding the wording, it makes it easier to get follow-on drugs to market. But I may have it completely wrong.

Title VIII establishes a voluntary insurance program to aid people with “functional limitations” who want to continue living in their communities. The insurance would cover the costs of assistance, equipment, and home care. If I understand what the act is saying, you would have to be enrolled for up to 5 years before receiving assistance, so maybe this is like a long-term care policy. For tax purposes, it is treated “in the same manner as a qualified long-term care insurance contract for qualified long-term care services.”

Now we get to one of the things that gives heartburn to the House of Representatives – Title IX. This is the “Cadillac tax” on employer-sponsored insurance plans that offer “excess benefits”. The excess is determined by the cost to the employer of the insurance, which must be reported on the employee’s W-2. Initially, the bar is set at $8500 for individuals and $23,000 for family coverage, and would increase according to the cost of living each year. The amounts would be higher for employees in high-risk occupations or “employed to repair or install electrical or telecommunications lines”. High-cost states get an additional bump. I have heard that the House wants this taken, but it’s part of the funding source in the Senate plan. There is also a provision wherein manufacturers of medical equipment would pay a yearly fee to the government, according to a formula that I didn’t even try to understand, and there’s a fee paid by insurance providers that I also didn’t try to understand. And there’s a half-percent hospital insurance tax (Medicare) on those making over $200,000 a year. And, a 5 percent tax on elective cosmetic procedures, and a 10 percent tax on tanning booth services.

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