big thanks to reddit user CaspianX2 for typing all this out!
What people call âObamacareâ is actually the Patient Protection and Affordable Care Act. However, people were calling it âObamacareâ before everyone even hammered out what it would be. Itâs a term mostly used by people who donât like the PPaACA, and itâs become popularized in part because PPaACA is a really long and awkward name, even when you turn it into an acronym like that.
Anyway, the PPaACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPaACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldnât have to.
So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):
It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices)
It increases the rebates on drugs people get through Medicare (so drugs cost less)
It establishes a non-profit group, that the government doesnât directly control, to study different kinds of treatments to see what works better and is the best use of money.
It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy.
It makes a âhigh-risk poolâ for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of âpre-existing conditionsâ altogether. For now, people who already have health issues that would be considered âpre-existing conditionsâ can still get insurance, but at different rates than people without them.
It renews some old policies, and calls for the appointment of various positions.
It creates a new 10% tax on indoor tanning booths.
It says that health insurance companies can no longer tell customers that they wonât get any more coverage because they have hit a âlifetime limitâ. Basically, if someone has paid for life insurance, that company canât tell that person that heâs used that insurance too much throughout his life so they wonât cover him any more. They canât do this for lifetime spending, and theyâre limited in how much they can do this for yearly spending.
Kids can continue to be covered by their parentsâ health insurance until theyâre 26.
No more âpre-existing conditionsâ for kids under the age of 19.
Insurers have less ability to change the amount customers have to pay for their plans.
People in a âMedicare Gapâ get a rebate to make up for the extra money they would otherwise have to spend.
Insurers canât just drop customers once they get sick.
Insurers have to tell customers what theyâre spending money on. (Instead of just âadministrative feeâ, they have to be more specific).
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when theyâre turned down.
New ways to stop fraud are created.
Medicare extends to smaller hospitals.
Medicare patients with chronic illnesses must be monitored more thoroughly.
Reduces the costs for some companies that handle benefits for the elderly.
A new website is made to give people insurance and health information.
A credit program is made that will make it easier for business to invest in new ways to treat illness.
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure theyâre not price-gouging customers.
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isnât paying for the Aspirin you bought for that hangover.
Employers need to list the benefits they provided to employees on their tax forms.
Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.
If you make over $200,000 a year, your taxes go up a tiny bit (0.9%)
This is when a lot of the really big changes happen.
No more âpre-existing conditionsâ. At all. People will be charged the same regardless of their medical history.
If you can afford insurance but do not get it, you will be charged a fee. This is the âmandateâ that people are talking about. Basically, itâs a trade-off for the âpre-existing conditionsâ bit, saying that since insurers now have to cover you regardless of what you have, you canât just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but youâll have to pay the fee instead, unless of course youâre not buying insurance because you just canât afford it.
Insurerâs now canât do annual spending caps. Their customers can get as much health care in a given year as they need.
Make it so more poor people can get Medicare by making the low-income cut-off higher.
Small businesses get some tax credits for two years.
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
Limits how high of an annual deductible insurers can charge customers.
Cut some Medicare spending
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.
Establish health insurance exchanges and rebates for the lower-class, basically making it so poor people can get some medical coverage.
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we wonât be footing their health care bills any more than any other American citizen.
A new tax on pharmaceutical companies.
A new tax on the purchase of medical devices.
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more theyâll get taxed.
The amount you can deduct from your taxes for medical expenses increases.
Doctorsâ pay will be determined by the quality of their care, not how many people they treat.
If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPaACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPaACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).
All health care plans must now cover preventative care (not just the new ones).
A new tax on âCadillacâ health care plans (more expensive plans for rich people who want fancier coverage).
The elimination of the âMedicare gapâ
Aaaaand thatâs it right there.
The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something in unconstitutional. Personally, I take the opposite view, as itâs not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.
Plus, as previously mentioned, itâs necessary if youâre doing away with âpre-existing conditionsâ because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.
