Below is just some of the information I got from the senate finance amendment to the health care reform.
Notice the costs involved. Looks like a Lot More than a Dime.
Also, you will notice that Illegals will be able to get health insurance, just not a federally funded insurance. (medicare or medicaid) This is listed
under "Personal Responsibility Requirement."
The Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA, P.L. 104-191) established Federal rules regarding guaranteed
availability, guaranteed renewability, and coverage for pre-existing health conditions in the individual market for certain persons eligible for HIPAA
HIPAA guarantees that each issuer in the individual market make at least two policies available to all ―HIPAA eligible‖ individuals, and renewal
of individual coverage is at the option of such individuals, with some exceptions.
HIPAA also prohibits individual issuers from excluding coverage for pre-existing health conditions for HIPAA eligibles. In addition, a number of
states have enacted guaranteed issue and pre-existing condition exclusion rules.
HIPAA established Federal rules regarding guaranteed issue, guaranteed renewability, and coverage for pre-existing health conditions for certain
persons and groups. HIPAA requires that coverage sold to firms with 2-50 employees must be sold on a guaranteed issue basis. That is, the issuer must
accept every small employer that applies for coverage. HIPAA also guarantees renewal of both small and large group coverage at the option of the plan
sponsor (e.g., employer), with some exceptions. And HIPAA limits the duration that coverage for pre-existing health conditions may be excluded for
―HIPAA eligible‖ individuals with group coverage.
Within a year of enactment, any uninsured individual who has been denied health care coverage due to a pre-existing condition can enroll in a
high-risk pool. Currently covered individuals must be uninsured for six months before gaining access to the high-risk pool. The high-risk pool will
exist until 2013 and $5 billion in funding will be provided to subsidize premiums in the pool.
Definition of a Cafeteria Plan. If an employee receives a qualified benefit based on the employee‘s election between the qualified benefit and a
taxable benefit under a cafeteria plan, the qualified benefit generally is not includable in gross income.1 However, if a plan offering an employee an
election between taxable benefits (including cash) and nontaxable qualified benefits does not meet the requirements for being a cafeteria plan, the
election between taxable and nontaxable benefits results in gross income to the employee, regardless of what benefit is elected and when the election
Flex-credits Under a Cafeteria Plan. Employer flex-credits are non-elective employer contributions that an employer makes available for every employee
eligible to participate in the cafeteria plan, to be used at the employee‘s election only for one or more qualified benefits (but not as cash or
other taxable benefits).
Personal Responsibility Requirement.
Exemptions from the requirement to have health coverage would be allowed for religious objections that are consistent with those allowed under
Medicare, and for undocumented aliens.
Legal U.S. residents will be able to obtain insurance through the state exchanges. Parents who are in the country illegally will not be able to buy
personal insurance coverage through the state exchange but will be able to buy insurance for their U.S. citizen or lawfully present children.
a U.S. health insurance provider includes (1) any insurer that sells employer-sponsored group health care coverage to employees that are either U.S.
citizens or are employed in the United States, and (2) any insurer that sells health care insurance to individuals or groups of individuals (whether
or not U.S. citizens) in the United States.
Additional contributions will be made in the amount of $5 billion in 2013 to 2015 to apply to employer-sponsored retiree coverage. The program would
reimburse any eligible employers or insurers 80 percent of claims between $15,000 and ends at $90,000.
The Chairman‘s Mark would authorize and appropriate $100 million over five years for the Secretary to establish an initiative to provide incentives
to Medicare beneficiaries who successfully participate in complete certain healthy lifestyle programs.
Beginning in 2011, the Secretary would fund eligible hospitals and community-based partnership organizations to provide patient-centered,
evidence-based care transition services to Medicare beneficiaries at the highest risk of preventable re-hospitalization. The program‘s funding level
would be set at $500 million over three years.
Medicare currently reimburses the direct costs of graduate medical education (DGME) for approved residency training programs without regard for the
setting where the residents‘ activities relating to patient care are performed as long as the hospital incurs all, or substantially all, of the
costs for the training program in that setting.
In order to promote training in outpatient settings and to ensure the availability of residency programs in rural and underserved areas, this policy
would provide increased flexibility in laws and regulations governing graduate medical education funding in the Medicare program.
A total of $230 million will transferred from the Medicare Part A trust fund for FY2011 to FY2015 using a formula for calculating the direct graduate
medical education expenses and the indirect expenses associated with operating approved graduate medical residency training programs established by
Advance Practice Nurse Training. The Mark adds an appropriation of $50 million per year for FY2012 through FY2015 to establish a graduate nurse
education demonstration program in Medicare.
Patient-Centered Outcomes Research Trust Fund.
The following amounts would be transferred to the PCORTF from the general funds in the Treasury: $10 million in FY2010, $50 million in FY2011, $150
million in FY2012, and $150 million for each of FY2013 through FY2019. In addition, the Secretary would transfer amounts from the Medicare Federal
Hospital Insurance and the Federal Supplemental Medical Trust Funds to the PCORTF in proportion to total Medicare expenditures that come from each
Fund for a given year. In FY2013, the amount would be equivalent to $1 multiplied by the average number of individuals entitled to benefits under Part
A or enrolled under Part B of Medicare during the year. In FY2014 through FY2019, the amounts would be equivalent to $2, increased by annual medical
inflation after FY2014 multiplied by the average number of such individuals for the given year.