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  • Senate Health Care Timeline

    Obamacare is not yet law, but the battle over which elements of it should be repealed has already begun with both sides believing they will have the upper hand. Key to this debate will be which elements of Obamacare phase in when. Heritage Foundation scholar Robert Book has pored through the Senate bill and produced the following chart (pdf) detailing how the Senate version of Obamacare is scheduled to be implemented between 2010 and 2017. Highlights from each year include:

    2010: Physician Medicare payments decrease 21% effective March 1, 2010

    2011: “Annual Fee” tax on health insurance, allocated according to share of total premiums. Begins at $2 billion in 2011, then increases to $4 billion in 2012, $7 billion in 2013, $9 billion in the years 2014, 2015, and 2016, and eventually $10 billion for 2017 and every year thereafter. Two insurers in Nebraska and one in Michigan are exempt from this tax.

    2012: Medicare payment penalties for hospitals with the highest readmission rates for selected conditions.

    2013: Medicare tax increased from 2.9% to 3.8% for incomes over $250,000 (joint filers) or $200,000 (all others). (This is stated as an increase of 0.9 percentage points, to only the employee’s share of the FICA tax.)

    2014: Individual mandate begins: Tax penalties for not having insurance begin at $95 or 0.5% of income, whichever is higher, rising to $495 or 1% of income in 2015 and $750 or 2% of income thereafter (indexed for inflation after 2016). These penalties are per adult, half that amount per child, to a maximum of three times the per-adult amount per family. The penalty is capped at the national average premium for the “bronze” plan.

    2015: Establishment of Independent Medicare Advisory Board (IMAB) to recommend cuts in Medicare benefits; these cuts will go into effect automatically unless Congress passes, and the President signs, an override bill.

    2016: Individual mandate penalty rises to $750 per adult ($375 per child), maximum $2,250 per family, or 2% of family income, whichever is higher (capped at the national average premium for the “bronze” plan). After 2016, the penalty will be increased each year to adjust for inflation.

    2017: Itemized deduction for out-of-pocket medical expenses is limited to expenses over 10% of AGI for those over age 65.

    Posted in Obamacare [slideshow_deploy]

    32 Responses to Senate Health Care Timeline

    1. Anil Petra says:

      This summary ignores the "exchanges" and the question of when insurance companies suffer the end of underwriting — the mandatory issue obligation courtesy of ObamaCare.

    2. Pingback: Instapundit » Blog Archive » A SENATE HEALTH-CARE BILL timeline….

    3. jef says:

      This is a very nice start. But, I hope the next step (soon) is to try to anticipate the "unintended" consequences of this welter of control mechanisms and taxes.

      For example, if first dollar coverage is mandated for preventative procedures I think we can forecast a shift in physicians/nurses workload from treating sick people to monitoring routine bloodwork. That's a dubious experiment from the start.

      And does anyone really think that companies will offer health insurance with this strange combo of $750 here or $3000 there? Basically, non-union people will be off-loaded to the public plans, union people will bargain for higher coverage.

      Also, there are details that need to be fleshed out. In one of the plans there is this business of penalizing the top 10% of physicians who charge too much…or something??? I'd like to see more on that (This will be a race to the bottom, since there is always a top 10%)

      And, with the OPM-run plans, why is the Left so hysterical???? (don't answer, I think I know)

    4. Pingback: UPDATEDx7: Kill the HealthCare Bill « Daniel McAndrew for U.S. Senate

    5. Matt Tanner, Chicago says:

      Not to be one of those guys, but it's "pore" over (or through, if you must), not "pour."

    6. Steven, SF Ca says:

      Like someone else mentioned, need more on the exchanges. I'm under the impression that under this bill "I can keep my existing insurance" but that it will be regulated to the point that it will no longer be the same (i.e., it will be worse)… it will be dragged down to be as bad as the public option insurance would have been / provide the left the forced equality they wanted out of this. This inability to easily buy better insurance or pay more will be a huge part what wreaks the medical system. Those willing to pay more invariably help fund research and pay for capitol equipment that ends up helping everyone.

    7. DS, Kansas City says:

      Some things you left out:

      Beginning in 2010, for example, dependent children up to age 26 (in the Senate bill) or 27 (in the House bill) could stay on their parents' insurance. Some new insurance industry regulations would begin in both bills, including a ban on insurance companies setting lifetime caps on benefits, and a ban on the practice of "rescission," in which insurers retroactively cancel customers' coverage after they are diagnosed with an expensive disease. In the Senate bill, insurers would also be immediately barred from denying coverage to children based on pre-existing conditions.

      Seniors would also see a small immediate change, as both bills begin to close the Medicare Part D prescription drug coverage "donut hole" by $500 in 2010.

      Both bills also provide $5 billion in funding for a temporary national "high-risk" insurance pool that will last until the new insurance regulations go into effect in 2013 or 2014, to provide a place for people with pre-existing conditions to look for temporary coverage.

      Finally, in the Senate bill, some tax credits for small business begin right away — meaning those businesses could be more likely to offer insurance to their employees. In 2010, businesses with fewer than 25 employees would be eligible for credits of up to 35 percent of their contribution to employee premiums (the credits ramp up to as much as 50 percent in 2013).

      From PBS site:
      http://www.pbs.org/newshour/rundown/2009/12/healt

    8. Richard P, Toronto says:

      Can anyone tell me what the ruling on expats will be? Will I have to purchase health insurance even if I reside outside the US?

    9. Bobbie Jay says:

      It's scary to be forced to give up the right and ability to take care of ourselves.

      Why doesn't everyone see this as an absolute take-over? GOVERNMENT ABUSE OF POWER! CONGRESS DIDN'T/DOESN'T want the bill to be read?????????? They want to force this on our lives! And some don't see that important enough?????!!!!!

      Congress members were bribed to support it??? Doesn't that scream of hidden agendas? False representation? They have time to bribe and stir up all kinds of controversy, but don't read the bill? THIS IS OUR LIVES!!!!!

      It's dangerous to promote and support something you know not everything about. Especially in the matter of decision making on the lives of individual, personal health care and livelihoods of personal responsibilities.

      Mankind didn't survive because they had health insurance. you'd think mankind would have strengthened in mind, not weakened. Oh, wait a second, that was government's doing.

    10. Pingback: Heathcare Bill Time Table

    11. Xmas, Worcester says:

      Aril,

      It's in the PDF file. I don't like the limits on deductions for insurance plans. This forces insurers to only provide low-deductible plans and drop high-deductible plans that are tied to HSAs.

    12. B & T, Flyover C says:

      Ditto Bobbie Jay. It is OUR LIVES. This is the end of everything. Including our right to take care of ourselves.

    13. Mary, Louisiana says:

      What about retroactive taxation that we've heard about?

    14. Mary, Louisiana says:

      Wonderful news for the 80% of us who were satisfied with the current system. Why couldn't government be sensible enough to develop a plan only for those who are uninsured or who don't like their plans and leave the rest of us alone to make our own doctor and procedure choices? After all, I thought we were living in the USA, not the USSA.

      The whole process, (the whole takeover of health insurance) is garbage and should be stopped somehow, any way. It's not constitutional and it's not legal. It was done dishonestly with the representatives of about half of the country not being allowed input into the details of the bills.

      That, to me, is a form of taxation without representation. We may have been represented, but our representatives were not included in any of the backroom deals, decisions and details. We have experienced taxation without responsible representation and our government is close to becoming a dictatorship when it can tell us what we have to pay for or else go to jail and pay penalties.

      Clearly, the person in charge of this country, who vowed not to sign a defense bill if it was laden with pork – and then did just that, the person who said illegals would not be covered, the person who said he wouldn't sign a bill that added to the deficit, clearly this person LIED to all Americans. He was aided and abetted by democrats and they are all guilty by association.

      We need less government, not more bureaucracies. Our country is being destroyed from within by people who claim to be Americans.

    15. Jeanne Stotler, Wood says:

      Bobby Jay, there are those who like ostriches, have their heads in the sand. Not mentioned is that with every cut in Medicare, suppl. Ins. goes up,ie: there is a cut this year to Drs., and an increase in Part B, suppl. went up $12.00 a mo, starting today. As of today I get over $20.00 less a month, we got no increase, Congress on the other hand voted themselves a raise as well as one for their staff, by the way they also get a beautiful health Ins. program, they ae intitled to alsmost free care at Military Hosp. FOR LIFE, when in DC they go to Bethesda Naval or Walter Reed and get VIP suites, believe me you and I cannot get this nor could most of us afford this kind of care in private hosp. I worked in Inova Fairfax yrs' ago and a VIP suite ran over $1,000 a day before adding medical care, Lord knows what it is today. This bill needs to be stopped, if it isn't most of us are going to be struggling to eat not alone pay for housing and util.

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    17. paul l.i. n y says:

      How come that little green lizard or some of his friends can,tgo across state lines to help some folks out?!!!

    18. Mike, Wichita Falls says:

      What are the names of the two Nebraska insurers?

      I wonder how much have they contributed to Ben Nelson's campaign coffers over the years and how much they plan to contribute to his 2012 re-election bid.

    19. dave, dayton says:

      I thought I had a contract with my government, I put my life on the line for 20 plus years and when I retire, I get free medical care. An offer, an offer accepted, a contract. Little did I know, or even think, that Congress would try to back out of our contract. They have the care I was supposed to to be able to receive, what do they care about people who have protected them for so long. They have theirs, well, they just might get more than they want. " A little revolution is good now and then you know". It may just be political (election 2010). P__ off enough people and it might be a railroad rail ride out of DC.

    20. Richard Sandve says:

      I have a question? Can anyone tell me or knows, if they find the corn-husker kickback is illegal or un-consitutional. Will the vote on Health-Care have to be re-done? My premise, would assume that the vote would be unexceptable?

    21. philip says:

      many are like ostriches their head are in the sand and only one thing is showing

    22. Andrew, Cambridge, M says:

      Clearly people who are happy with their health care are not footing the bill. It's like enjoying a Mercedes while making the payments of an Escort.

      Health care spending is out of control and needs to be addressed. Perhaps Obamacare is not the way but spending has to be dealt with. I am one of those that believe that insurance is the culprit. The consumer is not front in center in the transaction – ie they don't care what the cost is. Look at Greg Mankiw's blog and graph showing that less than 5% of spending comes out of pocket. There's no incentive to shop prices!

      http://gregmankiw.blogspot.com/

      Furthermore, I'd argue that the government has already taken over health care. Between Medicare, Medicaid and all the government workers, government drives health care policy – and this is without Obamacare.

      The momentum is going towards getting as many dependents as possible off of corporate health plans. There may be a time when the only people covered will be the employee.

      So even if you like your current coverage wait 1-5 years. Chances are you won't by then – if you have it.

      And if you're on Medicare: Socialism for me not for thee!

      Personally, I'd like to see a system where insurance is just that insurance – deductibles starting at say $2000 per person. You don't call your home insurer for peeling paint. Why should you get insurance reimbursement to get your eyes (or your head) examined?

    23. John Clancy, Wyan.MI says:

      Between 1776 and 1787 there was much debate after much experience in the colonies and much study of forms of government over whether we'd have a monarchy or a republic. Many wanted George Washington to be a monarch because they thought a republic could not survive.

      Ultimately the framers risked their fortunes, their honor, their very lives to form a republic of the people, by the people, for the people. Since then we paid dearly to build a nation of free people "who shall not perish from the earth."

      The unconscionable power move by President Obama and the unconscionable legislators must be stopped before this mammoth takeover (not for health reasons), and takeovers of energy and education (neither for energy efficiency nor for educational quality) destroys this great nation.

      At this eleventh hour, we pray, in the name of all who sacrificed their very lives, that leaders will rise up to vote NO with the vast majority of the American people. It would do more than destroy the best health care in the world. It will destroy us as a free people.

    24. Mike_K says:

      I assume that Congress will rush to override the 21% cut in Medicare reimbursement. The flight of physicians from Medicare will not slow if it is overridden but failure to prevent the cuts will empty Medicare of providers. It will be interesting to see if they can get this done in time if the reconciliation doesn't go well. The bill is not a done deal to my way of thinking. Too much smoke and mirrors.

    25. Pingback: Senate Health Care Timeline » The Foundry | Health Blog

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    28. Dave Baltimore says:

      DS, Kansas City writes:

      Some things you left out:

      a ban on the practice of “rescission,” in which insurers retroactively cancel customers’ coverage after they are diagnosed with an expensive disease.

      Maybe they left it out because that's been the law of the land since 1996. This is one of the biggest Democrat talking points and it drives me nuts because it's a flat out lie. They are attempting to sell this health care deform in part as a "solution" to a "problem" that hasn't existed for more than a decade. Educate yourself.

    29. Bobbie Jay says:

      Jeanne, I am a supporter of ss, medicare and medicaid for those who have paid into and military being the only entities. I don't feel there should be a cost at all to those mentioned who are entitled and government should take pay cuts and decrease in size in order to make it at no cost as it was already bought and paid for.

      The first course of action this inept government should be correcting, is the corruption in these government programs.

      The expectation is the able bodied to take care of themselves with necessary resources in the private market and at their cost. As many have paid into systems the government created to be there, should remain until the government stops taxing for those purposes. This is an ugly government, with ugly people leading the way. God Bless

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    31. François Coup says:

      Well, it seems the US is halfway to a sustainable and universal health coverage like the other developed countries.

      After this bill passes, it will need a few fixes to attained 100% coverage (it will be approximately 95%, 290 million out of 308).

      It will need another round of massive changes to attain sustainability, i.e price control. Seeing that the average cost yearly is about 180% more (averaging) for US citizen, this will be a very needed round of discussion, and soon.

      Seeing how the last one was, I wish you the best of luck.

      My hunch is that these discussions will rage just before the 2012 elections. Both parties will try to score points on the situation (Expanded coverage for Dems, Insurance industry woes for Reps).

    32. Pingback: Looking Forward to Health Care Reform | Finance Blog

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