It's Still Bad Medicine: 10 Things You Need To Know About Speaker Pelosi's Health Care Bill
Speaker Pelosi's bill -- H.R. 3962: It's still the same flawed bill. It is still a government takeover of health care. Totaling 1,990 pages, the bill completely rewrites nearly 1/6th of the nation's economy. Health care costs will go up, and the bill raises taxes, cuts seniors benefits, and doesn't come close to fulfilling the promise that if you like what you have you can keep it.
1. It Still Raises Taxes on Small Businesses
Surtax: Individuals, including small business owners (who pay their business taxes at the individual level) making $500,000 ($1 million joint) will be hit with a 5.4% surtax.
Employer mandate still applies to small businesses: Small employers with a payroll as low as $500,000 will be hit with a tax.
(0% (<$500,000), 2% ($500,000-$585,000), 4% ($585,000-$670,000), and 6% ($670,000-$750,000)).
2. New Medical Device Tax
Speaker Pelosi's bill includes a new 2.5% excise tax on the sale of a medical device in the United States. Some have taken to calling this the wheelchair tax as it will cover everything from bandages to prosthetics.
3. New Taxes on Health Savings Accounts
Speaker Pelosi's bill eliminates the nontaxable reimbursements of over-the-counter medication from HSAs, HRAs, and FSAs.
4. New Payroll Tax
Speaker Pelosi's bill creates a new "voluntary" payroll tax to fund new long-term care program--requiring mandatory spending--aka a new entitlement.
5. Abortions Are Authorized
In a break from the Hyde Amendment and other long-standing pro-life policies, the Speaker Pelosi's bill includes the Capps Amendment to authorize government funding of abortions through the public option. It also establishes an accounting gimmick to justify subsidizing private plans that cover abortion.
6. Members of Congress are Exempt from "Public Option"
Speaker Pelosi's bill doesn't require Members of Congress to enroll in the new government-run plan. Instead the language says the Members "may" enroll in the public option. In contrast the bill uses the word "shall" 3,425 times.
7. Doctors' Reimbursement Levels Are Up in the Air / Budget Gimmicks
The new government-run plan will reimburse providers based on rates set by the government. "Negotiated rates" could start at Medicare and future rates could be set at levels below Medicare reimbursements. The Secretary of Health and Human Services could coerce doctors to participate in the program by tying participation to other government run health programs, like Medicare.
Removes the Medicare Doc Fix. The Pelosi bill does not include doc fix--instead it has been introduced as a standalone bill, unpaid for -- meaning that Democrats' proposals really aren't deficit neutral.
8. Reduces Affordability Credits and Instead Expands Medicaid
Speaker Pelosi's bill reduces the size of the affordability credits for patients to purchase the insurance in the exchange and instead expands eligibility for Medicaid to 150% of the federal poverty level--placing more Americans on entitlement programs at a cost to both the federal and state governments.
9. Significantly Changes the Medicare Prescription Drug Program
Speaker Pelosi's bill requires the Secretary of HHS to negotiate drug prices for the prescription drug program. There are also several provisions in the bill that will likely increase seniors premiums, as identified by CBO, including that the bill would force seniors to pay at least an additional 20 percent more for their Medicare prescription drug coverage (Part D).
10. No Real Medical Liability Reform, Instead Rewards Trial Lawyers
Speaker Pelosi's bill includes a new grant program to encourage states to implement alternative medical liability reforms like early offer or certificate of merit programs. However, a state is not eligible for the incentive payments if its law limits attorneys' fees or imposes caps on damages--a key reform recognized by CBO as necessary to reduce defensive medicine.