How will small employers be affected by the changes?
Employers with 50 or more workers would face fines for not providing insurance coverage. Businesses with smaller workforces, though, would be exempt. Companies would get tax credits to help buy insurance if they have 25 or fewer employees and a workforce with an average wage of up to $50,000.
I’m covered by a large employer. How will it affect me?
Large employers would run their health plans as they do now, so there won’t be much change. Even though they have more insurance-buying clout, large businesses have seen steadily rising insurance premiums over the past decade without reform, as medical costs have increased. That pattern isn’t likely to change much, at least immediately.
How does the bill affect Medicare recipients?
Seniors will get immediate help on the "doughnut hole" - a gap in their coverage for prescription drugs. This year, those reaching that hole would get $250 to help pay their drug costs. Next year, they would receive a 50% discount on the cost of brand-name drugs in the doughnut hole. Meanwhile, preventive screenings would be free to beneficiaries beginning this year.
But federal payments to Medicare Advantage plans would be cut substantially, starting in 2011. So seniors in those plans may lose some extra benefits, such as free eyeglasses.
What changes will occur in Medicaid?
Individuals and families with incomes up to 133% of the federal poverty level (below $29,327 for a family of four) will gain coverage. The federal government will pay all the states’ costs for the newly eligible Medicaid beneficiaries for three years. And primary-care doctors treating Medicaid patients will get an increase in their fees.
Will reform reduce health insurance costs?
Many health care experts say that while it contains some cost-cutting provisions and pilot programs, the legislation doesn’t go far enough to tame rising costs. People with chronic medical problems, though, generally would see their premiums decrease because of the new ban on pre-existing condition discrimination.
How will the $940 billion price tag (over 10 years) be paid for?
Wealthier families will pay more in taxes. Starting in 2013, families with annual incomes above $250,000 (and individuals earning more than $200,000) would pay an additional 3.8% tax on investment income, and also face a higher Medicare payroll tax. Expensive, "Cadillac" insurance plans would draw a new tax starting in 2018. And the Medicare program would receive substantial cuts, including a $132 billion reduction in funding for Advantage plans run by private insurers.