The ACA and its companion bill, the HCERA ("Health Care
and Education Reconciliation Act of 2010) add up to nearly a thousand
pages. Plus, the regulations written under the authorization of those two bills
total over 10,000 pages. So if you don't start out with a full repeal, you're
left with thousands of pages still in effect.
Summary
of the Health Care and Education Reconciliation Act of 2010
The HealthCare and Education Reconciliation Act of 2010 was
signed into law along with the Patient Protection and Affordable Care Act,
below is a summary. The health care related sections of both of
these laws.
The Student Aid and Fiscal Responsibility Act was
attached as a rider to
the HealthCare and Education
Reconciliation Act of 2010. Small technical parts of the bill relating to Pell Grants were
removed during the reconciliation process. The end result is that some
important reforms, some we attribute to ObamaCare and others we don’t, are
actually contained within the HealthCare and Education Reconciliation Act
of 2010 and not within the core of the PPACA itself.
- See Summary of Provisions in the Patient Protection and
Affordable Care Act for a summary of each PPACA provision.
- Read
the full compilation of the PPACA and
HealthCare and Education Reconciliation Act.
Below is a quick summary of what this part of the legislation
does. Most of the information on this page is from Wikipedia articles on
the Student
Aid and Fiscal Responsibility Act and the HealthCare and Education Reconciliation Act of 2010.
We will include annotations when appropriate, please be aware that some of the
exact dollar amounts have changed.
Amending
the Senate’s Healthcare Bill
The Reconciliation bill made several changes to the Patient
Protection and Affordable Care Act that was signed into law 7
days earlier on March 23, 2010. These changes include the following
- Increasing
tax credits to buy insurance
- Eliminating
several of the special deals given to senators, such as Ben Nelson‘s “Cornhusker
Kickback“
- Lowering
the penalty for not buying insurance from $750 to $695
- Closing
the Medicare
Part D “donut hole” by 2020 and gives seniors a rebate of
$250.
- Delaying
the implementation on taxing “Cadillac health-care plans” until 2018
- Requiring
doctors who treat Medicare patients be reimbursed at the full rate
- Setting
up a medicare tax on the unearned incomes of families that earn more than
$250,000 annually.
- Offering
more generous subsidies to lower income groups. Households below 150% of
the federal
poverty level would pay 2% to 4% of their income on
premiums. Health plans would cover 94% of the cost of
benefits. Households with incomes from 150% to 400% of the federal
poverty level ($88,200 for a family of four) would pay on a sliding scale
from 4% to 9.8% of their income on premiums, rest will be covered by
government advanceable, refundable tax
credit. Health plans would cover 70% of the cost of the
benefits.
- penalty
for a company with more than 50 workers not offering health care coverage
after 2014, of $2,000 for each full-time worker above 30 employees. For
example, an employer with 53 workers will pay the penalty for 23 workers,
or $46,000.
- increasing
Medicaid payment rates to primary care doctors to match Medicare payment
rates, which are higher, in 2013 and 2014.
- the
federal government paying all costs of expanding Medicaid under the reform
until 2016, 95% in 2017, 94% in 2018, 93% in 2019, and 90% thereafter.
Some states that already insure childless adults under Medicaid would receive
more federal money for covering that group through 2018.
- a
50% discount on brand-name drugs for Medicare patients beginning in 2011.
By 2020, the government would pay to provide up to 75% discount on
brand-name and generic drugs, eventually closing the coverage gap.
- extending
the ban on lifetime limits and rescission of coverage to all existing
health plans within six months after signing into Law
Student loan reform
Title II of the reconciliation bill deals with student loan
reform. The language is very similar to the Student Aid and Fiscal Responsibility Act that
passed the House in 2009; but with some slight variation. The reform
package included
- Ending
the process of the federal government giving subsidies to private banks to
give out federally insured loans. Instead loans will be administered
directly by the Department of Education.
- Increasing
the Pell Grant scholarship
award.
- For
new borrowers of loans starting in 2014, those who qualify would be able
to cap the amount they must spend on loan repayment each month to 10% of their discretionary
income, down from 15%.
- For
new borrowers after 2014, loans would be eligible to be forgiven to those
who make timely payments after 20 years, down from 25 years previously.
- making
it easier for parents to take out federal loans for students.
- using
several billion dollars to fund schools that predominantly serve poor and
minority students, as well as increasing community college funding.
Tax avoidance
The law codified the “economic substance” rule of Gregory v. Helvering from
1935, which allows the IRS to invalidate tax avoidance transactions
in certain situations.
