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Healthcare Reform Legislation: The Bad…(Part 2 of 3)


Yesterday, I expressed my thoughts and opinions on the *good* side of “America’s Affordable Health Choices Act of 2009.” Today, here’s the bad…where the horsetrading shows:

  1. The plan is not universal. Despite the fact that the legislation includes both an individual and an employer mandate, the Congressional Budget Office (CBO) estimates that 9 million citizens (as well as a similar number of illegal immigrants) will remain uninsured. This means that at least 20% of the uninsured will stay that way.
  2. The small employer provision is weak. Tax penalties for failing to offer benefits kick in on a sliding scale for companies with payrolls of $250,000 and higher…and fast food chains and other retail chains can possibly simply reincorporate as multiple tiny businesses (with common ownership) to avoid the penalty.
  3. The legislation, for the most part, doesn’t kick-in until 2013. Ramping up a public plan sounds more difficult than it actually is mainly because the plan will rely on the Medicare infrastructure and payment plan. My point? This should not take 3 years!
  4. Those individual mandates seem more like a one-two punch than a help. Many uninsured middle-income Americans will find it difficult to pay five-figure premiums when the penalty for not obtaining insurance is only 2.5% of adjusted gross income…which means most people (families in particular) will find it less expensive to pay the penalty than to buy the insurance. Few families can afford 5-figure premiums—which was the problem in the first place…and this bill still will not provide coverage…. Go figure!

    PREVIOUS: The Good side of how “America’s Affordable Health Choices Act of 2009” includes a public plan option.

NEXT: The Ugly side of how “America’s Affordable Health Choices Act of 2009” doesn’t do enough to control costs.


American Hospital Association. AHA special bulletin: House leaders release reform bill. http://www.aha.org/aha/advocacy-update/2009/090714-bulletin.html. Published July 14, 2009. Accessed July 21, 2009.

Eskow RJ. The House Health Reform Bill: how good is it? Huffington Post website. http://www.huffingtonpost.com/rj-eskow/the-house-health-reform-b_b_234593.html. Published July 15, 2009. Accessed July 21, 2009.

H.R. ___. America’s Affordable Health Choices Act bill text. http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf. Published July 14, 2009. Accessed July 21, 2009.

Letter to the Honorable Charles B. Rangel, Chairman, Committee on House Ways and Means, US House of Representatives. Huffington Post website. http://big.assets.huffingtonpost.com/House_Tri-Committee.pdf. Published July 14, 2009. Accessed July 21, 2009.

Mahar M. What the HELP and House bills tell us about the Administration’s priorities—it may be time for Baucus to join his caucus part I. HealthBeat website. http://www.healthbeatblog.com/2009/07/what-the-help-and-house-bills-tells-us-about-the-administrations-priorities-it-may-be-time-for-baucu.html. Published July 15, 2009. Accessed July 21, 2009.

The House Health Reform Bill— just the highlights. Managed Care Matters website. http://www.joepaduda.com/2009/07/the_house_healt/. Published July 15, 2009. Accessed July 21, 2009.


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