(PP&ACA)

USPSTF AND IPAB

YES, OC AUTHORIZES THE USE OF THE US PREVENTIVE SERVICES TASK FORCE, THE SO CALLED "DEATH SQUAD." THE USPSTF IS A FIFTEEN MEMBER TASK FORCE OF UNELECTED COST-CUTTERS. IT INCLUDES PHYSICIANS, NURSES, BEHAVIORAL, HEALTH EXPERTS BUT DOES NOT INCLUDE UROLOGISTS, PROSTATE OR OTHER CANCER EXPERTS. THE USPSTF IS INDEPENDENT OF THE PUBLIC, SHIELDED FROM THE WRATH OF SENIORS BY THEIR MEMBERS' ANONYMITY. USPSTF RECENTLY RECOMMENDED LESS USE OF SCREENING TECHNIQUES: i.e. MAMMOGRAMS - PROSTATE EXAMINATIONS CAUSING AN IMMEDIATE PUBLIC OUTCRY. THE SECTRETARY OF HHS (SEBELIUS) IS ABLE TO MODIFY AND OR ELIMINATE PREVENTIVE SERVICES FOR SENIORS AT WILL BASED ON USPSTF'S RECOMMENDATIONS.

YES, OC AUTHORIZES THE USE OF THE INDEPENDENT PAYMENT ADVISORY BOARD. IT'S JOB IS IDENTIFY FURTHER CUTS IN WHAT DOCTORS, HOSPITALS, HOSPICE CARE AND OTHER PROVIDERS WHO ARE PAID TO CARE FOR SENIORS. IPAB CAN'T CUT BENEFITS BUT CAN PUSH PAYMENTS SO LOW THAT HOSPITALS, DOCTORS ETC WOUN'T BE ABLE TO PROVIDE THE PROCEDURES INVOLVED. WHATEVER IPAB RECOMMENDS AUTOMATICALLY GOES INTO EFFECT.

INDIVIDUALS

OC REDISTRIBUTES HEALTH RESOURCES FROM MEDICARE TO MEDICAID. CHANGES THE WAY EVERYONE IN AMERICA GETS HEALTH CARE. PUTS GOVERNMENT IN CHARGE OF ONE'S HEALTH CARE. BRINGS DOWN THE GOLDEN AGE OF MEDICINE. RULES OUT LIFETIME CAPS. LOWERS THE QUALITY OF CARE. SHORT CHANGES THE SERIOUSLY ILL. DESTROYS THE INDIVIDUAL'S MEDICAL PRIVACY.

2014: INDIVIDUAL MANDATE

YOU HAVE TO HAVE INSURANCE OR PAY A PENALTY. (ILLEGAL IMMIGRANTS BARRED FROM EXCHANGES, FREE FROM MANDATE, EXPECTED TO GET THEIR CARE AT FEDERALLY FUNDED WEBSITES.) YOUR QUALIFIED PLAN MUST COVER WHAT THE GOVERNMENT (HSS) SAYS IT MUST COVER. YOUNG ADULTS (UNDER 30) OK WITH CATASTROPHIC COVERAGE. CATASTROPHIC PLAN NOT AVAILABLE TO ADULTS OVER 30, CATASTROPHIC PLAN NOT AVAILABLE TO CHILDEN OF PARENTS ON MEDICARE, YET OC EXPANDS PROGRAMS TO SERVE PEOPLE REGARDLESS OF IMMIGRATION STATUS. PROOF OF COVERAGE CAN BE FOUND ON YOUR W2 OR GOTTEN FROM THE EXCHANGE. PENALTY: NOW: $95 OR 1% OF GROSS WHICH EVER HIGHER - UP TO $285. PENALTY: 2015: INDIVIDUAL: $695, FAMILY: $695 X 3. IN 2016: 2.55% OF GROSS - MAXIMUM: $2085. INDIVIDUAL CAN'T BE PROSECUTED FOR NON-PAYMENT OF PENALTY.

ObamaCare's implementers continue to roam the battlefield and shoot their own wounded; the latest casualty? The INDIVIUAL MANDATE.

The administration quietly excused millions of people from the requirement to purchase health insurance or pay a penalty (for two years: 2014 - 2016). (1) All one has to do is fill out a form attesting that his or her plan was cancelled and that he or she believes that the plan options available in the ObamaCare Marketplace in his or her area are more expensive than one's cancelled health insurance policy or "he or she considers other available policies unaffordable." This lax standard - no formula or hard test beyond a person's belief - at least ostensibly requires no proof such as an insurer's termination notice.

(2) In addition, people can also qualify for hardships for the unspecified nonreason that "one experienced another hardship in obtaining health insurance "which only requires documentation if possible."

(3) And yet another waiver is available to those who say they are unable to afford coverage regardless of prior insurance.

In a word these shifting legal benchmarks offer an exemption to anyone who wants one!

2014: QUALIFIED PLAN

OC 2014: REQUIRES YOU TO BE IN A QUALIFIED PLAN. SECRETARY OF HHS (SEBELIUS), USPSTF AND IPAB WILL DECIDE WHAT YOUR PLAN WILL COVER, WHAT IT WILL COST, WHAT Y0UR DOCTOR CAN DO FOR YOU. EVERY DOCTOR WILL HAVE ACCESS TO ALL YOUR MEDICAL RECORDS, YOUR DOCTOR'S DECISION ON YOU WILL BE MONITORED FOR COMPLIANCE. YOU WILL NOT BE ABLE TO KEEP YOUR MEDICAL INFORMATION PRIVATE. WHILE OC DOES NOT EMPOWER THE EXECUTIVE BRANCH TO ISSUE EXEMPTIONS, OBAMA ADMINISTRATION CLAIMS IT HAS THE POWER TO DO SO. THIS IS EXACTLY WHAT THE ADMINISTATION IS DOING AND WILL DO. WITNESS EXEMPTION OF PESONNEL OF BOTH HOUSES OF CONGRESS FROM OC.

2014: EMPLOYERS

EMPLOYERS WITH 50 0R MORE FULL TIME EMPLOYEES MUST PROVIDE AFFORABLE INSURANCE TO FULL TIME WORKERS OF 30 OR MORE HOURS. UNDER OC THE COST TO AN EMPLOYER PER HOUR (FINE) OF EMPLOYEE-EMPLOYEMENT-TIME IF EMPLOYER DOES NOT PROVIDE INSURANCE COVERAGE: $0.98. UNDER OC THE COST TO AN EMPLOYER PER HOUR OF EMPLOYEE-EMPLOYEMENT TIME IF EMPLOYER DOES PROVIDE INSURANCE COVERAGE: $1.79. THUS THE OCCURING EVER WIDENING LAYOFFS REPORTED IN THE MEDIA!

(PERSONAL INFORMATION ON EMPLOYEE & FAMILY AUTOMATICALLY MADE AVAILABLE TO EMPLOYER & IRS) EMPLOYERS DO NOT HAVE TO PAY FOR FAMILY COVERAGE. EMPLOYER CAN ASK EMPLOYEE TO HELP PAY COST OF INSURANCE. EMPLOYER CHOICE: PAY THE FINE OR CUT EMPLOYEE HOURS TO UNDER 30. (ANNUAL EMPLOYER FINE: $2000 x (50-30)=$40,000 2000 X (100-30)= $140,000.) INSURANCE PROVIDED CAN BE NO MORE THAN 9.5% OF FAMILY INCOME. (ONCE AGAIN, EMPLOYER CHOICE: PROVIDE THE INSURANCE, NOT PROVIDE INSURANCE (AND PAY A FINE) OR CUT EMPLOYEE HOURS TO UNDER 30. IF INSURANCE OFFERED UNAFFORABLE (2.9+ OF FAMILY INCOME)FOR THE EMPLOYEE AND IF EMPLOYEE SEEKS SUBSIDY: EMPLOYER FINED $3,000.

IF EMPL0YEE EARNS LESS THAN 4 TIMES FEDERAL POVERTY LEVEL AND IF HIS PREMIUM AT WORK IS BETWEEN 8% - 9.5% OF HOUSEHOLD INCOME, HE CAN ENROLL IN A SUBSIDIZED HEALTH PLAN INSTEAD OF GETTING INSURANCE AT WORK AND GET A "FREE CHOICE VOUCHER" = $ AMOUNT EMPLOYER WOULD HAVE SPENT ON HIS PLAN.

EXCHANGES

OC: EACH STATE IS TO SET UP AN EXCHANGE. IF A STATE EXCHANGE DOES NOT MEET FEDERAL STANDARDS, FEDERAL GOVERNMENT WILL SET UP THE EXCHANGE. EXCHANGES WILL SELL GOVERNMENT DESIGNED PLANS. EXCHANGES WILL OFFER 4 PLANS: ALL WITH SAME ESSENTIAL BENEFITS, EACH WITH A DIFFERENT LEVEL OF COST SHARING; ONLY COPAYS / DEDUCTABLES WILL BE DIFFERENT.

UNDER THE "ONE SIZE FITS ALL" ARRANGEMENT ANY PLAN OFFERED BY ANY PROVIDER MUST INCLUDE SERVICES SPECIFIED WHETHER OR NOT YOU NEED THEM, i.e. MAMMOGRAM (FOR MEN AS WELL AS WOMEN), PAP SMEAR (FOR MEN AS WELL AS WOMEN), COLONOSCOPIES (FOR WOMEN AS WELL AS MEN) ETC. AND YOU WILL HAVE TO PAY FOR THEM, USE THEM OR NOT.

HEALTH SAVINGS ACCOUNT	WAS UP TO $6,000 UNTAXED	OC: ONLY UP TO $2,000 UNTAXED
HSA FUNDS	WERE AVAILABLE FOR OVER COUNTER DRUGS	OC: NO LONGER AVAILABLE FOR THEM
PREVENTIVE CARE MUST BE	PAID FOR UP FRONT WHEN TREATED	OC: NOT LATER OUT OF HSA ACCOUNT. U PAY TWICE
MEDICARE ADVANTAGE	$3,700 LESS PER YEAR	OC: FOR 37 MILLION SENIORS

IN ADDITION TO FOUR PLANS DECRIBED ABOVE, EXCHANGES WILL ALSO OFFER PLANS ORGINATING WITH BLUE CROSS, WELL CARE ETC. THEN AGAIN, PLANS CAN ALSO ORIGINATE WITH PRIVATE INSURERS, EMPLOYERS, REGIONAL INSURERS, NOT-FOR PROFIT PROVIDERS OR INSURANCE BROKERS. HOWEVER, ANY PLAN OFFERED BY ANY PROVIDER MUST CORRESPOND TO THE "ONE PLAN FITS ALL" STANDARD ESTABLISHED UNDER OBAMA CARE (INCLUDING COVERAGE OF CHILDREN TO AGE 26).

ILLEGAL IMMIGRANTS BARRED FROM EXCHANGES, FREE FROM MANDATE AND EXPECTED TO GET THEIR CARE AT FEDERALLY FUNDED WEBSITES. LEGAL IMMIGRANTS NOT ELIGIBLE FOR MEDICAID FOR FIRST 5 YEARS,CAN SHOP ON EXCHANGE AND RECEIVE SUBSIDIES WITH NO WAITING PERIOD.

MEDICARE

OC: RAIDS MEDICARE DOES NOT SAVE IT. MEDICARE: NOW PAYS HOSPITALS: 91 CENTS FOR EVERY EVERY ONE DOLLAR OF CARE. MEDICARE'S OVERALL LOSS UNDER OC: PREDICTION: 275 BILLION TO 716 BILLION. MEDICARE: YEARLY LOSS TO SENIORS: IN 2019 PREDICTION: $1431. MEDICARE: 15% OF HOSPITALS COULD STOP ACCEPTING MEDICARE. SUPREME COURT HAS RULED THAT: THE STATES SHOULD BE ALLOWED TO DECIDE WHETHER OR NOT TO EXPAND MEDICAID. MEDICAID NOW PAYS HOSPITALS: 86-91 CENTS FOR EVERY DOLLAR OF CARE. MEDICARE NOW PAYS DOCTORS 81% OF WHAT PRIVATE INSURERS PAY. MEDICAID NOW PAYS DOCTORS 56% OF WHAT PRIVATE INSURERS PAY. OC TURNS MEDICAID INTO A PERMANENT ENTITLEMENT. OC QUALIFIES A FAMILY OF 4 WITH AN INCOME UP TO $30,657 FOR MEDICAID. QUALIFIES A CHILDLESS COUPLE, THOSE UNINSURED WHO CAN'T AFFORD INSURANCE FOR MEDICAID.

HOSPITALS

OC IS A COMPLIANCE NIGHTMARE AND WILL HAVE CATASTROPHIC CONSEQUENCES FOR HOSPITALS. IT SLASHES WHAT (DOCTORS), HOSPITALS, DIALYSIS CENTERS ETC ARE PAID TO CARE FOR ELDERS. OC LEADS TO CUTS IN PAYMENTS FOR KNEE / HIP REPLACEMENTS, ANGIOPLASTY, BY-PASS SURGERY ETC. HOSPITALS WILL OPERATE IN AN ENVIRONMENT OF SCARCITY. FEWER CLEANERS, FEWER NURSES WILL BE AVAILABLE ON ANY HOSPITAL FLOOR. SUPPLY OF DIAGNOSTIC EQUIPMENT WILL BE REDUCED WITH A LONGER WAIT FOR TESTS.

TAXES

20 NEW TAXES	AMT: HALF A TRILLION $	NEW TAXES 20
PAST	CATEGORY AFFECTED	UNDER 0BAMA CARE
TAX WAS O.0 %	FLEXIBLE SAVINGS ACCOUNT	ONLY UP TO: $2,000
EMPLOYER 1.45% EMPLOYEE 1.45%	HOSPITAL (MEDICARE PART A) INSURANCE TAX	EMPOYER & EMPLOYEE 2.35%
$16,330 IND TAX -$27,500 FAM: NO TAX	CADILLAC INSURANCE	INSURER PROVIDER TAX: 40%
WAS 0.0%	EARNED INCOME	3.8% + ALREADY EXISTING CAPITAL GAINS TAX ON INCOME OVER $200,000
DEDUCTABLE: AMOUNT ONLY OVER 7.5	DEDUCTABLE MEDICAL EXPENSES	DEDUCTABLE AMOUNT: ONLY OVER 10%
NEW TAXES ON (A):	MEDICAL DEVICE COMPANIES	HEALTH INSURERS
NEW TAXES ON (B):	TANNING SERVCES	PHARMACEUTICAL COMPANIES

DOCTORS

OC TRANSFERS DECISION MAKING AUTHORITY FROM THE DOCTOR TO THE FEDERAL GOVERNMENT. PUTS THE GOVERNMENT IN CHARGE AT YOUR BEDSIDE. PUTS WASHINGTON IN CHARGE AT ONE'S BEDSIDE. IMPOSES HUGH NUMBER OF REPORTING REQUIREMENTS ON DOCTORS. OC STANDARDIZES WHAT DOCTORS CAN DO. YOUR DOCTOR'S DECISIONS WILL BE MONITORED FOR FEDERAL COMPLIANCE. OC IMPOSES FINANCIAL PENALTIES ON DOCTORS WHO ARE NOT MEANINGFUL USERS OF TECHNOLOGY. PAYS DOCTORS LESS TO TREAT SENIORS. CLOBBERS DOCTORS' LIVELIHOOD BY EXPANDING MEDICAID. ENROLLMENT. TURNS DOCTORS INTO PAPER PUSHES INSTEAD OF HEALERS.

SUBSIDIES

OC OMITTED ANY REFERENCE TO EXCHANGES HANDING OUT SUBSIDIES. SUBSIDIES BASED ON HOUSEHOLD INCOME. BUT SEBELIUS (THROUGH THE EXCHANGES) IS HANDING OUT SUBSIDIES WITHOUT INCOME VERIFICATION, SO FAR. PAID DIRECTLY TO ONE'S HEALTH PLAN TO REDUCE ONE'S PREMIUM. AVAILABLE TO THOSE UNABLE TO QUALIFY FOR MEDICAID. NEW COMERS WHO ENTER US LEGALLY ELIGIBLE FOR SUBSIDIES. OFFERED TO INDIVIDUALS/HOUSEHOLDS MAKING 133% - 400 % OF THE FEDERAL POVERTY LINE. AVAILABLE TO PEOPLE WITH A HOSEHOLD INCOME UP TO $92,200. IN 2019 AVAILABLE TO HOUSEHOLDS EARNING $100 WITH NO ASSET TEST SO FAR OR PREVIOUS INSURANCE.

STAY TUNED FOR FURTHER ANALYSIS AS WE CONTINUE TO ADD TO AND FORMAT THE ABOVE PRESENTATION(TEXT)

The content of the above publication is intended for the sole in-house use of MCRA (informational purposes only). All rights reserved. No part of this publication may be reproduced, transmitted in any form: electronic, mechanical or otherwise for the purpose of handing it to a 3rd party for commercial or any other use whatsoever without the written consent and approval of MCRA.

MICHAEL J. DALY, PRESIDENT,

MIDDLE COUNTRY RETIREES' ASSOCIATION.

Thanks, Michael

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