Residents of states with higher-than-average health care costs -- states such as California, New York, Florida, and Connecticut, for example -- will be hit hard if the bill passes, because it includes a heavy tax on health plans that cost employees and employers more than a combined $12,000 per year per person. In these and many other states, because of the higher charges by doctors and hospitals, many of which are teaching institutions or public institutions that provide more tertiary care and that treat much larger numbers of low-income patients, and all of which have much higher real-estate costs and wage rates for staff, insurance plans are inevitably also costlier. Yet the residents of those states and their employers will end up getting socked with taxes as high as 40% on those plans that are over the limit. The result, experts say, is that many employers in these states will simply reduce coverage to bring the plans in under the limit.
Also slammed by this tax will be unionized workers -- most of them again concentrated heavily in relatively union-friendly states such as California, New York and much of the northeastern U.S. -- who over long years and many bitterly fought contract battles -- have negotiated better-than-average health insurance coverage. The fruits of their struggles, which often included tough strikes and lockouts, and deals that involved forgoing bigger pay increases in return for better health coverage, could be erased by this legislation if the bill is passed as written.
And what about the so-called "near poor"? Under the plan as it stands, everyone would be required to buy health insurance, or face a stiff fine of as much as $1,200 from the IRS for a family. People earning less than 133% of the federal poverty level (that would currently be approximately $13,000 a year for individuals or $30,000 a year for a family of four, except in Hawaii and Alaska where the numbers are slightly higher), and less than four times the federal poverty level ($40,000 for an individual or $88,000 for a family of four), would be given a subsidy to help them buy that insurance. But they would be expected to pay as much as 12% of their income out of pocket for coverage, up to a limit of $5000 for an individual and $10,000 for a family. (I'm just trying to imagine how that would hit a family earning $88,000 a year. First of all, it seems clear to me that many hard-pressed families will look at the costs, just decide can't afford it, and pay the IRS penalty.)
But the number of people who could lose insurance coverage under this legislation could be much higher.
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http://blog.buzzflash.com/lindorff/308