Affordable Care Act: Is the Fix in?

Affordable Care Act: Is the Fix in?

As I was listening to the Supreme Court’s decision, I went from the feeling of euphoria and vindication to utter disbelief. I haven’t felt this way since watching the recent Pacquiao fight. 

The Affordable Care Act was upheld because the bill was based on Congress’ ability to levy taxes? There were no taxes mentioned in the bill, and for the past two years advocates of Obamacare swore that the tenets of the bill were not based on taxing Americans — what a lie.

Now that this malignant law has passed, we are about to learn the extent of the disease that will ultimately kill the American system of healthcare (by destroying the doctor-patient relationship on the one hand and eliminating both the doctors’ freedom to treat, and patients’ freedom to choose treatment options on the other). 

For a party that purports to be the savior of the middle class and working poor in this country, the Democrats have crafted and passed a law that has saddled those very people with the largest tax hike this country has ever seen. It is funny how Congress carved themselves out of it. For those who thought they were going to get good healthcare, they are in for a rude awakening. 

Americans for Tax Reform highlights 20 new or higher taxes that will affect American families and small businesses. Read more information from ATR here. Below they describe some examples of this bill which will directly affect the quality, access and or costs of healthcare and are nothing but a middle finger to the American people:

Tax on Innovator Drug Companies ($22.2 bil/Jan 2010): $2.3 billion annual tax on the industry imposed relative to share of sales made that year. Bill: PPACA; Page: 1,971-1,980

This will likely affect patient access to innovative treatments because the cost of bringing new medications will increase.

Medicine Cabinet Tax ($5 bil/Jan 2011): Americans no longer are able to use health savings account (HSA), flexible spending account (FSA), or health reimbursement (HRA) pre-tax dollars to purchase non-prescription, over-the-counter medicines (except insulin). Bill: PPACA; Page: 1,957-1,959

This is simply a gift to the Pharmaceutical industry since you only have access to the most expensive option. This is exacerbated by the inability to import cheaper drugs.

Hike in Medicare Payroll Tax ($86.8 bil/Jan 2013): Current law and changes:

Bill: PPACA, Reconciliation Act; Page: 2000-2003; 87-93

Translated = more taxes for middle income families

Raise “Haircut” for Medical Itemized Deduction from 7.5% to 10% of AGI ($15.2 bil/Jan 2013): Currently, those facing high medical expenses are allowed a deduction for medical expenses to the extent that those expenses exceed 7.5 percent of adjusted gross income (AGI). The new provision imposes a threshold of 10 percent of AGI. Waived for 65+ taxpayers in 2013-2016 only. Bill: PPACA; Page: 1,994-1,995

This will increase healthcare costs for individuals who have increased healthcare costs.

15. Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D ($4.5 bil/Jan 2013) Bill: PPACA; Page: 1,994

This negates the “closing of the donut hole” and raises costs for seniors.

Excise Tax on Comprehensive Health Insurance Plans ($32 bil/Jan 2018): Starting in 2018, new 40 percent excise tax on “Cadillac” health insurance plans ($10,200 single/$27,500 family). Higher threshold ($11,500 single/$29,450 family) for early retirees and high-risk professions. CPI +1 percentage point indexed. Bill: PPACA; Page: 1,941-1,956

This affects most PPO plans (the ones that give patients the most freedom to choose their doctor. They generally also have less out of pocket expenses for patients.) This will effectively relegate people to HMO types of plans with the least choice in doctors, higher out of pocket expenses and gatekeepers that require patients to have referrals to see specialists.

Obamacare was sold to Americans using smoke and mirrors. We only need to look at what has happened in Massachusetts to see the future: their healthcare costs have risen despite mandates which allow people to game the system — carrying coverage when they are ill, then dropping it when they recover (getting far more out of the system then they are putting in). The waiting time to see doctors is longer, and because the system is losing money, reimbursement to providers and hospitals will drop. 

Obamacare sets up a system that is nothing but a transfer of wealth from the 99%; this is not change that Americans should stand for. It can only be reversed if doctors and patients stop playing the game and move to a free market system that removes the corporate and government middle men. This can be accomplished by both patients and doctors re-entering a fee for service system based on pricing transparency and patients moving toward catastrophic coverage.


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