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The Dartmouth
June 17, 2024 | Latest Issue
The Dartmouth

Tanner clarifies new health care act

04.05.10.news.HealthCareReform
04.05.10.news.HealthCareReform

"We lead the world when it comes to health care innovation," Tanner said. "We drive the innovation and new technology that then travels out around the world and raises the quality of health care for everyone."

Americans have more health care choices than do citizens of other countries, Tanner said. Residents of Spain, for example, are assigned physicians geographically, the same way American children are assigned schools, he said.

"Every year, tens of thousands of patients from around the world come to the United States for treatment," Tanner said. "This is where you get the best care if you're sick."

Despite these advantages, Tanner acknowledged that the U.S. health care system still has flaws, the most prevalent of which is cost, he said.

"We have far and away the most expensive health care system in the world," Tanner said. "We spend one-third more than the next highest country, which is France."

Cost distribution is also a concern for the United States, Tanner said, adding that "the way the costs fall means that some people can't afford the health care they want or need."

Tanner cited the 50 million Americans without health care as an additional problem. Not all uninsured Americans live below the poverty line, he added, as many can afford health care but choose not to buy it.

"Forty-three percent of the uninsured have incomes above 250 percent of the poverty level," he said. "In fact, about 15 percent have incomes above $75,000 a year."

The Patient Protection and Affordable Care Act consists of an individual mandate, an employer mandate, insurance exchange and subsidies, insurance regulation and Medicaid expansion, Tanner said.

The individual mandate requires that "everyone must have insurance," Tanner said. Those who do not receive insurance from their employers or the government must purchase health insurance independently, he said.

Those who fail to comply with this mandate will be charged a minimum fine of $95, or 1 percent of the person's annual income beginning in 2014, Tanner said.

In 2015, the minimum fine will increase to 2 percent of annual income or a minimum of $395, Tanner said. Parents with uninsured children will be fined half of this amount, he said.

Employers in companies with a 50 or more employees will be required to provide health care to all employees beginning in 2014, Tanner said. Failure to do so will result in fines for the employers, he added.

The act mandates insurance regulation, which will prohibit insurance companies from discriminating based on past medical history and pre-existing conditions, he said. Discrimination against children with pre-existing conditions will be prohibited immediately, and discrimination against adults will be prohibited beginning in 2014.

Insurance companies must now set community-based, rather than individually-based rates, Tanner said. Exceptions to this rule will include charging different rates by region, increasing rates with age and charging smokers 50 percent more than non-smokers, he said. Tanner added that community-based rates will cause premiums to decrease for the elderly and increase for the young.

"For most of the folks I see in this audience, your insurance is going to go up," Tanner said.

Insurance premiums will increase from as little as 17 percent to as much as 75 to 95 percent for the young, Tanner said.

The act will create an insurance exchange that will increase consumer access to insurance providers, and will also expand Medicaid, Tanner said.

Those who already have health insurance will be able to remain on their existing plans, Tanner said. They can stay on these insurance plans even if they do not meet new national standards. If an insurance holder who is on a plan that does not meet national standards wants to change his plan, however, he must change it to meet national standards, Tanner said.

The Congressional Budget Office has estimated that implementation of the act will cost the federal government $950 billion, Tanner said. The Act will cut Medicare costs to the government by $168 billion, he said. A separate bill will further increase Medicare costs by $280 billion, he added.