HR 4872 – Amendments to Patient Protection and Affordable Care Act – Day 98 – pages 1 – 12 – October 7, 2010
TAX CREDITS AND SUBSIDIES
–The amount of the tax credit is spelled out. It depends on one’s percentage of the federal poverty line.
Up to 133%, the initial premium percentage is 2%
133% to 150%, it is 3% to 4%,
150% to 200%, it is 4% to 6.3%
200% to 250%, it is 6.3% to 8.05%,
250% to 300%, it is 8.05% to 9.5%
300% to 400%, it is 9.5%.
–For those who make less than 250% of the federal poverty line, plans must pay a higher percentage than for other folks. For some, the 90% is increased to 94%; the 80% is increased to 87%; the 70% is increased to 73%. For those who make 250% to 400%, the maximum cost sharing is 70%-30%.
–The penalty for not having health insurance is reduced to $695 for an individual and $325 for a family member.
EMPLOYER RESPONSIBILITY
–For employees who work less than full-time, the number of total monthly part-time hours is divided by 120 to calculate the number of full-time employees.
–When calculating penalties for employees in the Exchange, the first 30 employees are not counted.
ADJUSTED GROSS INCOME
–Adjusted gross income includes income adjusted under Section 911 plus tax-exempt interest.
–Allowance is made for deducting health insurance premiums for dependents even for children under age 27 who are not actually dependents of the parents.
–5% leeway in income allowed for qualification in government programs.
IMPLEMENTATION FUNDING
–$1 billion in implementation funds is allowed.
MEDICARE
–Coverage gap is slowly closed over several years, with a $250 rebate mailed in 2010 for those who reach their coverage gap.
–Beginning in 2011, brand-name drugs are discounted 50% while in the coverage gap.
–Beginning in 2011, a 7% discount is allowed for generic drugs, increasing by 7% each year, until generic drugs will be covered at 25% by 2020.
