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Christine Grahl is the editor of POB magazine. She can be reached at pobeditor@bnpmedia.com.

Sight Lines: What Does the Health Care Reform Bill Mean for You?

March 22, 2010
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I would love to go into the politics of the health care legislation that the House passed by such a narrow margin and that President Obama subsequently signed into law, but I’ll refrain. Instead, I want to focus on what this new legislation might mean for those in the surveying, mapping and related professions.



[Originally posted March 22 and updated March 24] -- I would love to go into the politics of the health care legislation that the House passed by such a narrow margin and that President Obama subsequently signed into law, but I’ll refrain. Instead, I want to focus on what this new legislation might mean for those in the surveying, mapping and related professions.

First the good news. From 2011 to 2013, a temporary sliding scale tax credit will help small businesses (those with fewer than 25 employees) pay for up to 35 percent of employer costs for employers who cover 50 percent or more of the cost of a health plan for their employees, as long as employee wages average $40,000 or less. Beginning in 2014, the credit will remain available to businesses that purchase insurance through the state health benefit exchanges that are mandated by the legislation.

The bad news is that the full credit will only be available to businesses with 10 or fewer workers whose average wages are less than $20,000, and the credit will only be available to a firm for two years.

More bad news: Firms with more than 50 employees will have to pay a “free rider” tax penalty on any employees who receive a subsidy in the health benefit exchange. Of course, if this penalty costs less than the mandated health care coverage, which is likely based on current estimates, then more employers may decide to opt out of providing health care coverage and simply pay the tax. In either case, higher fees mean more pressure on numerous businesses that are already struggling to make payroll.

For sole proprietors and individuals buying their own coverage, the legislation appears positive at first glance. Within six months of enactment, which is planned for Jan. 1, 2014, all health insurance plans offered on the individual and small group market will be required to cover “essential health benefits” such as emergency services, hospitalization, physician services, outpatient services, maternity and newborn care, pediatric services (including dental and vision), medical/surgical care, prescription drugs, and mental health and substance abuse services. For many individuals, this is likely far more than what their current plan covers. There’s just one catch-it isn’t free. Individuals will be forced into higher-cost health plans that meet the new mandates. Sliding scale subsidies might help make the higher-cost plans more affordable for those who qualify, but many won’t qualify due to the income limits. Of course, these individuals can always opt out and pay the tax penalty.

What’s more, we can expect the cost for prescription drugs, medical devices (even such minor items as toothbrushes), and health insurance to rise immediately under the new legislation. Beginning Jan. 1, 2010, annual fees of $2.2 billion and $2 billion, respectively, will be imposed on manufacturers of prescription drugs and medical devices, and annual fees of $6.7 billion will be levied on health insurance companies. Who do you think will really pay these added fees?

No one is denying that our health care system has serious problems. My family and many others are struggling to afford rising insurance premiums and ever-increasing medical costs. But I’m having a difficult time understanding how the new legislation resolves these problems.

So much for keeping the politics out of it. My bias is clear. But I want to hear what you think. What will the new health care legislation mean for you and your business? Do you believe passage of the health care reform bill is a positive move for those in the surveying and mapping professions? Please share your comments below.
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Healthcare Bill

Deral in Oklahoma
March 22, 2010
Kristy I'm unsure at this moment what all this new bill will do to survey and engineering companies in Oklahoma. Many, like the rest of the country, are struggling to meet the high cost of health insurance now for their employees. I think many of the larger companies will opt to just drop their plans and pay the penalty leaving employees to face much higher premiums with the government plan. Senator Pelosi was quoted as saying "We need to pass this bill so we can find out what is in the bill". This scares me the most. I don't think they really just know what all the implications will be with this new plan. It's pretty simple economics for the large pharmacy companies. They will just increase the cost of medicine to make up the difference in their balance sheets. That increase will be funded by us directly or through increased taxes so we will still be paying more or at least the majority of business owners will. I do think it was about time they addressed the health industry and I hope this bill is a start to that but at this point I'm more confused on it's ramifications than ever. Maybe they will have to do a lot of modifications which likely will negate any true savings. So we will be paying more and nothing will have changed for most of us except less take home pay. I'm trying to be positive about the bill but everyone of our Oklahoma reps voted NO on the bill based on e-mails, calls, letters and other communication from their constituents. Apparently, this was not considered by others in congress. Most have forgotten who they are supposed to be working for but this is tough for them. They get all their money from these same groups that we are asking them to help control and rein in. Deral

Healtcare Bill

Kirk
March 22, 2010
I truly believe that once again the middle class will be screwed, althought they said that the upper class will be taxed the most. I think that everyone will be pinched simply because of the drug companies and insurance companies will just raise their prices and rates.

Healthcare Bill

Justin
March 22, 2010
Kristy, I live in Massachusetts, where for a few years now we have had a universal health care plan that is essentially the same plan that was just passed by the House. Two months ago I left my old company to start my own survey business, and had to look for insurance on my own. Our state's plan gives individuals and small businesses the benefit of buying insurance at the same rates previously available to only the largest companies. Through the state-run insurance exchange, I was able to find an unsubsidized private insurance plan that meets all of my needs for $235 a month. If I had continued my old plan through COBRA, it would have cost me $356 a month for a similar plan. I don't even want to know what I would have had to pay if I were buying it on my own in without the help of the state pool. I can't tell you what all the effects will be nationwide from this new legislation. From my personal experience though, I can tell you there will be a lot fewer uninsured people, and potential entrepreneurs won't have to worry so much about putting themselves and their families at risk.

For Justin

Deral in Oklahoma
March 22, 2010
What will this new bill do to your states plan that you have if anything? Sounds like Mass is doing it right already for its constituents. There is a similar plan in Oklahoma but it's reserved for certain incomes and age groups.

Healthcare Bill

Mitch in Seattle
March 24, 2010
This program will definitely help this small company of 12 to afford and maintain quality healthcare for our most import production element-our people and their families. This bill is the first in a series of steps to help us rein in the insurance companies, pharmaceutical industry, and medical industry. So should we have done nothing while they rob us blind for their massive profit taking in an industry that is un-American enough to have almost no competition? There is much work to do yet--it's not the be all end all, but it is a step towards taking care of our people.

Healthcare Bill

Stacy L. Little, R.P.L.S. - Texas
March 24, 2010
With so much opposition to this bill and the lack of bipartisan support, along with the lack of some Democrat support, why did they not just start over? They were so determined to pass this bill no matter the cost that they just crammed it down our throats! We need healthcare reform, but there needs to be a little common sense about it along with leaving it up to the states. What works for one state may not work for another! Being forced to purchase a product is inherently wrong!! I believe it to be more about control than healthcare, the more people you have dependent on you (ie: the Government) the easier it is to pass more laws for the "good of the people".

Health Care?

Harold Baldwin
March 24, 2010
If I could get a plan for $235 a month, I would be jumping up and down, with joy. Try 5 times that, for each employee. Mass may have a state run plan, but I would bet it is subsidized by a lot of unknowing persons. It is bad enough that the cost of business is escalating yearly, but penalties now for insurance? I thought this was a republic, not a democracy?? How about forcing the hospitals, drug companies, insurance companies, etc., to reduce their profit margins?

And you thot: "No more new taxes under $250,000.00 income"

Paul Jones, Sr.
March 24, 2010
As the new saying goes now: "I think we have all just been Pelosie'd!"

Security at what cost.

K.W. Miller
March 24, 2010
Perhaps it's an illusion, but it seems the more money you have, the more freedom and liberty you have. When Government dictates on what I must spend my money (mandatory health care), my freedoms and liberties have been seriously eroded. Government has traded liberty for a questionable security.

health care boondoggle

V. M. Mallory
March 25, 2010
Kristy, As always the feds think they knoe best. They passed a bill albiet narrowly, they themselves have no idea what's in it or how it is going to affect the American citizens. Any time the government adds taxes, fees and the like the people pays through the nose at all economic levels. It appears that Congress is doing a good job of complete takeovers, ie: GM, Banking,college student loans, etc., now it is health care. It will in just a few years bankrupt America. No way is this bill affordable or even viable. We have a small surveying firm of 5 total people and offer 100% health insurance coverage. Yes it is expensive yet we stuggle to pay premiums so everyone can be covered. But how I understand this health care bill we will be forced to drop our plan and go with the government national plan. God help us all. Congress is governing IN SPITE OF THE PEOPLE!! I believe this is the beginning of a COMPLETE LIBERAL TAKEOVER!

Health Care

Gene
March 26, 2010
Lucky for me I got out of the private sector years ago and started working for a city government...We get our insurance virtually free($5 a week). I feel a little ashamed. The tax payers pay our bills for us and we get all of the benefits...The right wingers here at work are completely happy in sticking it to the tax payers...Their motto is "We got ours and tough crap for everyone else". I appreciate the fact that the liberals or whoever are at least trying to do something for the people of America...rather then fill their pockets full of insurance or special interest campaign money.Of course it would be easier for a lifer political hack to side with big business and be on the take.

Health Care Reform

Phil
March 27, 2010
This bill will eventually destroy small surveying firms that are already faced with increasing utility costs, equipment costs, software costs, E & O insurance costs all the while trying to pay employees a decent living wage. All this while facing declining revenues because some licensed surveyors are cutting fees without consideration of the true costs associated with providing a quality service to the public. The healthcare industry needs to be reformed but this bill does not address the root problems. Tort reform is probably number one as the place to start. Frivolous lawsuits are driving the costs of helthcare up. Awards for truly negligent acts should be limited to actual damages incurred - ie. if person is unable to work then award the person their yearly salary with cost of living increases, payment for continued medical care resulting from the negligent act, etc. Obviously not a perfect solution but better than what we have now. Funny thing how tort reform was left out of this bill even though some Democrats and Republicans were trying to include this as part of the bill. Instead we get student loans being taken away from the banks and into federal hands - I must be stupid, can someone please explain what this has to do with healthcare reform? Gene, have you really looked at this bill in its entirety? True no special interest money from the insurance industry or pharmaceutical companies, but how about all the back door deals and special concessions granted to various states in return for the vote from that state's Senators or Congressmen? They most certainly are filling their pockets with special interest campaign money. The second place to start is with the charges for medical care at hospitals and clinics. A local news team interviewed the CEO's of two local healthcare providers and they could not explain why the hospitals charge what they do for medicine ($20.00 for an aspirin), room rates ($1500 to $3000 a day or more), etc. I believe tort reform and accountability for the healthcare provider charges would do more toward making healthcare affordable to everyone. Address those issues first, then move on to reforming the health insurance company's practices that deny coverage for pre-existing conditions, etc. I think everyone can agree there is not a perfect, quick-fix solution to a problem that has been growing over the past 50 or 60 years but I think most would agree that government intervention as displayed by this bill is flawed at best and downright dangerous to the liberty and rights of a free society.

Health Care Reform

Manny Gutierrez
March 30, 2010
I am very happy to see by most of the comments that people are beginning to realize the folly of adding control over Health Care to the already-bloated Federal Government. But these letters should instead be addressed to the traitors who voted for it in Congress and in the House, and then vote them OUT! Another wasteful expense will be the payroll of 150,000+ Government workers needed to put this behemoth in action! (And then the workers hired to fix what these 150,000 morons will mess up!)

Mandated health insurance

Roy Crawford
March 31, 2010
While it certainly sounds bad that people will be forced to buy health insurance and I wish they had done it another way, I am at a loss to understand why so many people oare so violently against it. Why do I say that? Becasue when people without insurance go to the emergency room, all we taxpayers get stuck with the cost. Is that really what you want to continue doing? Young people who are healthy and choose not to get insurance don't seem to realize that anyone can get sick or injured, and they shouldn't stick us with the cost. So, the issue isn't really whether they will be treated, it's who will pay for it - them or us.

Mandated health insurance

Roy Crawford
March 31, 2010
While it certainly sounds bad that people will be forced to buy health insurance and I wish they had done it another way, I am at a loss to understand why so many people oare so violently against it. Why do I say that? Becasue when people without insurance go to the emergency room, all we taxpayers get stuck with the cost. Is that really what you want to continue doing? Young people who are healthy and choose not to get insurance don't seem to realize that anyone can get sick or injured, and they shouldn't stick us with the cost. So, the issue isn't really whether they will be treated, it's who will pay for it - them or us. As much a cobbled up mess as the bill is, I'm glad we finally have leadership who cares about poor people who are sick and injured and want to help them.

Health insurance

Drew
March 31, 2010
The whole reason for the legislation was to help control rising medical costs. But when all you have to do is buy insurance when you need it, because you can't be denied for pre-existing conditions and its cheaper to pay the penalties. This is really just an expansion of medicaid that that the states will have to make up else were.

Health Care

Dave
March 31, 2010
Congress should be like NASCAR. The members should be required to wear jackets with their sponsor's logos on them so we know who they are working for.

Health Care

Don
April 1, 2010
Every social program run by the government has been a dismal failure. Is it wise for them to run our health care? The question begs an answer, "Why was it so important for them to pass this version of health care reform? I think the answer lies in the statement of the President in saying that this health care bill "will now be the law of the land." We have thought the Constitution has been the law of the land. It is being trampled little by little. We have aPresident whose birth origin is unproven; he has appointed czars (where is that in the Constitution); he accepted the Nobel Peace prize - again unconstitutional; what else? The health care bill puts unconstitutional requirements on us. The fault is really ours. We have voted our pocket book instead of principle. So se have Congressmen and Senators who are swayed by bribes and/or desire to take from us what is ours. they have been doing it by bits and pieces for many years. This is mearly a giant step in their theiving plot.

health care

Rob
April 1, 2010
Last year, I paid $26,000 for health care. Because my wife had a brain aneurysm a few years ago, it costs $4900 a year more to go from a $7500 deducilbe to a $2500 deductible. Last year, we paid the $7500 deductible, the $2500 matching, $10,000 in dental and $6000 for insurance. the existing system isn't working. I'm faced with working the rest of my life hoping I can keep the doctors paid. As for the new bill, why should we all be required to support AIG? I understand our current healthcare system is ranked 38th in the world but is the most expensive to the consumer. The biggest cost is the money the insurance companies are making and the paperwork burden and liablity insurance on the medical people. As for the presumed quality of the current system, I spend $100 for a doctor to glance at me for 3 minutes and take a wild guess at whats wrong. If they guess wrong, you'll pay hell trying to get them to look further. I think something needed to be done but I think the feds were too busy being democrat or republican to represent the people.

health care

jerry bradford
April 2, 2010
I AM HEAVY INTO POLITICS AND HEAVY INTO SURVEYING. WHAT THE HELL IS THIS ARTICLE DOING IN POB?

Healt Care is a must for everyone

Manfred Gulla
April 2, 2010
What are we talking about? America; a Christian Nation until now lived by the rule of Darwinism, where only the richest and fittest will survive? Walk down any main street. Chances are nearly one of every 10 people you see has no health insurance. Under our current health care system, more than 14,000 Americans will lose their health insurance daily. Somewhere has to be a start and we have to spread the message around, that the Earth is round!!! Health reform will completely restructure the employer-based health insurance market. In fact, it's no longer really insurance, but rather a federally defined and administered health benefit. This program will explain in English what Congress has done and how it will affect you and your associates. Some questions to be answered include: "¢ How will the Patient Protection and Affordable Care Act of 2010 affect employee health benefits? "¢ What will happen to the cost of health benefits between now and 2014 when most of the premium subsidies and new health insurance underwriting rules take effect? "¢ What are employers' strategic options in addressing this new world? Do not miss this important program. The information you gain by attending will have far-reaching effects on how you manage your business in light of this restructure of employer-based health insurance.

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