ObamaCare’s Immediate Impact

As we all know, most of ObamaCare is pushed out to 2014 or so. But Ezra Klein, ever helpful, points out this nice PDF which explains what will occur nearly immediately. Ezra is always celebrating the cost control measures of ObamaCare, so let us see how these provisions stack up:

1. SMALL BUSINESS TAX CREDITS. Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)

Okay, an immediate hit to Uncle Sugar here, but probably not big unless it really changes behavior immediately. So we start hurting the deficit right away. This is a net hit on government spending, but one might think that it probably will not do much to private healthcare costs in the short run. I expect this will result in marginally increased coverage and thus will show no real change to health insurance premiums.

2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE. Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand name drugs in the donut hole; also completely closes the donut hole by 2020.)

Another government spending hit on drug coverage. In 2011, a 0% subsidy in this range jumps to 50%. According to Wikipedia, this may affect somewhere in the range of 25% of Medicare Part D enrollees. I will leave it to others to quantify this, but this is another spending measure.

3. FREE PREVENTIVE CARE UNDER MEDICARE. Eliminates copayments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

Oh, look! Another government spending increase subsidy! And as one of the colleagues at WaPo points out, preventative care does not really lower total medical spending costs. So overall this is not a cost control measure for government budgets or spending in general.

4. HELP FOR EARLY RETIREES. Creates a temporary reinsurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55 to 64. Effective 90 days after enactment

Another subsidy. This will mainly hit government, I do not see a major change to insurance premiums here. There may be additional companies who provide early retiree benefits, but only union jobs and government tend to do so. Most who are wealthy enough to retire early on their own will cover their own medical insurance costs, not their employer.

5. ENDS RESCISSIONS. Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.

And here we go. The first of [many] provisions that will raise private insurance premiums. Of course, this depends on how common rescissions are. The left says they happen OMG like ALL THE TIME, so if they are right, it is a big hit. I do not think it is a huge change, but it is definitely going to raise premiums.

6. NO DISCRIMINATON AGAINST CHILDREN WITH PREEXISTING CONDITIONS. Prohibits health plans from denying coverage to children with preexisting conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)

Again, an increase to private health insurance premiums. But hey, who will complain? After all, it is for the children.

7. BANS LIFETIME LIMITS ON COVERAGE. Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.

Again, if you think anything other than that this will increase premiums up front, you are smoking something. And you should not be smoking, because it is bad for you. But on the bright side, in 6 months you can be assured your lung cancer will be treated with no limits. And do not worry about lying about that smoking habit on your insurance application, because rescissions are banned too.

(UPDATE 7:55 AM PDT: Commenter Fabio Escobar notes that rescissions are still allowed in cases of fraud, so it would be best not to lie on those applications, folks.)

8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE. Tightly restricts new planned use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)

Again, we have a regulation that will up private premiums. [Do you see a pattern here?] Costs must be amortized, so this added risk is going to show up in premium hikes rather than limits on annual coverage. Insurance is built to hedge risk, and its increasingly looking like the risks to the insurer do not expire [until you do].

9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS. Requires new private plans to cover preventive services with no copayments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)

Ahh, two fun ones here. Immediate premium increase (costs must be amortized, you know), and a probable increase in total healthcare costs, for the aforementioned reason that preventative care does not lower total spending.

10. NEW, INDEPENDENT APPEALS PROCESS. Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.

Again, here come higher premiums. Unless you think the external appeals boards are going to rule less in favor of the patient than the insurance companies would have, of course. Since the left believes insurers deny care left and right, this has to be a big impact, right?

11. ENSURING VALUE FOR PREMIUM PAYMENTS. Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

“Ensuring value for premium payments” sounds a lot nicer than “capping profit margins”, right? If the left belief that insurers are fat and happy and spend all their money on lavish bonuses instead of medical services, this would in fact be a cost control measure. One story from late last year suggests insurers already spend above 80% (Wall Street analysts say low 80s, industry says 87%). Overall, my read is that this probably is not a major component either way.

12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH RISK POOL). Provides immediate access to insurance for Americans who are uninsured because of a preexisting condition through a temporary high risk pool. Effective 90 days after enactment.

Initially there will be $5B in subsidy for this risk pool. It is unclear whether some of this funding will replace existing state govt funding (35 states already have high risk pools), so I am not sure how much of that $5B is a net adder to the total cost. But the simple fact is this , while it might be better for some of those people currently denied due to pre existing conditions (i.e. 100% risks), much of the cost will come out of *OUR* pockets.

13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents insurance policy, at the parents choice. Effective 6 months after enactment.

This one just baffles me. Should we really be disincentivizing kids adults to get good jobs where they might be covered? I can understand an exemption for people on the 7+ year college program (hopefully grad school, not this guy), but if your offspring is 24 and not in school, it seems to me that it is not your employers problem to provide them with health insurance (since it is usually the cheapest method). Perhaps this *IS* actually a cost control measure, since most 23 to 25 year olds are healthy and will add to the risk pool. But even so, I can imagine “Employee + Family” or “Employee + Children” plans increasing in premium, because they are not usually charged based on how many kids are specifically enrolled.

14. COMMUNITY HEALTH CENTERS. Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.

There is a short run deficit cost here, but the goal is understandable. Clinics are likely a better way of treating immediate non emergency medical needs than emergency rooms, so there may be some cost reduction in the delivery method of care. Presumably not all of the supposed “doubling” of patients will be people whose only alternative was a regular doctor visit or ER visit, so there may be some gross increase in the total number of patients served. This one could go either way, and I will leave it to the statisticians to score it. But I will grant that there is at least a possibility of cost control here.

15. INCREASING NUMBER OF PRIMARY CARE DOCTORS. Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

Again, another big subsidy. Gives 10% bonuses to PCP and General Surgeons starting in 2011, and it is unclear here what “new investment in training programs” really amounts to, but the early notes I have seen suggest it is largely student loan repayment changes. I do not see that much here that will blunt the existing trend for doctors to head into specialization rather than primary care. 10% is nice but it is nowhere near the difference between a specialist salary and a primary care doctor.

16. PROHIBITING DISCRIMINATION BASED ON SALARY. Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

This one is also somewhat vague. But usually when I hear about plans to avoid “eligibility rules” that “discriminate”, I think they are trying to find ways to make it impossible to discriminate against bad health risks. Richer people tend to be healthier people, so it seems that if they accomplish their goal, it necessarily raises premiums.

17. HEALTH INSURANCE CONSUMER INFORMATION. Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.

Ahh, a two fer! First is the direct government subsidy to states to hire new “consultants”. The second is the premium increase by pushing harder against health providers regarding complaints and appeals, which will likely often be adjudicated by the external appeals boards mentioned in point 10.

18. CREATES NEW, VOLUNTARY, PUBLIC LONG TERM CARE INSURANCE PROGRAM. Creates a long term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

Voluntary? I wonder how long it will remain so. And how exactly does this differ from the disability portion of Social Security? As things currently stand, in order to qualify for Social Security disability benefits, you must have held qualifying employment for a certain period of time and you must also be able to prove that you suffer from a totally disabling condition that prevents you from working. If you would like more information about the law surrounding Social Security Disability benefits, you can take a look at some of the resources on the Crest SSD website. As for this potential change though, I am not sure how this going to work yet. All I see here is a big new shiny bureaucracy, that will work as quickly as possible to entrench themselves by making this as involuntary as possible.


So there you have it, folks. Of 18 highlighted points, most or all of them will increase payments made by government or increase health insurance premiums. This is “bending the cost curve”.

UPDATE 7:09 AM PDT: Welcome Instapundit, Powerline, and Tigerhawk readers! Feel free to take a look around to find out more about us, and we hope a few of you may come back from time to time.

  • Justin Bowen

    This one just baffles me. Should we really be disincentivizing kids adults to get good jobs where they might be covered? I can understand an exemption for people on the 7+ year college program (hopefully grad school, not this guy), but if your offspring is 24 and not in school, it seems to me that it’s not your employer’s problem to provide them with health insurance (since it’s usually the cheapest method).

    Well, after they impose a living wage on employers people under 26 won’t have a job…just like the under-26 crowd in France. Sooooo, they’ll need to get insurance somewhere. And, since they’ll probably still be living with their parents, having their parents pay for their health insurance (along with everything else) is the most logical choice.

  • http://pith-n-vinegar.blogspot.com/ Quincy

    Sadly, I think Justin’s right on the money.

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  • http://www.lucysfrugalliving.blogspot.com Lucy Stern

    This is all being done to drive private insurers out of the market and the then the government will usher in their universal/single payer system…. Everything in this plan goes against the Insurer…

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  • Rachel

    The coverage up to age 26 is probably a very bad idea. It only covers unmarried children. So now shotgun marriages mean that the mother-to-be loses health insurance just when she needs it most.

  • JeffN

    One never finds you people going thru any weapons or the imperial military funding like this. Only if it’s something that might benefit the regular folks that deficits and government spending matter. I voted Republican all my life. No more.

  • Dave

    I think the purpose of #16 is to prevent higher income people from buying better coverage at a higher price. Basically it’s a way of making sure the rich can’t use their wealth to get better coverage. Bad healthcare for everyone!

  • Michael

    Jeff douchebag…you never voted Republican in your life. Ya know we are not stupid libs who fall for lies like hat.

  • Tigger

    jeffn, I take it regular folks don’t benefit from protection delivered by standing army that the constitution demands. Does the constitution demand I pay for your education or healthcare? Does it say I need to slap you? I’ll do that!

    Rachel, like yewts need anymore incentive to not marry. You could call it the babymoma clause.

  • Chuck

    The linked document explaining what takes effect immediately assumes that the reconciliation bill passes the Senate.

  • E

    JeffN, I’d bet good money you never voted R in your life. If you had you would be bright enough to know that this does not benefit “the regular folks”.
    “The regular folks” are the ones that will be paying for this in higher taxes and higher premiums, they will be the ones loosing their jobs when companies cant afford to keep them, and they are the ones that when they finally go to the hospital for that glorious “free healthcare” that “sorry, we dont have an opening now, you can have that heart exam sometime in august. Or not, we’ll see about it then”.

    and before anyone asks, I’m not american. I’m Scandinavian, and that last line was what I was told when I called up the hospital with a suspected heart attack.
    I’m good enough to pay higher and higher taxes, but if I get sick i get dumped in a waiting line. Coming to you soon with O-care.

  • Parad E. Makewater

    JeffN said, “One never finds you people going thru any weapons or the imperial military funding like this. Only if it’s something that might benefit the regular folks that deficits and government spending matter.”

    So, according to you the military only exists to benefit the military? Do I have that right? In your world it must be those vast herds of unicorns that have kept this country free for the last 200+ years.

  • bandit

    The left is big on infantilizing their constituency. This way if you’re 26 you can continue living off opm – but at least it’s their parents – otherwise they’d go into the exchange and receive a full subsidy and be living off mine.

  • y7

    The appeals process is the cost monster here. We can argue about whether doctors really practice defensive medicine under the OLD system but thanks to point #10, we know that they will have to now.

    So the NYT and democrats say we spend 1-1.5% of all healthcare spending on medical malpractice. I don’t see that changing one whit. The medical malpractice suits that, say, John Edwards filed were emotional heartbreaking cases where the doctor is doing everything possible and still ends up with a negative outcome. Vultures like Edwards take those cases because there is money in them.

    Now, there are many more cases where people are simply disgruntled with the answer the doctor gives them and since there is no money in this one, John Edwards won’t take the case. But the new independent panel will!

    If you are unhappy with your doctor, don’t get a second opinion…take him to the PANEL! They will make him give you that extra test!

    Now some things that insurance doesn’t currently cover like a second overnight stay after giving birth, are they covered now if you take it to the panel? Can people force the doctor to give them extra treatment and hope that the panel will make them pay for it? Or will there be a hotline that people can call to force the doctor to provide what the patient wants but perhaps doesn’t need? What if a woman is sent home a day after birth and has complications that second night? If she takes this to the panel, will there be a punishment or fine or award from the panel?

    I guess I think this is a horrible idea. I don’t think doctors are gods but I also don’t think they should be second guessed at every turn.

  • y7

    On second thought, this new system with independent panels just created a more robust medical malpractice system.

    They have put in place a mechanism by which insurance companies and doctors alike are liable for malpractice.

  • PamK

    The federal government’s purpose is to provide safety for the people and then get out of the way to allow them their right to liberty, equality and the pursuit of happiness. Some citizens spend everything they have in the pursuit of happiness, but some save a good portion of what they earn for future happiness. Healthcare is not a right, it is a personal responsibility like earning money to put food on the table and a roof over your family’s head. This legislation steals from those who save and invest in our country to give to those who spend what they get immediately. It removes the incentive to work long hours, difficult jobs, and plan for futures of families. It is the roadmap to mediocrity and historical oblivion.

  • http://organicbabyfarm.blogspot.com Wacky Hermit

    Would #8 mean an end to those cheap health insurance policies you can get to cover kids while at school or in sports? A lot of sports nowadays require kids to have health insurance to play. I suppose that’s only a problem for the kids whose parents don’t have a health plan, but still, I wouldn’t want to see them excluded from soccer.

    For #13: when I was in college, students could get free basic health services at the student health center, and could get insurance through the university, even through years of academia. As I recall it was very affordable, and because it was group coverage I was able to be covered when I was ineligible for a private plan. The only purpose I could see to extending coverage to age 26 would be to cover people who are not in school.

    For #16: I’m not convinced that higher salary is a good proxy for better health. Certainly higher salary makes a difference at the lower end of the scale where it’s the difference between nourishment and malnourishment, but I’m pretty sure there’s a point of diminishing returns and it wouldn’t surprise me if it were quite low on the salary scale.

  • trevor

    I think it’s interesting that hey call this “healthcare reform” when in reality it seems like health insurance reform. It’s just making the insurance companies have less of a free market, so that way in a few years when all this fails, the dems can be like “oh see, it failed. now we need universal care.” If they just took away most of this and prior legislation, health insurnace companies would have to compete, and thus we would see lower health insurance premiums.

  • jt

    “15. INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.”

    So the plan is to increase the number of primary care doctors but also further cut back on Medicaid reimbursement rates, thus guaranteeing that no sane doctor will set up a medical practice in a low-income community? Brilliant.

    (This is not a hypothetical situation, by the way. Massachusetts now has “guaranteed” health insurance that covers just about everyone, but ER visits rose by 7% last year. Similarly, at least some of the big drugstore chains have stopped filling Medicaid prescriptions that reimburse less than wholesale costs of the medication. Insurance doesn’t mean diddly-squat if doctors and pharmacists can’t survive on the payment rates.)

  • Sean

    The left realized that if you could not get a single payer system directly, all you needed to do was basically make it impossible for private plans to make any money, so that they’d have to close.

    Then the government will come in and “rescue” the insured by putting them on a government plan.

    Quite simple really. It may take 5-10 years, but private insurance will be gone entirely, aside from the very wealthy, union members and government workers.

  • http://www.commieblaster.com CommieBlaster

    4 Years of Payments before Benefits.

    Mass Dem Treasurer says Obamacare with cause US to go bankrupt in 4 years.

    This isn’t about Healthcare. It’s about destroying America.


  • Laurence

    4. HELP FOR EARLY RETIREES—Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55?64. Effective 90 days after enactment

    I see this as another direct subsidy for unions. They tend to be able to retire earlier and have retiree health care that is bankrupting their employers.

  • David in Cal

    As an actuary, I find this law infuriating. I spent a lifetime making insurance companies behave responsibly. Making sure that they would have the resources to fulfill the promises made in their policies.

    Meanwhile, the government has behaved ignorantly and irresponsibly. They dole out benefits without knowing of caring whether they have the resources to pay them.

    By this law, the ignorant and irreponsible want to abolish knowledge and responsibility by insurance companies. My expertise now makes me evil from their POV.

    When health insurance companies raise rates, go bankrupt, or cease doing health insurance businss, will the politicians take responsibility? Ha!

  • Lisa

    Just wait until #11 is reworked to include all businesses/employees. So if rent, food, etc. expenses only take 50% of my salary, then
    I can give the government the remaining 30% of my allotment? We can only reap 20% in profits? Now there’s a great incentive to work, own a business, hire more employees….Is there a provision to hire all the insurance employees once their companies fold and they are out of work? Can they be guaranteed the new IRS jobs?

  • Jeanie

    I’d rethink #14, Community Health Centers, if I were you. “But I’ll grant that there’s at least a possibility of cost-control here.” They will increase the dollars for community health centers, so there goes more of our tax dollars. Plus, I can’t think of a time when federal dollars led to lower costs for anything.

  • http://lyflines.blogspot.com Lyford


    “So there you have it, folks. Of 18 highlighted points, most or all of them will increase payments made by government or increase health insurance premiums. This is “bending the cost curve”.”

    From the point of view of those on the left, despite their protestations of concern over people’s costs, this is not a bug, it’s a feature.

  • NaSa

    The left realized that if you could not get a single payer system directly, all you needed to do was basically make it impossible for private plans to make any money, so that they’d have to close.

    Then the government will come in and “rescue” the insured by putting them on a government plan.

    Yes, that is the plan. Obama pretty much said that he sees a transition to single payer in 15 to 20 years. I remember the time when the White House was asking people to send them all the “fishy” things they were hearing about HCR legislation – this was back in July of last year. And his speech to the AFL-CIO where he openly talks about single payer and the TV interview where he talked about the transition to single payer was getting lots of hits on YouTube.

    At the Presidential debates, he said that he would prefer single payer if “we were starting from scratch”…

    It is hard to blame Obama for going after what he wanted – there are enough number of people in this country who support it whole-heartedly/wont mind single payer. They voted for socialism when they voted for him – Al Sharpton pretty much said that.

    I would gladly eat crow but I think America’s decline is now pretty much official.

  • Fearless Leader

    As a former health insurer agent I realize this social care sounds too good to be true.

    And take my word, it is too good to be true.

    1- No insurance company can afford to allow non screening of a client or unlimited coverage on that client with no pre existing conditions.

    Just these three changes will drive all health care insurers out of business.

    All that other wonderful stuff is just the sound of unicorns singing-

    as one commenter said so eloquently.

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  • jeanneb


    I, too, think this is a $10 BILLION gift to unions. I’ll be astonished if any businesses make their way onto this gravy train.

    Most disturbing, though, is the specific inclusion of state and city retiree plans. These are the health-care-for-life plans that are breaking the backs of states like California, Illinois, NJ, etc.

    I’ve been following this provision all the way through and am convinced this is the foot in the door for “federalizing” those state/city expenses. Fiscally responsible states are going to be made to bail out the grossly over-spending states, especially the ones that showered generous benefits on the public workers.

    It makes me sick.

  • Les Nessman

    Well, here’s one immediate impact:
    From Wizbangblog.com

    “Posted by Alan Orfi
    Published: March 23, 2010 – 12:50 AM

    As a business owner with 28 employees, I’ve had much to contemplate after the passage of the “historic” bill.”… “I consulted with my crew leaders and have given them the choice of a 12 percent pay cut or we must eventually release three men.” …. “We have decided to proceed with firing three men and will do so within the next few months.” … “I’m sure the three men who will lose their jobs as a direct result of this bill will be comforted in knowing they now have health insurance.”

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  • FB

    I don’t see how this could fail to drive the cost of insurance premiums out of the reach of most self-employed individuals and small business owners. Big businesses will only be marginally effected, the cost to employees will probably rise a bit faster than they would have otherwise, but it’s manageable.

    So, Democrats provide the death of capitalism and rising corporatism, while their anti-corporation voters bemoan the power of big corporations in modern politics. It’s nothing short of amazing.

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  • Eddie Smith

    You only mentioned the effects of Obamacare on health care and insurance. What about the funding for Obamacare changes – tax increases…

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  • http://thelibertypapers.org/ Brad Warbiany


    I thought it obvious that the increased government spending would have to come from taxes or deficits (future taxes/inflation). But like any experienced politician, Pelosi didn’t put the revenue generating provisions into her little brief, only the stuff she thought was great. My goal we rebutting those points specifically.

  • Fabio Escobar

    There’s one correction: rescissions are still legal in cases of fraud. So don’t lie about your smoking habit on the app.

  • http://thelibertypapers.org/ Brad Warbiany

    Thanks for the correction, Fabio. I’ve noted it up above in the original post.

  • Dr. Deano

    Another impact of this bill:

    I’m the founder of a solar energy start up company who is close to getting a multimillion dollar round of funding.

    Our business plan – which is enthusiastically supported by our investor – includes not outsourcing anything overseas such that we build a great and profitable business that also provides great American jobs with great benefits. This aspect of the plan is very important to me and to this investor.

    Last Friday, the investor’s accountants and attorneys indicated to him that should the health care bill pass, the new 3.8% tax on investment income, increased taxes and other costs on the business itself, along with increasing systemic risk brought on by massive government borrowing and the changing regulatory environment may well make our deal “unworkable”.

    To say that is heartbreaking is an understatement. What will be lost to America is well over 200 great jobs with great benefits, the taxes we would have paid on a local, state and federal basis, the multiplier effect that spending our $32M investment would have on our community as well as the loss of even more dollars to the community as we started bringing in revenue.

    Gone too is our technology which would have been a boon to energy generation and distribution.

    Of course we will seek to find other investment if we can’t make this deal work, but even in the so-called ‘green’ sector, investment money is *extremely* hard to find since the end of 2008.

    Finding an investor who was happy to create American jobs at the cost of some ROI will be difficult – especially since the government is taxing their investment returns even more with the probability being that taxes will increase even more over time. As such, we may have to forgo the non-outsourcing part of our business plan and so make heavy use of overseas suppliers and manufacturers to make our plan work in this new environment.

    Of course we are trying to salvage the deal. The investor is as heartbroken as we are and wants to make it work, but we are in a new America now and what used to work doesn’t anymore.

    And we are not the only business in this position. Many other investment deals are either not happening in the first place or are being rendered “unworkable” by our new ever-growing, increasingly controlling government.

  • Jeff

    For many items in the list posted above, it indicates that premiums will go up. I don’t believe it. The premiums will actually go away. Insurance is based on actuarial statistics. That means that the boundaries are known and have limits. Some of the impacts listed above are indefinite, and an insurance company wouldn’t be able to calculate what the costs are really going to be for those issues. Rather than be saddled with commitments they may not be able to keep, they will go out of business by attempting the impossible or simply by quitting.

    Each of the impacts that will have an effect if they can be measured will dramatically increase premiums assuming the insurance companies don’t quit. That will be passed on to workers in the form of pay cuts to offset the new higher premiums, or alternatively pay might go up as employers abandon health insurance altogether.

    The good news is that if this really goes into effect in six months, then workers all across the country will see these effects before the election. Cross your fingers.

  • Rose

    I know that some may consider this a bit off topic, but it all ties in?
    The trust between lawmakers and the American people has been broken.
    We have seen the “in your face arrogance” of the majority and Obama for over a year now. Pelosi and her gavel march, she did NOT have to walk through that crowd of protestors … that was a choice (funny, they are taking away our choices and it appears that ALL their choices have been bad ones) yet she did so with that smirk on her face that said it all…. we can and will do what we want.
    No matter what happens between now and Nov, if we allow those that voted in favor of this bill against the will of the American people to remain in office after the Nov elections…. then we will get more of the same and worse. Everyone knows that if you get away with doing something wrong once… it’s easier to justify doing the next time.
    God only knows what will be next. We already know that they are preparing to grant amnesty to thousands and thousands of illegals.
    What makes this all the sadder, is that this administration and the mainstream media have given more attention and coverage to people that have broke the law, than they have to the concerned American citizens.
    Concerned American Citizens protest, opposing bad legislation and we are called Domestic terrorist and many other hurtful names. People that are in OUR country illegally go out and protest and this administration says, we haven’t forgotten you…. be patient and you will get what you ask for. How sad that as Americans our voices go unheard, accusations of being domestic terrorist and nazis. And lest we forget the famous words of Pelosi…. we are astroturf.
    And those here illegal are heard loud and clear. Any day now, they will get what they ask for. As our voices will continue to go unheard.
    We still have choices, at least at the polls… we need to make sure that there is no mistake about the message we send then!!
    God Bless American and all her people!!

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  • M. Rad.

    You can see the effects of such mandates on the individual insurance market in New York. Or I should say you can’t see it, because the individual insurance market doesn’t exist here anymore. Every single provider has pulled out. The follow-on to gov’t single-payer has gotten stuck on the fact that the gov’t unions have plundered the treasury and NY’s credit rating is too poor to borrow the money.

  • Barb

    Doesn’t the provision that keeps 26 year old “children” on the parents insurance only do so if the child is a dependant child. In other words, if you can’t claim them on your taxes as a dependant then they will not be covered.

  • http://thelibertypapers.org/ Brad Warbiany


    If the “kids” don’t have health insurance, one might assume that they’re not making much money, in which case it’s possibly worth claiming them as a dependent.

  • Bob Smith

    Big businesses will only be marginally effected, the cost to employees will probably rise a bit faster than they would have otherwise, but it’s manageable.

    All the better to make us more like their utopia, Europe. Crushing tax and regulatory burdens entrench the big businesses and prevent formation of small businesses.

    When Democrats claim they’re against the rich they’re lying, their policies further stratify the classes by making it harder to become rich. Ever noticed how much wealthier Democrats are than Republicans?

  • http://thesins.blogsome.com Sinner

    Re #11:

    Missed the point here I think. If the law says that 80%/85% must be spent on health services you can bet your bottom dollar that the is EXACTLY what will be spent. Since they currently spend MORE than that, this means LESS spent on health services.

  • http://www.screwliberals.com Jenn of the Jungle

    I refuse to pay. Period.

  • Daniel Sanders


    My former employer (a pharma comapny!) “discriminated” in the reverse: higher salary employees were charged more for the same health plan.

    Some colleagues thought this was “just.”

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  • Carolynn Gockel

    5. ENDS RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.


    Actually, this is a fair rule. The thing is, at least in Illinois its unneeded. They aren’t allowed to do this. Also, in Illinois, if the parent is insured, any new born child is insured too even if they have a pre-existing condition. AND if you have independent insurance they aren’t allowed to raise premiums more than they do for the rest of the pool (however small businesses they can raise premiums indefinitely.)

    I think the BIGGEST blow will be that the health plan doesn’t allow for high deductible plans. As a small business person, I think that is what is going to hurt me most.

  • Bob Smith

    I think the BIGGEST blow will be that the health plan doesn’t allow for high deductible plans.

    Yep. They’ve eliminated new HSAs (which they never liked) without explicitly repealing the enabling legislation. When asked I expect them to deny they’ve done so by claiming the enabling legislation wasn’t repealed.

  • Carolynn Gockel


    We’ve got four years before the High Deductible Health Plans (HDHPs) go away. I’m going to fight for them. I have to — we self insured.

    The bad press for High Deductible Health Plans is mostly bunk “Only good for the healthy, wealthy and wise”. With the premium savings and the tax savings for medical expenses they can actually wind up a much better deal for the chronically ill. The low premiums benefit for the non-wealthy don’t need explaining.

    Having a HDHP does make you think about unnecessary medical testing ($700 Billion a year at last count) — but that is good for EVERYONE.

  • John

    Now that we are all entitled to absolutely unlimited medical care, we must help bankrupt the system as fast as possible.

    “Free” unlimited preventive care? Be at the clinic 5 times a week for a checkup. Ya know, just in case.

    Unlimited insurance benefits? Insist on the most exotic, costly remedy for anything that ails ya. Actually ask the doctor “What is the most conceivably expensive manner in which to treat my malady?” Then insist on even more.

    Let’s face it, we’ve become a completely socialist society. The only way to ever be truly free again is to completely bankrupt the country. Then we can air out our differences, um, properly and rid ourselves of the thieves.

  • Eddie Smith


    That is the dumbest idea – DO YOU REALIZE HOW LONG IT TAKES NOW TO GET AN APPOINTMENT? With 30+ million more folks going to the doctor, we can’t possible get in often enough to make your plan work…

    Good point though.

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  • Carolynn Gockel

    Good one Eddie.

  • http://weblog.theviewfromthecore.com/ ELC

    “And don’t worry about lying about that smoking habit on your insurance application, because rescissions are banned too.” With all due respect, it is not obvious from the quotations you provide that rescissions are banned in cases of fraud. (That may be the case, but it’s not in evidence here.)

  • http://weblog.theviewfromthecore.com/ ELC

    Shoot. I should have refreshed before posting. Sorry.

  • http://tinyurl.com/mfyh47 Douglas W. Cooper

    What puzzles me is why the health insurance stocks have gone up recently. Certainly, Obamacare looks disasterous for them. Unless, of course, they expect to become a regulated utility and eventually capture the regulators, as often is the case.

  • http://thelibertypapers.org/ Brad Warbiany


    You’re on the right track. Insurers get a huge new group of customers, and there are really no limits on premium hikes (only on total profit margin). Their revenues will increase, profit margins likely not change much at all, and you can bet your bottom dollar that within a decade, there will be some serious regulatory capture (if there isn’t already, judging by the immediate stock price jumps).

    Welcome to corporatism.

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  • http://www.poorschmuck.net John D

    I think the whole thing stinks.

    But I wonder about the long-term care thing. My wife has Rheumatoid Arthritis (under control) but I bought long term care insurance years ago because I didn’t want either of us to end up the crappy nursing home my mother and stepfather died in, or at the VA where my father died. (If the Va is a foretaste of Obamacare, we’re truly screwed)

    What’s going to happen with the long term care insurance I bought? Am I going to end up in the crappy nursing home anyway. Did I piss away thousands of dollars only to end up a ward of the government anyway.

    I do not have a warn and fuzzy feeling about this. But my military service should have prepared me for this. BOHICA!

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