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Healthcare Promises [aka ACA]

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On the Affordable Care Act

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

Rick Kahler CFP“I’m not sure what’s wrong or what kind of surgery you need, but we have to operate right now.”

If you heard this from your doctor, you’d jump off the examination table and run for the door. Yet that’s essentially the approach the President and Congress used three years ago to pass a bill, optimistically called the Affordable Care Act, which was the largest transformation of the U.S. health care system in our lifetime.

The Debate

During the frenzied debate our elected leaders made many promises as to the amazing benefits this legislation would bestow on Americans. After listening to speeches from President Obama, Speaker of the House Nancy Pelosi, and President of the Senate Harry Reid, I recounted those promises in this blog on March 21, 2010.

The Promises

Let’s revisit those promises.

  1. All Americans will now receive affordable, or free, quality health care.
  2. No one will ever be denied coverage.
  3. No one will ever go into bankruptcy because of the costs of health care.
  4. There will be increased access to health care for 95% of Americans.
  5. There will be no decline in the quality of health care.
  6. Health care costs will go down.
  7. Health insurance coverage will be affordable to the middle class.
  8. There will be no decline in Medicare benefits.
  9. Insurance premiums will decline for the middle class.
  10. It will unleash unprecedented entrepreneurial opportunity for the economy.
  11. The deficit will decline, saving taxpayers $1.3 trillion.
  12. It will cut $500 billion of waste, fraud, and abuse out of Medicare.
  13. No government funds will be used to fund abortion.

Are these promises coming true? Many of them are pending full implementation of the act in 2014. Others have fallen flat or encountered the law of unintended consequences.

Obama Care

Business Owner’s

I’ve heard recently from several owners of small businesses about their increased health insurance costs. In addition to premium increases of nearly 50% over the past two years, they are seeing increased administrative costs from what one person called the “insanity and complexity” of the new regulations.

Businesses with fewer than 50 employees aren’t required to provide health insurance. The incentive for owners of businesses close to that threshold is to keep employee numbers below 50, which means curtailing growth or even laying people off.

Those without employer-provided insurance are supposed to be able to shop for coverage in new health care exchanges, beginning this October. However, half the states have chosen to rely on the federal government instead of setting up their own exchanges.

This has brought criticism even from former supporters like Democratic Senator Max Baucus of Montana, who helped write the health care bill. He is concerned that the exchanges will not open on time and consumers won’t have the information they need to use them. He told the Huffington Post that Obamacare is headed for a “train wreck.”

ACA Cost Estimates

The proponents said the ACA would cost $938 billion over 10 years. In addition to the promised Medicare savings, this was to be covered by a total tax increase of $562 billion over 10 years. This included a Medicare tax of 3.8% on dividends, rents, interest, and investment income on individuals and small business earning over $250,000.

The Office of Management and Budget, however, places the cost at $1.8 trillion over 10 years, resulting in a shortfall of around $900 billion.

Assessment

Whether Obamacare becomes the wild success the proponents guaranteed is yet to be seen. However, what we’ve seen so far isn’t promising. We as consumers would be well advised to pay close attention and ask tough questions before we accept this drastic surgery.

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Conclusion

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The status of African American insurance coverage

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A Struggling PP-ACA Sector    

By FinancesOnline.com

The Affordable Care Act has developed into one of the critical pivots on which the success of President Obama’s second term is expected to turn. Yet, one sector that’s already struggling is African Americans.

In 2012, 17.4 percent of non-Hispanic African Americans were uninsured. More critically, only 55.9 percent of African Americans are expected to continue to live in good health, while a more or less healthy life is expected in 69.4 percen of white Americans.

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infographic-health-insurance-of-african-americans

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Assessment

These and other alarming facts were revealed by the National Health Interview Survey of the Center for Disease Control and Prevention, and corroborated by data from the U.S. Census Bureau. Both these agencies were data sources for this infographic, which takes a closer look at the health insurance situation of African Americans.

Conclusion

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The Supreme Court Permits Healthcare Taxation “Penalty”

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On the PP-ACA

By Children’s Home Society of Florida Foundation

In 2010 Congress passed the Patient Protection and Affordable Care Act (PPACA). A key part of the Act is an individual mandate for health insurance. All individuals must have health insurance by 2014 or pay a tax-penalty.

The Tax Penalty

The tax-penalty starts at the greater of $285 per family or 1% of income in 2014. However, by 2016, the tax-penalty increases to $2,085 per family or 2.5% of income, whichever is larger.

Commerce Clause

Many states sued the federal government and asked that the individual mandate be held invalid. While the various courts had different positions on the issue, some federal judges were concerned that requiring a person to purchase insurance could be a violation of the Commerce Clause of the U.S. Constitution.

CJSC John Roberts

Chief Justice of the Supreme Court John Roberts wrote the opinion for a 5-4 majority in the PPACA case. First, he determined whether or not the Court was prohibited from ruling on the case under the Anti-Injunction Act. He decided that the required payment would be a “penalty” for purposes of that Act and not a tax. Therefore, the Supreme Court could issue a ruling.

Second, Chief Justice Roberts reviewed the powers of government under the Commerce Clause. He agreed with the other four justices opposing PPACA that Congress had the right to regulate commerce, but does not have the right to regulate non-activity. Therefore, requiring individuals to purchase health insurance is not a permitted power under that provision. PPACA could not be approved under the Commerce Clause.

However, Roberts observed that it is permissible for the Court to consider the validity of PPACA under the power of the government to tax. He determined that the individual mandate to purchase insurance or pay a penalty-tax is permitted under that power. Roberts stated, “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.” He carefully approved the use of the power without discussing the appropriateness of PPACA provisions.

Roberts found several reasons for permitting the taxing power. The tax-penalty will be paid when filing IRS Form 1040. As is true with other tax provisions, lower-income individuals are excluded from this tax-penalty. The tax-penalty is part of the Internal Revenue Code and will be collected by the IRS.

Dissenters

The four dissenting Justices would have determined that PPACA fails to meet the requirements of the Commerce Clause and would have invalidated the entire bill.

Editor’s Note: The taxes to pay for PPACA include a new tax on medical devices that will increase costs to individuals and healthcare providers. There also is a new 3.8% Medicare tax. It applies in 2013 to income and capital gains. If the expected post-election tax bill extends the current 15% capital gain rate, then the capital gains tax rate will be 18.8% in 2013. However, if the 15% federal capital gains tax rate is increased to 20%, then the new rate in January of 2013 will be 23.8%. The increase in capital gains rate may influence charitable gifts of appreciated property in 2013.

Conclusion

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The Best, Most Revealing Reporting on Our Healthcare System

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Reading and Reviewing

By Blair Hickman and Cora Currier

ProPublica,  March 30, 2012, 1:44 pm

As we wait for the Supreme Court to issue its verdict on the health-care reform law  we rounded up some of the most revealing reporting on the issues.

They’re grouped roughly into articles on high costs and those on insurance.

Assesment

Link: http://www.propublica.org/article/top-muckreads-the-best-most-revealing-reporting-on-our-healthcare-system

Conclusion

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Dire Emails About New Medicare Surtax Have It Wrong

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Enter the Obama Care Fear Mongers

By Rick Kahler MS, CFP®, ChFC, CCIM

www.KahlerFinancial.com

Ronald Reagan was noted for saying, “Trust but verify.” And, that was before Al Gore invented the Internet. When it comes to believing forwarded emails with dire warnings, it’s a good idea to go even further and “Verify before trusting.”

My e-mail

Here are a few lines from an email I’ve received numerous times over the past two years: “Did you know that if you sell your house after 2012 you will pay a 3.8% sales tax on it? That’s $3,800 on a $100,000 home . . . It’s in the health care bill and goes into effect in 2013. . . . Under the new health care bill all real estate transactions will be subject to a 3.8% Sales Tax. If you sell a $400,000 home, there will be a $15,200 tax.”

Before trusting this, I verified it with Paul Thorstenson, an accountant with Ketel Thorstenson in Rapid City, South Dakota. He said, “The information in this email is nearly entirely false.”

As with a lot of what you read on the Internet and hear from politicians, if you sift through the rubbish in this statement you will find a few grains of truth.

The True, and Not So True, Grains

First the truth

There is a 3.8% Medicare surtax contained in the health care act passed by Congress and signed into law by President Obama in 2009. It does take effect in 2013.

Now the falsehoods

This is not a sales tax. Sales taxes apply to the gross sale price of an item. Thorstenson explained this is a surtax that only applies to a gain (not the sales price) on sale of an investment asset. This not only includes real estate, but other investments like stocks, bonds, mutual funds, commodities, precious metals, and collectables. The surtax will also apply to other passive and investment income, such as interest, dividends, and net rental income.

The act only applies the surtax to investment gains when the total adjusted gross income on a return exceeds $250,000 for couples and $200,000 for single taxpayers. If your adjusted gross income is less than those amounts, the surtax will not apply.

If you sell a primary residence, the surtax will not apply to the first $500,000 of gain for couples or the first $250,000 of gain for individuals (IRS Code Section 121). “The surtax will only apply if the gain is above $500,000,” explained Thorstenson, who added, “And who even has a gain in a home these days, let alone over $500,000?”

Section 121

What is important to note is there is no Section 121 exclusion on the gains of vacation homes, second homes, or rental property. So if your adjusted gross income tips over $200,000 for individuals and $250,000 for couples in the year you sell an investment like a mutual fund, rental property, second home, or small business, you will be hit with a 3.8% tax on the portion that exceeds the $200/$250 threshold.

Assessment

Now consider what happens if President Obama gets his way and raises the capital gains tax to 28% on taxpayers earning over the $200/$250 limits. You could easily see the capital gains rate more than double from 15% to 31.8%. On every $100,000 of gain, that means a tax increase from $15,000 to $31,800.

Thorstenson told me, “This law is an atrocity in my opinion. It is an attack on successful investors, and the tax revenues aren’t even earmarked for Medicare. The proceeds just go into the general fund.”

The truth about this surtax is bad enough without believing exaggerations about it. The next time this particular email shows up in your inbox, just delete it. Trust me; I verified.

Conclusion             

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What’s at Stake in the Supreme Court’s Health Care Decisions?

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On the PP-ACA

By Lena Groeger ProPublica

Yesterday, the Supreme Court began hearing arguments on the health care reform law. So, in this essay, we made a map of the possible outcomes following the Court’s schedule over the next three days.

The Court will hear all three days of arguments, even if they eventually decide not to decide the bulk of the case, and is unlikely to issue a decision on the case until late June or early July.

Assessment

Link: http://www.propublica.org/special/mapping-the-supreme-courts-health-care-arguments

For more information on different states’ progress implementing health care reforms, see this comprehensive list.

Conclusion

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Happy Birthday PP-ACA

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What if You Threw a Party – and Nobody Came?

Assessment

Two year anniversary [2010-2012].

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