Healthcare Reform to Be Financed by Penalties

The CBO stated in a 2009 report that while government expenses would rise by $10 billion, a corresponding increase in government revenues would more than offset the cost. The report projected increased revenues of $12 billion, with $7 billion of that coming from penalties.

Other changes include the elimination of the 5 percent excise tax on cosmetic surgery. However, a new excise tax on indoor tanning services (set at 10 percent) would more than double revenues from that one source. (Section 10907)

A new rule that sounds like it might be a bane for insurers and a boon for policyholders is one that would require insurers to cover out-of-network emergency services as if the services were provided in-network. ER services are among the costliest of hospital expenses no matter where one goes. Yet delaying treatment long enough to get permission to go the ER can add greatly to the final expense. The film Sicko detailed one mother's fight to get her child admitted to an out-of-network ER; the child later died. This scenario need never be played out again. (Section 2719A)

One boon for small businesses is that they will receive grants for employee wellness programs. Up to $200 million is earmarked for the purpose. Wellness programs may include everything from covering employee memberships in local health clubs, smoking cessation or weight loss groups, or even hiring a company nurse. (Section 10408)

Insurers who pay out less than 85 percent of premium income (on large group markets) on claims would have to provide rebates. The percentage would be 80 percent on small group and individual markets. This would mean a shift from awarding year-end bonuses to their own employees, to mailing out checks to policyholders. The public might actually start to look upon insurers as Santa Clauses who give them money to pay Christmas bills.