Lets not everyone be to scared about this bill because it will eventualy die in the supremem court ad will get over turned. This bill is so unconstitutional that this scum bag could even get Impeached if he keeps up his crap and turns our great country into his own slave ship. 54% of americans dont want this and never did want this bill to pass and it took a reconciliation a pussy tactic and yes the repubicans have used it to and I wasnt happy back then but the low life scum liberals could only pas it by using this reconciliation. But please everyne this wont happen things will be drasticly changed in it plus when we the republicans take back control then get the white house back you can say god by to this HC for good.All the pusy democrats did as commit plitical suiciced to pas this bill becaue the peole will elected them will now vote them out

I'm not fully understanding this bill at all. From what i have heard it is all good but yet so many people are pissed. I like the idea of pre excisting conditions being covered, for i have to have a knee replacement in the next 10 years and it nice to know it will be covered. So explain to me the downsides? I am unaware.

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Here is a quick synopsis, I don't see this helping businesses at all. Look at the losses already booked by John Deere, AT&T and Caterpiller last week!

Provision
Patient Protection and Affordable Care Act
CBO Cost Analysis
$940B over 10 years.
Medicaid Coverage
Expands Medicaid to 133% of Federal Poverty Level and provides subsidies for individuals up to 400% of FPL.
Insurance Exchanges
Creates state-based exchanges through which individuals and small businesses can purchase insurance. Establishes multi-state plans. Does not include a public insurance option.
Individual Responsibility
Institutes individual mandate beginning in 2014; fines start at $95 or 1% of income (whichever is greater) in 2014, and rise to $695 or 2.5% of income by 2016.
Employer Responsibility
Requires employers with more than 50 employees to provide coverage or pay fines up to $2,000/employee beginning in 2014.
Taxes
Imposes a 40% excise tax on certain high cost health plans in 2018. Imposes a 3.8% tax on net investment income in 2013 and increases the Medicare payroll tax by .9% on wages of over $200K for individuals or $250K for couples. Imposes a non-deductible annual fee on health insurers and drug manufacturers; imposes a 2.3% excise tax on manufacturers on the first sales of medical devices.
Medicare Part D (Rx Benefits)
Requires drug manufacturers to provide a 50% discount to Part D beneficiaries for brand-name drugs and biologics purchased during the coverage gap (“donut hole”). Provides a $250 rebate for enrollees who hit the donut hole in 2010. Eliminates the donut hole by 2020.
Pharmacy Reimbursement
Calculates the Federal upper limit (FUL) at no less than 175% of the weighted average of the average manufacturer price (AMP) for Medicaid generic drug reimbursement. Redefines retail pharmacy.
Medication Therapy Management
Requires Part D plans to include a comprehensive review of medications as part of their medication therapy management programs.
Health IT
Requires development of standards and protocols to promote the interoperability of systems for enrollment of individuals in federal and state programs. Accelerates the development, adoption, and implementation of standard, consensus-based operating rules for HIPAA transactions.
Medical Home
Establishes medical homes for Medicaid beneficiaries with chronic conditions; grants for home-based primary care.
340B Program
Expands 340B discounted Rx pricing program participation to childrens’ and cancer hospitals, critical access and sole community hospitals and rural referral centers.
Physician Payments Sunshine
Requires Rx, device and medical supply manufacturers to report gifts to physicians; distributors excluded, although definition of manufacturer is broad.
Generic Biologics
Creates pathway for generic biologics with 12 years of exclusivity.
Independent Payment Advisory Board (IPAB)
Establishes a new independent payment advisory board with added authority to make binding recommendations to Congress if Medicare growth is above the targeted rate or if the growth in Medicare spending exceeds overall healthcare spending.
Comparative Effectiveness
Establishes a private, nonprofit entity to conduct research on the comparative effectiveness of diagnostics, pharmaceuticals, devices and other medical treatments.
Waste, Fraud and Abuse
Increases penalties and sanctions; adds more stringent compliance requirements.

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