The Independent Payment Advisory Board, unaccountable to Congress, will be empowered to set reimbursement rates for government health programs.
Reduce Medicare Disproportionate Share Hospital (DSH) payments initially by 75% and subsequently increase payments based on the percent of the population uninsured and the amount of uncompensated care provided.
Require Medicare Advantage plans to have medical loss ratios no lower than 85%.
Expand Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% FPL based on modified adjusted gross income (MAGI) and provides enhanced federal matching for new eligibles.
Reduce states’ Medicaid Disproportionate Share Hospital (DSH) allotments.
Increase spending caps for the territories.
Permit employers to offer employees rewards of up to 30%, increasing to 50% if appropriate, of the cost of coverage for participating in a wellness program and meeting certain health-related standards. Establish 10-state pilot programs to permit participating states to apply similar rewards for participating in wellness programs in the individual market.
Impose fees on the health insurance sector.
Requires states to expand their Medicaid eligibility rules to cover those up to 133% of the federal poverty level. Over half of those newly insured via ObamaCare will be getting their new insurance coverage through Medicaid.
Myth
It’s not a government takeover.
See: President Obama’s weekly radio address from July 19, 2009
Fact
The new health law hands over to the federal government immense new powers, powers that will, over time, mean all important decisions about the organization and financing of American health care will need to meet the approval of federal agencies and bureaucrats.
Among the new federal powers created in the health law are the following:
The power to establish standardized insurance benefit packages from which all Americans must choose their coverage (see section XXXX). This means that everyone must conform with federal requirements regarding what is and is not covered by health insurance.
The power to include or exclude insurers from the marketplace based on any criteria the Secretary of HHS considers appropriate (see section XXXX). This means the federal government will have the power to pick winners and losers in the insurance marketplace.
The establishment of a new unelected and unaccountable Independent Payment Advisory Board with the power to unilaterally cut payment Medicare rates to providers of medical services (see section 3403).