Posted by: reddiva | October 30, 2009

Pelosi’s Folly


A friend sent this information to me because she knows that I am already reading Nancy’s Play Time trying to get some information together to pass along to you.  This will give you a good look at the tax increases Obama said over and over again we wouldn’t have with his dream socialized medicine health plan.

 

This compilation comes from the Americans for Tax Reform (ATR), and I thank them for the work they did to provide this information.   They have also included some additional information regarding senior health care.  I have marked the places that will no doubt we called “death panels” and/or “care rationing” so that you can spot it quickly.  Look for GREEN BOLD print.

My thanks to Laurie for sending this to me.

By the time this news reaches the maximum possible number of American citizens, I think there will probably be another march on Washington which will make the estimated two million who were there look like a small Sunday school class.

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Comprehensive List of Taxes in House Democrat Health Bill provided by Americans for Tax Reform (ATR)

Employer Mandate Excise Tax (Page 275): If an employer does not pay 72.5 percent of a single employee’s health premium (65 percent of a family employee), the employer must pay an excise tax equal to 8 percent of average wages. Small employers (measured by payroll size) have smaller payroll tax rates of 0 percent (<$500,000), 2 percent ($500,000-$585,000), 4 percent ($585,000-$670,000), and 6 percent ($670,000-$750,000).

Individual Mandate Surtax (Page 296): If an individual fails to obtain qualifying coverage, he must pay an income surtax equal to the lesser of 2.5 percent of modified adjusted gross income (MAGI) or the average premium. MAGI adds back in the foreign earned income exclusion and municipal bond interest.

Medicine Cabinet Tax (Page 324): Non-prescription medications would no longer be able to be purchased from health savings accounts (HSAs), flexible spending accounts (FSAs), or health reimbursement arrangements (HRAs). Insulin excepted.

Cap on FSAs (Page 325): FSAs would face an annual cap of $2500 (currently uncapped).

Increased Additional Tax on Non-Qualified HSA Distributions (Page 326): Non-qualified distributions from HSAs would face an additional tax of 20 percent (current law is 10 percent). This disadvantages HSAs relative to other tax-free accounts (e.g. IRAs, 401(k)s, 529 plans, etc.)

Denial of Tax Deduction for Employer Health Plans Coordinating with Medicare Part D (Page 327): This would further erode private sector participation in delivery of Medicare services.

Surtax on Individuals and Small Businesses (Page 336): Imposes an income surtax of 5.4 percent on MAGI over $500,000 ($1 million married filing jointly). MAGI adds back in the itemized deduction for margin loan interest. This would raise the top marginal tax rate in 2011 from 39.6 percent under current law to 45 percent—a new effective top rate.

Excise Tax on Medical Devices (Page 339): Imposes a new excise tax on medical device manufacturers equal to 2.5 percent of the wholesale price. It excludes retail sales and unspecified medical devices sold to the general public.

Corporate 1099-MISC Information Reporting (Page 344): Requires that 1099-MISC forms be issued to corporations as well as persons for trade or business payments. Current law limits to just persons for small business compliance complexity reasons. Also expands reporting to exchanges of property.

Delay in Worldwide Allocation of Interest (Page 345): Delays for nine years the worldwide allocation of interest, a corporate tax relief provision from the American Jobs Creation Act

Limitation on Tax Treaty Benefits for Certain Payments (Page 346): Increases taxes on U.S. employers with overseas operations looking to avoid double taxation of earnings.

Codification of the “Economic Substance Doctrine” (Page 349): Empowers the IRS to disallow a perfectly legal tax deduction or other tax relief merely because the IRS deems that the motive of the taxpayer was not primarily business-related.

Application of “More Likely Than Not” Rule (Page 357): Publicly-traded partnerships and corporations with annual gross receipts in excess of $100 million have raised standards on penalties. If there is a tax underpayment by these taxpayers, they must be able to prove that the estimated tax paid would have more likely than not been sufficient to cover final tax liability.

 

In addition to the list of taxes for in the ATR report, our people found the following:

Employer FINE Under Mandated Excise Tax (Page 310): A $100 per day excise tax imposed on employers for each employee for whom employer fails to “satisfy the health coverage participation requirements”. Excise tax will not apply if Secretary determines even after “exercising reasonable diligence” employer was unaware of employee’s lack of participation in health coverage.

 

“CADILLAC” INSURANCE PLANS

Credit vs. Points (Pages 318-320) This portion gives the appearance of providing a temporary two-year credit while at the same time deducting “points” if the Secretary deems that the employer is too generous with its health care benefit package. Ex. p. 319, lines 11-18: “Credit not allowed with respect to certain highly compensated employees. No credit shall be determined under subsection (a) with respect to qualified employee health coverage expenses paid or incurred with respect to any employee for any taxable year if the aggregate compensation paid by the employer to such employee during such taxable year exceeds $80,000”.

 

MEDICAL REIMBURSEMENT

Uncompensated Care Increase (Page 389-390) Page 389, lines 14-19 detail a “significant” decrease in uninsurance will be triggered by only 8% decrease – “There is a “significant” decrease in the national rate of uninsurance as the result of this Act” if there is a decrease in the national rate of uninsurance from 2012 to 2014 that exceeds 8 percentage points.” Page 390, lines 4-9 detail the increase in uncompensated care – “For each fiscal year (beginning with 2017) , the Secretary shall estimate the aggregate reduction in the amount of Medicare DSH payment that would be expected to result from the adjustment under paragraph (1)(A)”. This, in turn, will lower payments to hospitals in reimbursement rates.

 

Government to legislate Pain Research, page 1493 line 14

Begins with Line 14 ‘‘SEC. 409J. PAIN RESEARCH.
This section covers research that will be conducted at National Institutes of Health (NIH)
Provides for a “Pain Consortium” and a committee to be known as “Interagency Pain Research Coordinating Committee”

page 1496 describes the attributes of committee members (6 members are scientists, physicians, other health professionals while another 6 members are from general public representatives from leading in research, advocacy and service organizations for individuals with pain-related conditions)

This committee will coordinate all efforts within the Department of Health and Human Services and other Federal agencies that relate to pain research. Appears to be a decision making board on treatment protocols (could rationing be involved here?), create a public awareness campaign on pain,

Page 1501 lines 15-18:

 

“AUTHORIZATION OF APPROPRIATIONS.—For purposes of carrying out this section, there are authorized to be appropriated $2,000,000 for fiscal year 2011 and $4,000,000 for each of fiscal years 2012 and 2015.’’

 

Employer Excise Tax (Pages 313-317): If an employer chooses not to provide health insurance to employees, an excise tax on the total wages paid is imposed on the employer. The excise tax percentage ranges from 2% of total payroll of $500,000 to 8% of payroll of $750,000 or more. If an employer has less than $500,000 annual payroll, he pays no excise tax.

Employer Health Coverage Tax Credit (Pages 317-319): Small business owners receive a tax credit of 50% of health insurance paid for employees whose wages are $20,000 or less per year when the employer has 10 or fewer employees. The tax credit is prorated as the amount of wages increases, leaving no tax credit for the employer when such employee’s wages total $80,000 or more per year.
For employers with more than 10 employees, the tax credit calculated by the proratio shall be reduced by an amount in the ratio of 10 to total number of employees.

 

SEC. 1416. Ensuring Staffing Accountability
(a) Skilled Nursing Facilities
(b) Nursing Facilities

Page: 822 – 826

Subject: privacy

Remarks:
This section of the bill calls for an amendment to the Social Security Act “(C) Submission of Staffing Information Based on Payroll Data in a Uniform Format.”
The Secretary of Health and Human Services shall require a skilled nursing facility to electronically submit to the Secretary direct care staffing information including agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format (GE?) (as established by the Secretary in consultation with among others, consumer advocacy groups (ACORN?)

 

GOVERNMENT REGULATION OF CARE AND RESEARCH

*Government Panel for Senior Care Decisions (Pages 649-661): The Secretary has the right to waive requirements of the Social Security Act Titles XI & XVIII. These providers will put together patient decisions aids and share in seniors’ decisions regarding their health care. Seniors will attend counseling provided by said panel. Compensation will be granted to providers who generate less cost for care with regards to Parts A and B of Medicare.

Government Legislation of Pain Research (Pages 1493-1501): Page 1496 describes the attributes of committee members (6 members are scientists, physicians, other health professionals while another 6 members are from general public representatives from leading in research, advocacy and service organizations for individuals with pain-related conditions). This committee will coordinate all efforts within the Department of Health and Human Services and other Federal agencies that relate to pain research. Appears to be a decision making board on treatment protocols, create a public awareness campaign on pain. Ramifications include overly regulated treatment protocols for chronic pain and the possible end result of rationing. The viability of private research is questioned in light of this section.
(Page 1501): Lines 15-18 establish the authorization of appropriations – “For purposes of carrying out this section, there are authorized to be appropriated $2,000,000 for fiscal year 2011 and $4,000,000 for each of fiscal years 2012 and 2015”.

NATIONAL HEALTH SERVICE CORPS
Sec. 2201

Obligated Service Requirement (Page 1220): “The entity and the Corps member agree in writing that the Corps member will perform half-time clinical practice”. Essentially, this details “those individuals who have entered into a contract for obligated service under the Scholarship Program or Loan Repayment Program un which the individuals are authorized to satisfy the requirement of obligated service through providing clinical practice”. Essentially these individuals are obliged to work off debt in this capacity.

 

ABORTION

Abortion Coverage (Page 110): “Nothing in this Act shall be construed as preventing the public health insurance option from providing for or prohibiting coverage of services described in paragraph (4)(A)”. Paragraph (4)(A) Abortion Services – Abortions for which public funding is prohibited. That said, paragraph (4)(B) “The services described in this subparagraph are for abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted.”

 

 

GOVERNMENT REGULATION OF INDUSTRY

Health Czar (Page 133): Establishes Health Czar and bureaucracy, i.e. “Health Choices Commissioner” and “Health Choices Administration”. Essentially, this area lends the Health Commissioner and Health Choices Administration power over health insurance plans both inside and outside of the Health Insurance Exchange. The concern is that the provision invites overreaching authority and oversight of plans specifically set up to provide timely and needed care not readily available through the government exchange-controlled plans.

Government Regulation of Patient Care

Regulation of Services (Page 383) Lines 11-16 allot for using appropriate indicators for non-therapy ancillary services classification, which may include age, physical and mental status, ability to perform activities of daily living, etc. The concern is over the method of deciding care delivery, placing key decision-making elements in the hands of politicians and other non-medical staff as opposed to the hands of patients’ doctors and families.

Regulation on Patient Stay (Page 385) Establishes payment based on total costs during stay in a skilled nursing facility as opposed to the number of days in such stay.

 

ABORTION

Abortion Coverage (Page 110): “Nothing in this Act shall be construed as preventing the public health insurance option from providing for or prohibiting coverage of services described in paragraph (4)(A)”. Paragraph (4)(A) Abortion Services – Abortions for which public funding is prohibited. Paragraph (4)(B) “The services described in this subparagraph are for abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted.”

Federal Funding of Abortion (Page 147) Lines 14-(1) IN GENERAL.—“Nothing in this Act shall be construed to have any effect on Federal laws regarding – (A) conscience protection; (B) willingness or refusal to provide abortion; (C) discrimination on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion. The concern regards lines 20-23 (C) as it is viewed as a potential open door for funding of organizations such as Planned Parenthood. The document affirms that this bill has no effect on current law where discrimination based on either willingness or refusal to participate in abortion services, and thus, provides no additional protect against the use of Federal funds allocated for abortion services. As, additionally, the Hyde Amendment is in no way incorporated into this piece of legislation and because no additional explicit protections exist in this document, this piece of legislation will, indeed, provide authorization of federal funding of abortion under the public option.

Additionally, because there is no ban on abortion funding under the reauthorization of the Indian Health Service (IHS), and additionally no additional protections such as the Vitter Amendment, there is nothing to prevent abortion funding.

 

GOVERNMENT REGULATION OF NON-HEALTH INDUSTRY

Regulation of Disclosure of Nutrient Content/Menu Variability (Page 1514) Lines 5-14 – “The Secretary shall establish by regulation standards for determining and disclosing the nutrient content for standard menu items that come in different flavors, varieties, or combinations, but which are listed as a single menu item, such as soft drinks, ice cream, pizza, doughnuts, or children’s combination meals, through means determined by the Secretary, including ranges, averages, or other methods”. Rules extend to maintaining the calculation of combo meals an addition cost to restaurants.

Regulation of Vending Machine Owners/Suppliers (Page 1516) Lines 4-8 – Pertaining to businesses that own or operation 20 or more vending machines, “the vending machine operator shall provide a sign in close proximity to each article of food or the selection button that included a clear and conspicuous statement disclosing the number of calories contained in the article”.

Regulation of Food Preparation/Presentation (Page 1517) Lines 14-22 – “The Secretary shall (aa) consider standardization of recipes and methods of preparation, reasonable variation in serving size and formulation of menu items, space on menus and menu boards, inadvertent human error, training of food service workers, variations in ingredients, and other factors, as the Secretary determines”.

 

Pg. 1601
Line 19 – “…solved with reasonable premium increases”

 

PG 1555 [NOTE FROM RED DIVA – THIS PART IS REFERRING TO THE INFORMATION GLEANED FROM THE DECISION MAKING PROCESS REGARDING THE LICENSING AND MANUFACTURING RESTRICTIONS OF “BIOSIMILARS”  aka drugs.]

lines 1 through 7 – “…and no such information or documentary material may be made public…”

‘‘(E) ENFORCEMENT.—
‘‘(i) CIVIL PENALTY.—Any person that violates a provision of this paragraph shall be liable

for a civil penalty of not more than $11,000 for each day on which the violation occurs.

 

Pg. 1800
‘‘(3) PEER REVIEW PANELS18 ‘‘(e) PEER REVIEW PANELS.—The Secretary may provide for the establishment of peer review panels, as necessary, to review and evaluate applications using the criteria developed pursuant to subsection (d)

 

Pg. 1584
”…paid into a Life Independence Account for obtaining assistance with decision making concerning medical care…”

 

A compilation of what’s been found so far on p. 110-200. Some highlights:
p. 110 (4) (B) Federal funding for abortion is in;
p. 111 Sec. 223 “Health Benefits Advisory Committee” to recommend covered benefits (AKA “rationing board”)
p. 120-130 HHS Sec. directed to clarify/define several bits in this section (reader found 50+ calls for Sec. to clarify/define, including in rest of bill)
p.133-134 “Health Choices Administration” with power over health insurance plans both inside and outside the Health Insurance Exchange invites harassment of non-Exchange plans and abuse aimed at driving private plans out of business.

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It is once again time for us to flood Washington with our telephone calls and letters.  This bill can not be allowed to be passed, and I haven’t even published any of the research I’ve done personally yet.  I’ll give you a little hint:

 

At the top of page 26 there is an interesting piece of information.  In reference to the cost to the national budget for providing health care for people on the “risk list” who are not able to buy insurance because of a previous illness or pre-existing condition, the bill says that if there is no money left in the budget to pay for the health care, the government will either limit treatment or start waiting lists.  Sounds just like the horror stories I’ve read about other countries who have socialized medical care.

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  1. […] hint I gave you in what has now become Page One of Pelosi’s Folly about limiting care and creating waiting lists was only the start of this atrocious mess she calls […]


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