Unless you’ve been living under a rock with no TV, internet, or outraged relatives, I’m sure you’ve heard that the Affordable Care Act was declared constitutional last week by the Supreme Court by a 5-4 margin. Huzzah! But what does that really mean for you and me? Let’s look at some of the numbers to try to make sense of the real-world implications.
- First, there’s my favorite number to come out of the plan: zero. There will be $0 copay for prescription contraceptives under the new plan, unless you work for a religious institution that opposes birth control. Plan B and other emergency contraceptives are also free, but not abortion pills like RU-486 (as has been reported by some conservative sites). Given that many contraceptives cost up to $50 per month even with insurance, this can save women up to $600 per year.
- Women will also have a $0 copay for annual well-woman visits; mammograms and other preventive services; screenings and counseling for HIV, HPV, other STIs, and gestational diabetes; breastfeeding support and rentals of breastfeeding equipment; and domestic violence counseling. In the two years since this provision has taken effect, 45 million women have already benefited from this.
- Zero: the number of preexisting conditions that insurance companies will be able to discriminate against once the state healthcare exchanges roll out in 2014. Until then, there’s a temporary program in place to help adults with preexisting conditions find insurance. Thanks to the Affordable Care Act, insurers already can’t refuse to cover expenses relating to preexisting conditions in children.
- Another zero: the number of people who will be kicked off plans for getting sick.
- Insurers will no longer be able to set lifetime limits on the amount they spend on your care, and annual limits will disappear in 2014.
- Starting in 2014, insurance companies won’t be able to charge women more than men for the same plan. Right now, some women are paying more than double what a man in identical health pays. Bull. Shit.
- Seniors will have a $0 copay through Medicare for preventive healthcare, and there are provisions in the bill to lower their prescription drug costs as well.
- 15% or 20%: The maximum amount an insurance company can spend on administrative costs such as payroll and advertising; with 15% being the limit on insurance provided for large companies and 20% applying to small business and individual plans. Right now, some insurers are only spending 70% of premiums collected on actual medical procedures, so they’ll owe people who are overpaying a refund of the difference. By August 1, about 12.8 million Americans will receive a refund or reduction in future costs to offset this. The overall average refund will be $151, but healthcare.gov has a great breakdown of how much providers overcharged in each state.
- 26: The age until which you can get coverage through your parents’ health insurance plan. 3.1 million young Americans have already benefited from this provision.
- Tax credits! Starting in 2014, about 14.8 million Americans will be able to claim part of their premium expenditures toward their taxes, while about 13.8 million uninsured individuals will qualify for tax credits to help them buy insurance. For more info, check out the highlights or a .pdf of the full report from Families USA.
- What about those penalties we keep hearing about? Only about 2% of Americans would actually have to pay them. Everyone else either already has insurance (through a private or employer plan or Medicare/Medicaid), will be able to get it under the Affordable Care Act, or will be exempt.
- Exemptions will be granted to individuals if their income is less than $9,500 (or $19,000 for a married couple filing jointly). Exemptions are also available for members of Native American tribes, members of certain religions who are also exempt from Social Security taxes, people who are only uninsured for a brief period (say, between jobs), or people whose contribution to an employer plan would exceed 8% of their annual income after taking into account any tax credits or other assistance for which they’d be eligible. You can also request to not pay the penalty for vague “hardships” in acquiring coverage.
- For the people who do have to pay the penalty, it’s being phased in and by 2016 the minimum payment will be $695 per person for an individual making between $9,500 and about $37,000 a year. For incomes between$37K and $200K, the penalty will be 2.5% of income above the minimum to pay taxes ($9,500 per individual; $19,000 per couple). Above $200K, the penalty will be equal to the cost of a Bronze-level insurance plan under the exchanges to be set up. Regardless of the number of children in a family, no one will pay more than triple the individual penalty. (For more info on the penalties, Business Insider has a good list of sample payments.)
- How long will Obama throw people in jail if they don’t want to pay? Zero days. It’s illegal for the IRS for seek criminal penalties for non-payment. It looks like the most they’ll be able to do is sue people for double the amount they should have paid.
- What about Republican claims that “Obamacare” is cutting Medicare by $500 billion? Eh, not really. It’s been estimated that through lowered costs of medicare care after the Affordable Care Act and savings based on better preventative care that keeps people from getting sick in the first place, future spending will be lowered by about $500 billion over 10 years. The plan doesn’t cut money, it saves money. (As a comparison, if you plan meals, shop sales and use coupons, you can say you saved money on your grocery bill rather than that you cut your grocery budget.) It sounds like a technicality, but it’s an important distinction.
- Finally, 30 million. That’s the number of people who will gain access to affordable insurance now that the healthcare bill has been deemed constitutional. Hell yeah.
(First two images courtesy of Planned Parenthood; third image is from Barack Obama’s Facebook page.)